Prof Melanie Swalwell @melswal.bsky.social

My long journey to get the NSW hospital-acquired COVID figures! I filed a GIPA (Government Information Public Access application) asking the NSW Ministry of Health how many people caught COVID in hospital, and how many had died, on 6th Feb 2023 (GIPA-23/35). Answer: It would take 140 hours to produce a report showing number of hospital acquired COVID cases. I did not believe this. Surely they had this critical information on hand? I requested an internal review. On 6th July 2023 MoH confirmed “the Ministry does not hold complete and accurate records regarding nosocomial infections acquired in hospitals”. 16th March 2023 the CEC responded to my request for “any correspondence between the NSW Ministry of Health and hospital administrators, health care workers hospital patients or their representatives concerning nosocomial COVID-19”. They answered “Extensive searches by the Infection Prevention and Control team and the Chief Executive’s Office were conducted. However, despite an initial belief that the CEC might have held correspondence that related to your application, after an extensive search it has been established that the CEC does not have any such documents.” I was shocked. The CEC is the body who sets infection control policies for NSW. How could they not know how well their policy is working? In mid 2023 Greens MLC Amanda Cohn wrote to Health Minister Ryan Park expressing concern about hospital acquire infections. The minister stated in his reply that that “healthcare acquired infections are recorded in the incident management system”. On Oct 2023 I asked for NSW MoH for numbers of hospital acquired COVID-19 (GIPA23/276) as recorded in the system referred to by the Minister. The MoH transferred this request to the CEC. The CEC said it would not be feasible to extract the information from the IMS. I requested a conference and on 24 Jan 2024 I had a Teams meeting with CEC’s Associate Director of Patient Safety Steve Bowden who explained the IMS is largely a free-text database and it would be necessary to manually review 11,000 records to identify those of interest. He said the information I was seeking is available in the MoH’s coded medical records. I explained that I had been directed to the CEC by the MoH and asked Mr Bowden to speak to the Ministry and sort this out. He was not willing to do so. I also expressed my disbelief that the CEC, who is the body responsible for setting infection control guidelines, would not have any correspondence from hospitals about hospital acquired infections and would not know how many HAIs were occurring. Armed with the exact description of what I needed to ask MoH to provide, on 13 May 2024 I made another GIPA request to MoH, seeking: "(1) All coded medical records which indicate hospital acquired COVID-19, including at least the date, week or month onset was recorded and whether the record indicates the patient died. (2) Aggregate numbers of the above by day, week, month or year. Note: If there is any doubt what information is being sought or you cannot find it, please consult Steve Bowden of the CEC who advised on 10/5/2024 that CEC cannot provide the information we seek because MOH owns it." Now backed into a corner by CEC having said MoH has the information they previously denied having, the MoH invited me to another conference where I confirmed what I wanted. On 13th June 2024 I was advised they could provide the information but it would take 31 hours to produce it and would cost $930. Another barrier which is contrary to “freedom of information”. Finally, on 17th September 2024 (18 months after my initial request) I received the decision with the data I had asked for. The summary is that in 2023 there were 6007 hospital acquired cases of COVID-19 and 5% of these people died in hospital (cause of death not shown). This suggests that about 1 in 7 people who died from COVID in the last year in NSW caught it in hospital. Peter Vogel Legal 14 Oct 2024