A tribunal has been told a Victorian hospital where a cluster of babies died, or were stillborn, had slashed the hours of its experienced medical adviser it had contracted as its director of medical services.
Dr Lee Gruner held the consultancy role at Djerriwarrh Health Services, which ran Bacchus Marsh Hospital, from 2009 to 2015.
A 2015 review of stillbirths and newborn deaths at the health service during that period found seven may have been avoidable.
Dr Gruner is contesting allegations brought against her by the Medical Board of Australia at the Victorian Civil and Administrative Tribunal.
The Medical Board does not argue Dr Gruner was responsible for any deaths, but it alleges she ought to have known she was unable to fulfil the requirements of her role to ensure the safety of patients at Djerriwarrh.
It also alleges she did not follow-up issues and risks she had identified with the health service.
'I would walk away'
The tribunal heard Djerriwarrh's small maternity service was delivering up to 1,000 babies a year and, in 2010, Dr Gruner had flagged the pressure on its obstetrics as being an "extreme risk".
But the following year, hospital management cut the hours she was contracted to work for them.
The hospital's director of clinical and quality support services, Elizabeth Wilson, told the Australian Health Practitioner Regulation Agency (AHPRA) in a formal interview that she had disagreed with that decision.
"We were, ah, cost-cutting in all sorts of directions," the tribunal heard Ms Wilson told AHPRA.
Experienced health administrator Dr John Ferguson told the tribunal Dr Gruner was "put in an invidious situation" and that he "would walk away" if his hours had been cut to such an extent.
"To accept that and not respond vociferously surprises me for someone of Dr Gruner's experience and gravitas," he said.
Consultancy role ambiguous
However, another witness with health administration expertise, Dr David Campbell, said Dr Gruner's role was an advisory position with no executive responsibility.
The tribunal heard Dr Gruner's responsibilities in her limited contracted hours included some staff performance reviews and biannual reviews of deaths of patients aged over 65.
Dr Campbell said it would have been up to senior hospital executives, such as the CEO, to identify any other important clinical issues and ask Dr Gruner to review them.
"And that availability was better than nothing at all."
Dr Campbell said clinical governance at hospitals was ultimately the responsibility of boards and CEOs.
VCAT must determine whether the allegations against Dr Gruner are proven and, if so, whether they constitute either professional misconduct or unprofessional conduct.
The hearing continues.
