Historical notes

By
Patricia Mackay, FRCA, FANZCA
Chairman

In 1973 the Faculty of Anaesthetists of the Royal Australasian College of Surgeons made a submission to the National Health and Medical Research Council (NH&MRC) for the establishment of a Standing Committee on Anaesthetic Deaths as a public health measure. The response, dated 26th October 1973, was that it agreed in principle but considered it was a matter for individual States as there were already such committees in New South Wales and South Australia.

In April 1974 the Victorian Regional Committee of the Faculty of Anaesthetists approached the Australian Medical Association (AMA) and the State Government for support and in July 1974 the Victorian Department of Health drew up a proposed budget but there was no further action by December 1974.

Following further pressure by the Victorian Regional Committee and adverse publicity about anaesthetic deaths in Victoria, particularly in relation to dental anaesthesia, the Chief Health Officer, in May 1975, put forward suggested membership of the proposed Council and this was ratified in July 1975 with Dr Kevin McCaul as Chairman.

Funds were finally approved by Treasury in December 1975, the members were appointed by the Minister of Health on 8/1/76 and the Council was formally established on 29/2/76.

The Terms of Reference were formulated and it is noteworthy that, on the insistence of Dr McCaul, morbidity was included although it was anticipated that in the first instance the main attention would be directed to mortality.

The Ordinary Members of the Council were:

Dr K McCaul - Chairman Royal Women's Hospital
Dr W Sloan Department of Health
Dr D Race Hospitals and Charities Commission
Dr G Darby Anaesthetist Geelong Hospital
Dr G Robinson Anaesthetist Western General Hospital
Dr W H J Cole Anaesthetist Royal Melbourne Hospital
Professor V Marshall Surgeon Prince Henry's Hospital
Dr J V Champion de Crepigny General Practitioner
Mr G B Hester Secretary

A further list of 'Occasional Members' were also appointed to be co-opted as required by the Chairman.

Occasional Members were:

Professor Louis Clinical Pharmacology
Dr J E Clark Physician
Dr N Cass Anaesthetist Royal Children's Hospital
Dr P Maplestone Anaesthetist
Dr R Hare Anaesthetist
Dr R Cole Anaesthetist Royal Melbourne Hospital
Dr J Bell Anaesthetist Royal Dental Hospital
Dr E Morgan Anaesthetist Alfred Hospital
Dr D Adey Obstetrician
Dr D Fortune Forensic Pathologist

The first meeting of the Ordinary Members was held on 9/3/76 and early discussions were largely related to the need for adequate legislation for provision of confidentiality.

In November 1976 all Victorian medical and dental practitioners were circulated by Dr McCaul, outlining the functions of the Council and requesting notification of deaths occurring during or as a result of anaesthesia.

It would appear that the response was not overwhelming, provisions for confidentiality were not reassuring, the Council did not have a high profile and activity partly lapsed between 1978 and 1981 when Dr D Race was appointed Acting Chairman and more regular meetings were held.

In 1983 the Council was reactivated, its methods of operation reviewed and Ordinary Membership expanded with the inclusion of an Intensive Care Specialist and a decision was made to provide regular reports to all Victorian medical practitioners. Dr John Paull was appointed Chairman. Amendments to the Health Act were enacted in early 1984 to ensure full protection of information submitted in voluntary reports to the Council.

The first report, covering the period 1977-1982 was published in December 1983 and there have been six (6) subsequent reports, covering the years 1982 to 1996 (see Table).

In 1991 the Minister revoked all previous orders under Section 24 of the Health Act concerning the establishment of a Consultative Council on Anaesthetic Mortality and Morbidity. The Council was then reconstituted with the same Terms of Reference but differing membership. Dr Patricia Mackay was appointed Chairman and six (6) anaesthetic representatives were appointed, three (3) nominated by the Victorian Regional Committee of the Faculty of Anaesthetists, three (3) by the Australian Society of Anaesthetists and additionally one (1) nominee from each of The Royal Australasian College of Surgeons, The ANZ Society of Intensive Care, The Royal Australian College of Pathologists, The Royal Australian College of General Practitioners and a representative of the Health Department, Victoria.

This structure has remained with the addition of a ministerial nominee from the Department of Forensic Pathology. In addition, the Chairman can co-opt members with special expertise, as required.

Table: Reports issued to Parliament and to all medical and dental practitioners and hospital executives in Victoria

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