JCPSLP Vol 17 Supplement 1 2015_lores

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JCPSLP Volume 17, Supplement 1, 2015 – Ethical practice in speech pathology 9
From an allied health and
clinical perspective
Balancing clinical requirements and
prioritisation with resource allocation
“At a broad level this covers social justice concepts, in
other words, considerations regarding the fair and equitable
allocation of resources, rationing of services – also obliquely
called prioritisation of services and the reality of dual
servicing and agency policy about this. It causes real
distress to clinicians who are not able to undertake good,
let alone best, practice.”
“This is a constant challenge for clinicians and includes
limited capacity for clinical intervention, the non-servicing of
some patient groups based on lack of resources, the ethics
of prioritisation (what factors to consider in prioritisation).”
impact on the demands being made of us – in terms of new
knowledge and skills (just think about all the new mobile
technologies and applications contained in smart phone
and iPad apps!), the introduction of telehealth, and how the
Internet is changing how we learn and deliver services. It is
also worth reflecting on how global factors such as the GFC
have had an impact on our scope of practice.
The SPA Ethics Board has many roles around promoting
and managing the ethical standards of our profession –
and one of these is to respond to complaints. We receive
many complaints and while the greatest number of these
are resolved with support and mediation, some of these
progress to a formal investigation. Complaints are made
by members of both the public and the profession. As a
Board we have noticed an increasing number of complaints
paralleled by an increase in the complexity of the issues
raised.
Given the focus of the current issue of the Journal
of Clinical Practice in Speech-Language Pathology,
members of the Ethics Board of SPA were asked to reflect
on and respond to the question: “What do you consider
to be emerging ethical and professional issues in your
workplace?”
The Ethics Board of SPA consists of senior and elected
members of the profession, as well as community
representatives and the Senior Advisor Professional Issues.
We come from a wide range of geographical locations and
workplace contexts. We work in direct clinical practice,
in management positions, in research, in teaching, and
in policy and funding development. The Board members’
responses to the question have been grouped together
below into broad themes with reflections.
“There may be specific concerns in relation to waiting list
management, for example, long waits for some patients
which staff know will affect clinical outcomes in the long
term and the issue of having to prioritise people who make
complaints even if they are not the most urgent client.”
“Inadequate staffing numbers to meet National Standards
for service provision (e.g., Acute Stroke Guidelines), i.e.,
fairness and doing good.”
“Resource allocation can so easily become focused on
managing ‘numbers’ rather than ‘people’!”
“The bigger issue is that there are simply not enough
services available and rationing (which this effectively is)
denies access and equity to a whole group of clients who
are already compromised in their ability to advocate for
themselves.”