Now my saga with the Southern NSW Local Health District administration.
The Southern New South Wales Local Health District (SNSW Health), my former employer, oversees health services for about 200,000 residents. When somebody lodged a complaint about my low carb approach for patients with metabolic syndrome and type 2 diabetes with the DAA (Dietitians Association of Australia), SNSW Health also got into the act. They came up with specific conditions for my return to practice — this was before I was officially sacked.
Remarkably, they specifically said:
“Nutritional advice to clients must not include a low carbohydrate diet. Jennifer will be advised on the information that she may provide to clients…. ”
Can you imagine having to tell a client with diabetes, who has lowered his BGLs, lost weight and come off all diabetes medications by reducing his carb intake, that he now has to start eating more carbs because SNSW Health says so !?
In any case, I was prepared to go back to work and fight this from within the organisation. That was not to be. As I was getting my head around returning to work, DAA informed my employer that the Association had found me guilty of professional misconduct and deregistered me. DAA’s “Far Deeper Issues” Revealed . SNSW Health immediately went along and fired me.
To bring their obsession into clear view, just before my dismissal, SNSW Health circulated a memo to their executive and dietitians.
It read: “As a result of a recent investigation, please be advised that Southern NSW Local Health District requires adherence to the Dietitians Association of Australia (DAA) Practice Guidelines for Dietitian Management of Diabetes.”
Of course, they admitted that DAA doesn’t actually produce clinical practice guidelines, but that it has produced a Nutrition Manual for use in hospitals and other facilities. So: “As an interim measure, all dietitians employed within Southern NSW Local Health District are directed that all diets prescribed for Diabetics must reflect the principles of Diabetic Diets outlined in the 2014 DAA Nutrition Manual”, which unsurprisingly doesn’t include low carbohydrate diets. In fact, for people with type 2 diabetes, the DAA manual recommends ensuring a regular carbohydrate intake and to spread carbohydrate over the day.
And to make sure all bases are covered, just before firing me, as described above, a suggested script had been prepared saying that “specific referrals that are received for a low carbohydrate diet from GP’s will be directed to the attention of the local Allied Health Manager who will contact the GP regarding the PP directive.” and, “Further discussion may then occur about the notion of a low carbohydrate intake diet not currently supported by the DAA.”
It’s not easy to be a dietitian in Australia advocating carbohydrate restriction, but even worse to be a person with diabetes in the SNSW Health district where you are denied the choice of a low-carbohydrate diet.
This breakdown in health care may not be evident to the government and a lack of oversight may have allowed this to get out of hand at the local level. I’d like to think that my experience could allow me to be a catalyst for positive change and I would like to suggest that, if you agree that this is a serious problem — not being allowed to offer all beneficial therapies to patients — you might join me in bringing this to the attention of the NSW Health Minister. Hopefully she will initiate some action.
If you think that this is a serious matter, could you please write to the NSW Health Minister, Jillian Skinner, expressing your concerns; an inquiry or hearing on this issue is reasonable to ask for.
Could I ask that you also post your letter here or leave a comment? Thank you.
The Hon. Jillian Skinner, MP
GPO Box 5341
SYDNEY NSW 2001