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Speaker 1: My name is Headley Thomas. Sick to Death is based

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Speaker 1: on my book of the same name, and it's the

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Speaker 1: true story of doctor Jayant Patel's lies and manipulation and

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Speaker 1: the herculean effort it took to finally stop him. We've

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Speaker 1: used voice actors throughout this series, and on occasion the

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Speaker 1: real people from the story have read their words for us.

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Speaker 1: It is brought to you by me and the Australian

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Speaker 1: Chapter fifteen Fortuitous. We had just switched off the lights

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Speaker 1: and settled into bed when the house shook with a

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Speaker 1: series of bangs. It was ten thirty pm on twenty

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Speaker 1: three October two thousand and two. Outside the dust from

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Speaker 1: an eerie freak storm swirled across the city of Brisbane,

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Speaker 1: but in our bedroom, tiny splinters of glass sprayed our hair,

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Speaker 1: faces and the bed sheets. Our daughter, Sarah, they'n eighteen

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Speaker 1: months old, awoke screaming. One of four zero point four

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Speaker 1: to five caliber bullets had exploded through the bedroom window

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Speaker 1: thirty centimeters above our heads. It continued through the bathroom wall,

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Speaker 1: shattering plaster tiles and a mirror. Another bullet ripped into

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Speaker 1: the toy room, close to the eye level of my

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Speaker 1: son Alexander. Then three another ricocheted off the top of

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Speaker 1: the car port. The path of the fourth bullet was

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Speaker 1: never established. It took several minutes to comprehend what had happened.

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Speaker 1: Our neighbors Chris and Louise, had seen a car spating off.

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Speaker 1: I asked, tree had fallen on the house in the storm.

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Speaker 1: No Headley, you've been shot at. I ran back upstairs

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Speaker 1: and called Triple O. Our sanctuary in a quiet street

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Speaker 1: in a semi rule enclave on the western outskirts of

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Speaker 1: Brisbane was soon full of police dogs and ballistics experts,

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Speaker 1: and then the media came. We wrapped up the children,

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Speaker 1: packed overnight bags and left. A shooting at an investigative

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Speaker 1: journalist's home was, according to the media commentators, unprecedented in Australia.

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Speaker 1: Police narrowed a long list of suspects down to those

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Speaker 1: with a definite motive, arising from a number of stories

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Speaker 1: I had written in the Courier Mail exposing various scams.

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Speaker 1: For three weeks we remained in Tasmania, touring, talking about

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Speaker 1: our future and trying to be rational about suspicious looking

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Speaker 1: people who drove too close to our higher car or

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Speaker 1: looked at us strangely in the streets of Hobart, Lonceston

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Speaker 1: and Strawn. I considered quitting journalism. We could grow vegetables

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Speaker 1: instead in a mountain village behind the Sunshine Coast, or

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Speaker 1: take up a safe pr type job in a distant

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Speaker 1: corner of Rupert Murdoch's news corporation, perhaps in London or

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Speaker 1: New York. We were grateful for the compassion of John Hartigan,

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Speaker 1: the company's Sydney Bay CEO, and Lachlan Murdoch, rupert son,

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Speaker 1: both of whom pledged support when it seemed I was

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Speaker 1: losing my way. Ruth and I were appalled at the

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Speaker 1: cowardly act of the shooting, and I became angry with

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Speaker 1: people who seemed oblivious to our pain. Days after the shooting,

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Speaker 1: strangers emailed and telephone to urge me to step up

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Speaker 1: my work, to look at their particular issues to solve

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Speaker 1: their problems. The level of self interest disgusted me. Let

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Speaker 1: them put themselves and their families in the line of fire.

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Speaker 1: Until that point, my career had been charmed. At the

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Speaker 1: age of twenty two, I had worked in the company's

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Speaker 1: London office while my friends went backpacking on shoe string

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Speaker 1: budgets I was paid to travel through Europe and the

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Speaker 1: Middle East, reporting momentous events including the fall of the

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Speaker 1: Berlin Wall, the violent revolution in Romania, and the First

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Speaker 1: Golf War. I had covered epic sporting contests Wimbledon, the

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Speaker 1: British Open, Golf, the French Open, and Silly's squabbles within

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Speaker 1: the royal family. The London assignment was followed by six

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Speaker 1: years in Hong Kong. In nineteen ninety nine, after witnessing

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Speaker 1: the handover of the British Colony to China, Ruth and

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Speaker 1: I had returned to Australia with our baby boy. We

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Speaker 1: started raising a family in Queensland. In the three years

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Speaker 1: before October two thousand and two, I had been toiling

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Speaker 1: as an investigative journalist at the Courier Mail property scams,

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Speaker 1: crooked lawyers, venal politicians and dangerous doctors. They were all

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Speaker 1: grissed for the mill. Some of these stories had made

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Speaker 1: a difference, but after the shooting, I doubted I would

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Speaker 1: care as much again about any of it. Journalism had

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Speaker 1: put my wife and children in peril. After much soul

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Speaker 1: searching and counseling, we decided to stay in Brisbane. We

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Speaker 1: decided to stay in journalism. We would have lost more,

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Speaker 1: we reasoned by giving up our home and profession. I

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Speaker 1: returned to reporting, but I dreaded the constant reminders of

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Speaker 1: our trauma. Did they ever catch the bastard who shot

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Speaker 1: up your house? Although those who asked were well intentioned,

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Speaker 1: the question aggravated us all the same. It forced us

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Speaker 1: to relive something that we did not want to revisit,

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Speaker 1: and to mumble clumsily a reply to the contacts, acquaintances

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Speaker 1: and sticky beaks who believed they had a right to

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Speaker 1: discuss it. The question forced me to fight the tears

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Speaker 1: welling in my eyes. It forced both of us to

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Speaker 1: face reality that the police had got next to nowhere,

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Speaker 1: despite a heavily promoted investigation and the personal overseeing of

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Speaker 1: the Police Commissioner Bob Atkinson. Almost a year after the shooting,

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Speaker 1: the Courier Males editor David Fagan asked me to start

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Speaker 1: working on a major project, an investigation and series of

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Speaker 1: articles about health and the public hospital system. As he

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Speaker 1: briefed me on the project, I privately weighed the risk

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Speaker 1: of reprisals low. The assignment was actually a lucky break

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Speaker 1: in Brisbane in the exquisitely appointed lestrange terrorists office of

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Speaker 1: doctor Ingrid Tall, the new head of the Australian Medical

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Speaker 1: Association's Queensland branch. I explained the potential angles Ingrid Tall

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Speaker 1: held ambitions to be a Liberal Party petitian. Her role

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Speaker 1: in the Northern branch of one of Australia's most powerful

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Speaker 1: trade unions was a stepping stone. I used the meeting

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Speaker 1: with Tall to stress the seriousness of the articles on

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Speaker 1: health I was preparing. The major series I planned would

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Speaker 1: not be possible without her cooperation. I wanted to examine

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Speaker 1: public hospital waiting lists, abominable conditions in emergency departments, morale,

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Speaker 1: a lack of funding, and a vacuum of political leadership.

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Speaker 1: There was much more I suspected, hence my appeal too

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Speaker 1: Tall to involve her colleagues in medical centers and hospitals

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Speaker 1: throughout the state. They held knowledge that the government spin

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Speaker 1: doctors would render themselves dizzy trying to control. Near the

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Speaker 1: end of our one PM meeting, Ingrid Tall raised a

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Speaker 1: new topic.

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Speaker 2: There are also serious concerns about overseas trained doctors.

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Speaker 1: My response was at first dismissive. The issue smacked of racism.

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Speaker 1: To my knowledge, it had not been raised publicly as

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Speaker 1: a serious problem in the past. Taul pressed her point.

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Speaker 2: No, it is a serious issue. Some of our members

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Speaker 2: have good information about it. I can put you in

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Speaker 2: touch with doctor marsh Godsall, who knows it better than anyone.

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Speaker 1: Dr Godsall, who practiced in Central Queensland, knew my wife

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Speaker 1: Ruth's father, doctor Ian Matthewson, who practiced in Mackay. When

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Speaker 1: I returned to my office in Bowen Hills, another family

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Speaker 1: related medical contact from Mackay promised to help me crack

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Speaker 1: the waiting list s fiasco.

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Speaker 3: Waiting lists sob manipulated by administrators to put themselves in

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Speaker 3: the best light. You have heard the saying lies, damn

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Speaker 3: lies and statistics.

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Speaker 1: Over the weekend I researched the subject of medical negligence

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Speaker 1: an extracted part of a judgment by Lord Denning and

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Speaker 1: then in a judge of the House of Lords in

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Speaker 1: Britain from a famous case Roe versus Minister of Health.

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Speaker 1: The relevant passage.

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Speaker 4: Read, it is so easy to be wise after the

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Speaker 4: event and to condemn as negligence that which was only

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Speaker 4: a misadventure. We ought always to be on our guard

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Speaker 4: against it, especially in cases against hospitals and doctors. Medical

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Speaker 4: science has conferred great benefits on mankind, but these benefits

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Speaker 4: are attended by considerable risks. Every surgical operation is attended

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Speaker 4: by risks. We cannot take the benefits without taking the risks.

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Speaker 4: Every advance and technique is also attended by risks. Doctors,

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Speaker 4: like the rest of us, have to learn by experience,

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Speaker 4: and experience often teaches in a hard way.

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Speaker 1: After the weekend, Doctor Godsall contacted me to emphasize the

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Speaker 1: concerns about overseas trained doctors. He told me that the

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Speaker 1: single biggest issue in the public health system was Queensland's

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Speaker 1: dependency on them.

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Speaker 3: We are also concerned that appropriate qualifications, including language skills,

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Speaker 3: are not being ensured. This means the public is potentially

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Speaker 3: and increasingly at risk from doctors with less than the

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Speaker 3: skills required to work here, though they may be adequate

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Speaker 3: in the environment in which they were trained, and who

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Speaker 3: did not have the communication ability which is expected from

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Speaker 3: those selected for Australian medical schools. This in turn means

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Speaker 3: the public purse is exposed to litigation.

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Speaker 1: Godsaw mentioned a report by Bob Birell, a Melbourne academic.

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Speaker 1: I found it on the internet. The report was alarming.

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Speaker 1: Having at first been less than enthusiastic, I knew now

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Speaker 1: that an investigation of the Overseas Trained Doctors or OTD

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Speaker 1: had no real potential. It might be the backbone of

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Speaker 1: the series. Doctor Godswall also hinted that Queensland Health knew

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Speaker 1: all too well about the dangers. One of its senior advisors,

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Speaker 1: doctor Dennis Lennox, had produced an important report. Doctor Godswall

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Speaker 1: suggested that the report had been deliberately smothered. As my

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Speaker 1: interest sawed, I told Godswill that the story would become

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Speaker 1: a priority. I was determined to see the report by

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Speaker 1: doctor Lennox. Doctor Godswall told.

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Speaker 3: Me, I do not think that many appreciate the situation

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Speaker 3: or are aware of it. For example, you seemed incredulous

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Speaker 3: this morning when I told you of the lack of

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Speaker 3: vetting of the skills and qualifications.

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Speaker 1: Godswall kept giving Over several days. He sent me emails

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Speaker 1: and he telephoned with new snippets of information.

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Speaker 3: I send you this to help put things in perspective

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Speaker 3: for you, as if you were not living with these

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Speaker 3: things on a daily bank. It is very easy to

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Speaker 3: misinterpret or be misled. I'm telling everybody they can speak

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Speaker 3: to you on and off the record and you will

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Speaker 3: respect their request. Those with queens and Health positions feel

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Speaker 3: threatened because of the retribution that can be their lot.

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Speaker 1: He offered names and telephone numbers of other doctors with

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Speaker 1: insight into the issue. He urged me to investigate a

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Speaker 1: death at a hospital in Charters Towers. He suggested I

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Speaker 1: talk to a pharmacist in Mackay. He mentioned a GP

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Speaker 1: in Bunderberg who had employed doctors from overseas, and he

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Speaker 1: hinted again at this explosive secret report, adding.

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Speaker 3: If QHS try to snow you, it'll be difficult to

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Speaker 3: get people to speak because of the code of conduct.

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Speaker 1: After interviewing two overseas trained doctors, I could see the

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Speaker 1: story being a potential blockbuster. These doctors were stunned at

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Speaker 1: the lack of screening of their qualifications and their competence.

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Speaker 1: I told Godzill they reflect your concerns, I wrote to him.

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Speaker 1: No doubt the spin from Queensland Health will be that

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Speaker 1: if the system is working so poorly, why are there

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Speaker 1: no or few complaints and why no adverse outcomes. I

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Speaker 1: think that if your contacts can point to some events

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Speaker 1: in which an overseas trained doctor's conduct has produced a

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Speaker 1: bigger problem. It would lend more credibility to the issue.

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Speaker 1: I also tried to impress on doctor Godwill that a

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Speaker 1: story involving clinicians merely expressing concern would have little or

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Speaker 1: no impact. If he and his colleagues wanted to change

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Speaker 1: the situation, they needed to think about cause and effect.

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Speaker 1: They needed to reveal cases involving negligent clinical conduct with

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Speaker 1: adverse consequences for patients. The word went around sections of

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Speaker 1: the medical community for a few days. I was urged

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Speaker 1: to talk to doctor Chris Blenken, a leading orthopedic surgeon

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Speaker 1: and the president of the Australian Orthopedics Association's Queensland branch.

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Speaker 1: Although his brother Max was a senior journalist in Canberra,

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Speaker 1: doctor Blenkin's professional contact with journalists had been limited before

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Speaker 1: he heard from me, but he spoke frankly and strongly.

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Speaker 1: He cited a crisis at the public hospital in Harvey Bay,

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Speaker 1: about three hundred kilometers north of Brisbane, involving two Fiji

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Speaker 1: trained doctors being held out as consultants in orthopedic surgery.

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Speaker 1: Neither had done the training demanded of Australian surgeons, nor

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Speaker 1: had they been assessed or accredited by peers. Since their

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Speaker 1: arrival at the hospital, they had not been properly supervised. Inevitably,

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Speaker 1: their lack of competence had raised concerns in the medical field. Orthopods,

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Speaker 1: as they are known, are often the butt of jokes.

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Speaker 1: If cardiac surgery is a fine art, orthopedic surgery is

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Speaker 1: roadside laboring. It can quite literally involve a hammer, nails

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Speaker 1: and brute force. When I pressed Blenken on the Harvey

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Speaker 1: Bay situation, he promised to check into it more thoroughly.

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Speaker 1: He called me a few days later and said he

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Speaker 1: was sincerely worried. The dangers at the hospital, he explained,

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Speaker 1: were unacceptable. He detailed two of the most recent adverse

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Speaker 1: outcomes in Harvey Bay, a femur that exploded because the

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Speaker 1: pin was nailed in wrongly and a hip fractured on

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Speaker 1: the operating table.

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Speaker 5: You have to see it to believe it. It highlights

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Speaker 5: the problems that occur when we drop standards. You are

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Speaker 5: better off with no one than someone who is bad,

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Speaker 5: because it is possible to do so much damage. The

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Speaker 5: community expects a reasonable standard, but the damage done far

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Speaker 5: outweighs any benefit. In providing a service. Who knows why

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Speaker 5: the medical superintendent and a district manager have gone down

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Speaker 5: this path. They probably think a doctor is a doctor.

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Speaker 1: I decided it was imperative. I talked to a number

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Speaker 1: of doctors in different fields and in different parts of Queensland.

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Speaker 1: I didn't want the story to lack credibility for a

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Speaker 1: failure to gauge a variety of views. In Atherton, North, Queensland,

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Speaker 1: doctor Bruce Cameron told me that a large number of

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Speaker 1: doctors coming from overseas were simply unsuitable without significant upskilling.

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Speaker 1: He told me that there may be some situations where

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Speaker 1: no doctor is safer than a bad doctor. Doctor Drew

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Speaker 1: spat a GP at Bunderberg's Burnett Medical Center, described the

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Speaker 1: need to introduce a formal program of screening and mentoring.

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Speaker 1: He said to me, I don't want to sound racist.

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Speaker 1: We welcome these people here. In a situation where there

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Speaker 1: is a shortage of Australian doctors, we need to ensure

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Speaker 1: they have the skills. Doctor David Malloy, who would become

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Speaker 1: the next Australian Medical Association Queensland president, called for systems

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Speaker 1: to measure the experience and skills of overseas trained doctors.

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Speaker 6: As the health system tightens with the emphasis on meeting budgets,

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Speaker 6: nobody is available to evaluate the doctors when they hit

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Speaker 6: the hospitals. Our natural inclination is to protect the medical system,

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Speaker 6: but the fact is, where there are language problems and

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Speaker 6: people are asked to work above their level, the potential

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Speaker 6: for adverse outcomes has to be so much greater. Everyone

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Speaker 6: knew this was a bit of a powder keg. I

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Speaker 6: think we have been afraid to approach it because of

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Speaker 6: a fear of being seen as elitist and racist.

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Speaker 1: Anxious for the two Fiji trained doctors to have an

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Speaker 1: opportunity to comment, I telephoned one. He rejected the concerns

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Speaker 1: and told of the community's gratitude for their work. We

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Speaker 1: are not specialists. We are not saying that our qualifications

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Speaker 1: mean we should be recognized as specialists. I don't think

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Speaker 1: I have a lack of experience. Within a few days

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Speaker 1: of hearing for the first time about the issue, I

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Speaker 1: received a fax from a confidential source. Somebody had sent

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Speaker 1: me the July two thousand and three report by doctor

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Speaker 1: Dennis Lennox, the senior Queensland Health Workforce Advisor. It ran

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Speaker 1: for eighteen pages and seemed complete. But for a signature,

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Speaker 1: I turned to the executive summary, which said what I

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Speaker 1: already knew, A chronic shortage of Australian graduates had resulted

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Speaker 1: in an increasingly heavy reliance on overseas trained doctors. My

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Speaker 1: faith in doctor Godswill rose as I read the warnings.

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Speaker 7: Evidence is increasing of increased risk of OTD recruits being

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Speaker 7: insufficiently assessed and prepared for practice in Queensland under pressure

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Speaker 7: of recruitment of such increasingly large numbers of otds. Some

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Speaker 7: recent experience of overseas trained doctors without the competence or

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Speaker 7: capability for medical practice in Queensland presages adverse outcomes for patients, employees,

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Speaker 7: community and medical profession.

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Speaker 1: Doctor Lennox had done his homework. He mapped out a

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Speaker 1: policy and tactical response, embracing a comprehensive assessment and management process,

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Speaker 1: bridging courses for doctors not up to scratch, Australian Medical

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Speaker 1: Council examinations and fellowship of the relevant medical colleges. Lennox

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Speaker 1: wrote that these options would ensure that doctors from overseas

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Speaker 1: were appropriately qualified.

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Speaker 7: It also protects the community from incompetent medical practice and

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00:19:49,440 --> 00:19:51,040
Speaker 7: consequent adverse outcomes.

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Speaker 1: The report was the smoking gun of this story. It

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Speaker 1: evinced evidence that Queensland Health knew of the concerns because

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Speaker 1: they had been this stilled and emphasized by one of

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Speaker 1: its managers. I felt even more strongly about the seriousness

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Speaker 1: of the story, but I decided not to show my

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Speaker 1: hand too soon. On twenty one October, I wrote to

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Speaker 1: my former colleague from the Courier Mail, Steve Rouse, who

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Speaker 1: managed communications for the then Health Minister Wendy Edmund. As

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Speaker 1: a seasoned political reporter before crossing to what we call

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Speaker 1: the dark side, Rouse was one of the better advisors

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Speaker 1: in the Beady government's army of spinners. He was also

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Speaker 1: my main point of contact for the series I had

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Speaker 1: been asked to produce. I explained to Steve Rouse some

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Speaker 1: of the issues I wanted dealt with in interviews with

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Speaker 1: Wendy Edmund, the Minister, and her Director General, Dr Rob Stable.

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00:20:50,280 --> 00:20:53,119
Speaker 1: I told him that I sought information to address the

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00:20:53,200 --> 00:20:56,640
Speaker 1: claims of clinicians and patients that the waiting lists are

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Speaker 1: misleading because they don't indicate the waiting time for the

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Speaker 1: appointments for assessments for surgery. I also flagged my interest

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Speaker 1: in the bigger picture issues. I wrote, for example, what

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Speaker 1: the community might want or expect versus what it is

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Speaker 1: prepared to pay for, and the increasing tensions arising out

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Speaker 1: of strife of interests with what clinicians would like to

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Speaker 1: do for patients versus administrators who are responsible for the budgets.

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Speaker 1: The secrecy issues being raised constantly by the doctors and

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Speaker 1: nurses concerned me. I emailed Steve Rouss about it. I wrote,

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Speaker 1: a number of clinicians claim that when they identify serious

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Speaker 1: issues relating to public health, the problems are denied or

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Speaker 1: not addressed seriously. They claim as cans doctors claimed earlier

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Speaker 1: this year that only by speaking out can they alert

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Speaker 1: the public to what is really going on, but they

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Speaker 1: risk their jobs by doing so. They say that this

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Speaker 1: puts them in an impossible situation. Can you address this

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Speaker 1: please with reference to the Code of Conduct, why it

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Speaker 1: restricts the doctors from whistleblowing and why in Queensland Health's view,

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Speaker 1: the doctors are no different from any other public servant

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Speaker 1: when it comes to highlighting internal issues. On the matter

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Speaker 1: of overseas trained doctors, I decided not to disclose that

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00:22:23,480 --> 00:22:28,160
Speaker 1: I had already been leaked the sensitive Dennis Lennox Report. Instead,

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Speaker 1: I ask for information that addresses the number of overseas

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Speaker 1: trained doctors in Queensland in both the private and public sector,

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Speaker 1: the extent to which the system relies on them, and

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Speaker 1: the due diligence undertaken to ensure they're sufficiently skilled. I

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Speaker 1: ask does the Minister believe that the current arrangements are

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Speaker 1: adequate or is she concerned that doctors without appropriate experience

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Speaker 1: or skills are slipping into an undermanned sector because of

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Speaker 1: the chronic shortage. What can be done to ensure that

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Speaker 1: adverse out comes are minimized. Steve Rouse confirmed my appointments

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Speaker 1: for interviews or briefings with the Director General, Doctor Rob Stable,

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Speaker 1: his probable successor, Dr Steve Buckland, and Minister Wendy Edmund

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00:23:13,800 --> 00:23:19,919
Speaker 1: for Monday twenty seven October. Files and folders stuffed with

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Speaker 1: documents about Queensland Health covered the kitchen table as I

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00:23:23,640 --> 00:23:26,960
Speaker 1: worked the telephone and read again the Lennox Report on

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Speaker 1: overseas doctors. When it came time to go to the

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Speaker 1: nineteenth floor of the Queensland Health Building in Charlotte Street

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Speaker 1: on the afternoon of twenty seven October I was well

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Speaker 1: prepared in just a few days. Rob Stable, who took

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Speaker 1: most of the questions while Buckland listened and occasionally added something,

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00:23:46,359 --> 00:23:48,879
Speaker 1: would be out of the top job in Queensland Health.

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Speaker 1: He was leaving for a new role in the private sector,

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Speaker 1: heading up Bond University on the Gold Coast. Dr Stable

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Speaker 1: told me we.

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Speaker 8: Have some very good over these trained doctors in this state,

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00:24:02,200 --> 00:24:04,960
Speaker 8: but we are finding that where we need to recruit them,

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00:24:05,440 --> 00:24:08,760
Speaker 8: some don't have the same degree of language skills. The

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00:24:08,800 --> 00:24:11,800
Speaker 8: pool of Australian medicine has not kept pace with the demand.

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00:24:12,400 --> 00:24:16,200
Speaker 8: The market has changed and we do everything practical, interviewing them,

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Speaker 8: checking references, giving clinical scenarios. We have this situation. We

355
00:24:21,440 --> 00:24:25,440
Speaker 8: have to provide services. We have hurdles in place. It's

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00:24:25,480 --> 00:24:28,119
Speaker 8: been reported to us that their communication skills have not

357
00:24:28,280 --> 00:24:31,159
Speaker 8: been very good, but we have noticed this ourselves with

358
00:24:31,240 --> 00:24:35,400
Speaker 8: the applicants. This is a no win. The politicians don't

359
00:24:35,440 --> 00:24:39,000
Speaker 8: accept that we can't have doctors. Is no service better

360
00:24:39,040 --> 00:24:41,240
Speaker 8: than taking the risk that one or two cases per

361
00:24:41,320 --> 00:24:43,280
Speaker 8: year of the six hundred we get in the public

362
00:24:43,320 --> 00:24:45,640
Speaker 8: system in Queensland are not up to scratch.

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Speaker 1: Doctor Buckland seemed perplexed we are not in the business

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Speaker 1: of causing harm and seeing adverse outcomes. My meeting with

365
00:24:56,560 --> 00:25:00,960
Speaker 1: Wendy Edmund covered a range of topics played the problems

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Speaker 1: facing health. Generally, there would always be people, she told me,

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Speaker 1: who were like Chicken little talking about the sky falling in.

368
00:25:10,840 --> 00:25:13,320
Speaker 1: It was her way of saying that the public health

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00:25:13,359 --> 00:25:16,920
Speaker 1: system was in good shape, despite the regular reports from

370
00:25:16,960 --> 00:25:22,320
Speaker 1: clinicians and patients to the contrary. A few hours after

371
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Speaker 1: meeting Stable Buckland and Edmund, I sent a note asking

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00:25:26,880 --> 00:25:31,439
Speaker 1: further questions about the situation at Harvey Bay. Was it

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Speaker 1: the only public hospital at which the qualifications of overseas

374
00:25:36,160 --> 00:25:42,919
Speaker 1: trained doctors were not recognized by the respective colleges? I asked, Also,

375
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Speaker 1: can you copy to me a report by Queensland Health

376
00:25:47,160 --> 00:25:51,440
Speaker 1: doctor Dennis Lennox earlier this year into issues arising from

377
00:25:51,440 --> 00:25:58,160
Speaker 1: overseas doctors. Kato O'Donnell, who handled Queensland Health's official responses

378
00:25:58,200 --> 00:25:59,920
Speaker 1: to some of our queries.

379
00:25:59,480 --> 00:26:03,560
Speaker 2: Told me this report has no official status and was

380
00:26:03,600 --> 00:26:07,359
Speaker 2: not accepted or endorsed by Queensland Health Executive.

381
00:26:08,680 --> 00:26:12,440
Speaker 1: Doctor Buckland and the Medical Board of Queensland had received

382
00:26:12,520 --> 00:26:16,680
Speaker 1: doctor Lennox's report, They had read it and they had

383
00:26:16,680 --> 00:26:35,200
Speaker 1: buried it Chapter sixteen Discredit. November two thousand and three,

384
00:26:35,359 --> 00:26:39,159
Speaker 1: the last patient left doctor Ross Cartmill's waiting room on

385
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Speaker 1: wickham Terrace above the lights of the city's office building,

386
00:26:42,280 --> 00:26:48,080
Speaker 1: sometime after seven pm. A urologist with a successful private practice,

387
00:26:48,440 --> 00:26:52,840
Speaker 1: Cartmill was also a visiting medical officer, meaning he gave

388
00:26:52,960 --> 00:26:56,359
Speaker 1: some of his time for relatively minimal financial return to

389
00:26:56,400 --> 00:26:59,959
Speaker 1: look after patients and to mentor junior doctors in Brisbane

390
00:27:00,240 --> 00:27:05,720
Speaker 1: public hospitals. For many specialists, like Cartmell, the motive for

391
00:27:05,800 --> 00:27:09,120
Speaker 1: doing part time work in the public system was altruistic.

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00:27:10,000 --> 00:27:12,840
Speaker 1: They were giving something back to hospitals which had been

393
00:27:12,880 --> 00:27:17,680
Speaker 1: their training ground years earlier. But doctor Cartmell was now

394
00:27:17,800 --> 00:27:22,520
Speaker 1: gravely worried about the performance and sustainability of public health care.

395
00:27:23,280 --> 00:27:25,760
Speaker 1: I took notes as he vented his spleen.

396
00:27:27,160 --> 00:27:30,520
Speaker 9: The first fact the community needs to understand is that

397
00:27:30,600 --> 00:27:34,080
Speaker 9: doctors are afraid they'll be sacked if they talk openly

398
00:27:34,160 --> 00:27:38,679
Speaker 9: about what is actually happening in public hospitals. The second

399
00:27:38,720 --> 00:27:42,760
Speaker 9: fact is that if doctors could talk openly, Queenslanders would

400
00:27:42,800 --> 00:27:46,840
Speaker 9: hear that their public health system is chronically underfunded and

401
00:27:46,920 --> 00:27:50,480
Speaker 9: suffers from an acute lack of staff and beds. It

402
00:27:50,600 --> 00:27:53,960
Speaker 9: means people who need surgery wait much longer than they should,

403
00:27:54,480 --> 00:27:58,240
Speaker 9: and some people never get operations that would change their lives.

404
00:27:59,240 --> 00:28:03,080
Speaker 9: Doctors and medical staff are frustrated because they feel unable

405
00:28:03,119 --> 00:28:06,880
Speaker 9: to tell the community the whole story. The culture prevents

406
00:28:06,920 --> 00:28:10,720
Speaker 9: people from hearing about the deficiencies. The doctors are told

407
00:28:10,800 --> 00:28:14,600
Speaker 9: they must report their concerns internally, but we've reached the

408
00:28:14,680 --> 00:28:18,320
Speaker 9: point where we believe that reporting upwards will not make

409
00:28:18,520 --> 00:28:23,400
Speaker 9: any difference anymore. Every so often, when someone breaks ranks,

410
00:28:23,560 --> 00:28:27,080
Speaker 9: there's a crackdown and severe reprimand.

411
00:28:28,200 --> 00:28:31,080
Speaker 1: I had been hearing similar complaints from some of the

412
00:28:31,119 --> 00:28:35,960
Speaker 1: most senior clinicians in Queensland. Many were fearful that they

413
00:28:36,040 --> 00:28:39,560
Speaker 1: might be seen meeting me. We went to unusual links

414
00:28:39,560 --> 00:28:42,320
Speaker 1: to avoid detection, as they told me about a corporate

415
00:28:42,400 --> 00:28:47,520
Speaker 1: culture that stamped violently on whistleblowers. One of Queensland's top

416
00:28:47,560 --> 00:28:51,320
Speaker 1: specialists wanted to provide evidence of a clinical disaster in

417
00:28:51,360 --> 00:28:54,760
Speaker 1: a hospital, but he insisted on a secret rendezvous in

418
00:28:54,800 --> 00:28:59,480
Speaker 1: a car in a backstreet. Six months earlier, Health Minister

419
00:28:59,560 --> 00:29:03,000
Speaker 1: Wendy Edmund had turned on doctors in the North Queensland

420
00:29:03,040 --> 00:29:06,880
Speaker 1: city of Cairnes after they protested publicly about cuts in

421
00:29:06,960 --> 00:29:10,960
Speaker 1: the services at the hospital. Wendy Edmund made a statement

422
00:29:11,000 --> 00:29:13,720
Speaker 1: to stay Parliament in May two thousand and three.

423
00:29:14,880 --> 00:29:17,280
Speaker 10: There will always be some winges and I will meet

424
00:29:17,360 --> 00:29:19,680
Speaker 10: with the wines and talk to them.

425
00:29:20,040 --> 00:29:24,040
Speaker 1: The doctors who had funded advertisements in the Cairns Posts

426
00:29:24,080 --> 00:29:28,280
Speaker 1: to make their point were threatened with discipline, reaction and dismissal.

427
00:29:29,600 --> 00:29:33,160
Speaker 1: On three November two thousand and three. I reported this

428
00:29:33,360 --> 00:29:37,680
Speaker 1: in the Courier Mail. If only half the concerns about

429
00:29:37,680 --> 00:29:41,440
Speaker 1: the clinical standards of some of the overseas doctors imported

430
00:29:41,560 --> 00:29:45,240
Speaker 1: into Australia in the past few years are true, it

431
00:29:45,360 --> 00:29:50,720
Speaker 1: would have serious ramifications for patients and the profession. Senior

432
00:29:50,760 --> 00:29:55,400
Speaker 1: medical specialists, rural gps and doctors in the public hospital

433
00:29:55,480 --> 00:29:59,080
Speaker 1: system believed that the failure of registration boards and the

434
00:29:59,120 --> 00:30:03,160
Speaker 1: state and federal governments in checking the competence of imported

435
00:30:03,280 --> 00:30:11,480
Speaker 1: overseas doctors could end up costing the community dearly. I

436
00:30:11,560 --> 00:30:15,240
Speaker 1: knew that many health professionals were also angry that the government,

437
00:30:15,360 --> 00:30:19,280
Speaker 1: led by Premier Peter Beatty, continued to promote itself for

438
00:30:19,360 --> 00:30:25,120
Speaker 1: supposedly reducing the waiting times for surgery in hospitals as

439
00:30:25,200 --> 00:30:29,280
Speaker 1: the Health Minister Wendy Edmund and Premier Beatty lauded themselves

440
00:30:29,320 --> 00:30:33,640
Speaker 1: for achieving their best ever results for elective surgery, the

441
00:30:33,760 --> 00:30:37,960
Speaker 1: clinicians insisted that the claims were a gross misrepresentation of

442
00:30:38,000 --> 00:30:42,600
Speaker 1: the truth. Doctors were sure that an independent audit of

443
00:30:42,640 --> 00:30:45,719
Speaker 1: the results would prove that the public was being told lies.

444
00:30:47,040 --> 00:30:51,480
Speaker 1: I looked at the situation overseas and elsewhere in Australia.

445
00:30:51,600 --> 00:30:55,440
Speaker 1: In the United Kingdom, the National Audit Office had identified

446
00:30:55,520 --> 00:31:00,000
Speaker 1: what it called deliberate manipulation or misstatement of the fears

447
00:31:00,680 --> 00:31:05,960
Speaker 1: in public hospitals in nine major districts. In New South Wales,

448
00:31:06,160 --> 00:31:10,000
Speaker 1: the Independent Commission against Corruption was bringing charges after the

449
00:31:10,120 --> 00:31:13,840
Speaker 1: discovery that a number of major public hospitals had falsified

450
00:31:14,200 --> 00:31:20,320
Speaker 1: and misrepresented waitingless data. I mentioned the concerns to Queensland's

451
00:31:20,400 --> 00:31:23,760
Speaker 1: Order to General Len Scanlon and sent him data, but

452
00:31:23,880 --> 00:31:29,080
Speaker 1: he showed little interest in investigating. On seventeen November, my

453
00:31:29,200 --> 00:31:32,400
Speaker 1: interview with doctor Cartmill was published in The Courier Mail

454
00:31:32,480 --> 00:31:36,160
Speaker 1: with an article about the alleged manipulation by Queensland Health

455
00:31:36,320 --> 00:31:42,200
Speaker 1: of waitingless data in Queensland. Documents taken by the politicians

456
00:31:42,240 --> 00:31:47,800
Speaker 1: to Cabinet remain exempt from disclosure for thirty years. This

457
00:31:48,040 --> 00:31:52,800
Speaker 1: law has been routinely exploited by politicians who have thwarted

458
00:31:52,920 --> 00:31:58,160
Speaker 1: Freedom of information applications and concealed sensitive documents from public

459
00:31:58,200 --> 00:32:04,000
Speaker 1: scrutiny by taking those documents into cabinet. Health Minister Edmund

460
00:32:04,080 --> 00:32:08,600
Speaker 1: had taken waiting lists data to cabinet, ensuring their concealment

461
00:32:08,680 --> 00:32:12,760
Speaker 1: for thirty years. She sent me a statement.

462
00:32:12,360 --> 00:32:17,560
Speaker 10: Which said Queensland waiting times for elective surgery are not misleading.

463
00:32:19,120 --> 00:32:23,360
Speaker 1: Another prominent article I wrote revealed how patients needing urgent

464
00:32:23,440 --> 00:32:28,320
Speaker 1: surgery had been left disfigured by aggressive cancers after operations

465
00:32:28,360 --> 00:32:31,560
Speaker 1: were canceled because of a lack of intensive care beds

466
00:32:31,600 --> 00:32:36,040
Speaker 1: in hospitals. The next day I wrote about eleaked memo.

467
00:32:36,400 --> 00:32:39,960
Speaker 1: It was written by doctor Phil Kay, an emergency department

468
00:32:40,040 --> 00:32:44,000
Speaker 1: head who was furious that administrators had decided to close

469
00:32:44,080 --> 00:32:50,160
Speaker 1: the gynecology unit in one of Queensland's largest hospitals. Our articles,

470
00:32:50,360 --> 00:32:53,240
Speaker 1: part of the Courier Mals series on the health system,

471
00:32:53,360 --> 00:32:58,480
Speaker 1: were causing top level angst. Minister Wendy Edmund's efforts to

472
00:32:58,600 --> 00:33:02,400
Speaker 1: keep health off the front page had failed. Her staff

473
00:33:02,480 --> 00:33:05,600
Speaker 1: feed the series might do significant harm to the image

474
00:33:05,600 --> 00:33:08,520
Speaker 1: of the Beaty government. Just a few months out from

475
00:33:08,560 --> 00:33:13,160
Speaker 1: the February two thousand and four state election, the Career

476
00:33:13,200 --> 00:33:17,760
Speaker 1: Mail's editor, David Fagan, received an angry letter from Hendrik Gout,

477
00:33:18,080 --> 00:33:23,920
Speaker 1: Queensland Health's executive manager for Media and Communications. Gout began

478
00:33:24,080 --> 00:33:25,440
Speaker 1: by expressing what he.

479
00:33:25,360 --> 00:33:29,720
Speaker 11: Called his sincere concern about the ethics and behavior of

480
00:33:29,800 --> 00:33:32,040
Speaker 11: Hedley Thomas over the past few days.

481
00:33:32,960 --> 00:33:36,280
Speaker 1: He described me as an.

482
00:33:35,400 --> 00:33:38,800
Speaker 11: Unprincipled, unprofessional, unscrupulous journalist.

483
00:33:39,880 --> 00:33:43,360
Speaker 1: In the eighteen November message, Gout said.

484
00:33:43,640 --> 00:33:46,360
Speaker 11: Either the Minister's office is lying or one of your

485
00:33:46,400 --> 00:33:50,360
Speaker 11: own reporters has a pinocchio nose. Hedley is making a

486
00:33:50,400 --> 00:33:51,080
Speaker 11: practice of this.

487
00:33:52,920 --> 00:33:56,320
Speaker 1: After examining my actions and double checking the facts of

488
00:33:56,400 --> 00:34:00,240
Speaker 1: the stories, I realized that doctor Cartmell and the other

489
00:34:00,320 --> 00:34:05,040
Speaker 1: doctors were right. The culture of fear and loathing in

490
00:34:05,120 --> 00:34:10,200
Speaker 1: Queensland Health was thriving. It was an organization with serious

491
00:34:10,280 --> 00:34:15,200
Speaker 1: fundamental shortcomings which were being camouflaged by glossy pr and

492
00:34:15,320 --> 00:34:20,120
Speaker 1: aggressive shoot the messenger strategies. It was little wonder that

493
00:34:20,280 --> 00:34:24,880
Speaker 1: many clinicians were afraid to tell the truth. A number

494
00:34:24,920 --> 00:34:29,160
Speaker 1: of the doctors, professional administrators and former health chiefs had

495
00:34:29,200 --> 00:34:32,600
Speaker 1: made a persuasive public case that the health system was

496
00:34:32,640 --> 00:34:36,359
Speaker 1: in crisis. They were adamant that the public was being

497
00:34:36,480 --> 00:34:39,200
Speaker 1: conned into believing that it had one of the finest

498
00:34:39,320 --> 00:34:44,040
Speaker 1: systems in the world. In fact, spending on health in

499
00:34:44,120 --> 00:34:49,560
Speaker 1: Queensland was the lowest per capita in Australia. The underfunding

500
00:34:49,640 --> 00:34:52,600
Speaker 1: of more than one billion dollars a year had produced

501
00:34:52,800 --> 00:34:57,759
Speaker 1: huge gaps. Doctors and health professionals had little incentive to

502
00:34:57,800 --> 00:35:01,120
Speaker 1: remain in a system which treated them and their patients

503
00:35:01,160 --> 00:35:07,240
Speaker 1: so poorly. The drain of experienced professionals, cutbacks on beds

504
00:35:07,280 --> 00:35:11,040
Speaker 1: in hospitals, the rationing of care, and the punishment of

505
00:35:11,160 --> 00:35:14,880
Speaker 1: administrators who did not churn through waiting lists while making

506
00:35:14,960 --> 00:35:18,680
Speaker 1: budget had set Queensland Health up for a painful fall.

507
00:35:20,200 --> 00:35:23,720
Speaker 1: When doctor Steve Buckland sought the top job as Director

508
00:35:23,800 --> 00:35:27,200
Speaker 1: General a few months after the Courier mal series, he

509
00:35:27,239 --> 00:35:32,040
Speaker 1: wrote a confidential letter acknowledging that Queensland Health's focus on

510
00:35:32,160 --> 00:35:38,120
Speaker 1: fiscal management had suppressed its ability. In his job application, he.

511
00:35:38,000 --> 00:35:42,000
Speaker 12: Wrote, this has also resulted in a disaffected workforce, a

512
00:35:42,120 --> 00:35:46,600
Speaker 12: lack of innovative problem solving, strained relationships with other government agencies,

513
00:35:46,960 --> 00:35:51,120
Speaker 12: and a lack of public confidence in the system's capability.

514
00:35:51,160 --> 00:35:55,719
Speaker 1: Publicly, however, the message from Queensland Health and its political

515
00:35:55,800 --> 00:36:20,279
Speaker 1: sponsors was the exact opposite. Chapter seventeen. Starting over. Long

516
00:36:20,320 --> 00:36:24,719
Speaker 1: before the first European explorers ventured almost four hundred kilometers

517
00:36:24,760 --> 00:36:29,120
Speaker 1: north of Brisbane to identify future settlements and farming opportunities,

518
00:36:29,560 --> 00:36:33,279
Speaker 1: a local Aboriginal tribe known as the Bunder had the

519
00:36:33,320 --> 00:36:39,840
Speaker 1: area to themselves. The government assistant surveyor James Charles Burnett

520
00:36:40,080 --> 00:36:43,680
Speaker 1: visited in the eighteen forties, but failed to appreciate the

521
00:36:43,719 --> 00:36:48,399
Speaker 1: potential of the rich volcanic soil. The oversight meant that

522
00:36:48,440 --> 00:36:51,680
Speaker 1: the Bunder people were left alone for another two decades.

523
00:36:52,920 --> 00:36:57,320
Speaker 1: The first white settlers, brothers John and Gavin Stewart, arrived

524
00:36:57,320 --> 00:37:00,959
Speaker 1: on Christmas Day eighteen sixty six and began to raise

525
00:37:01,040 --> 00:37:05,640
Speaker 1: the hardwoods. They were followed by European migrants keen to

526
00:37:05,680 --> 00:37:09,560
Speaker 1: exploit the fertile black soil and the readily available water

527
00:37:09,640 --> 00:37:15,759
Speaker 1: source of the Burnett River. Their success attracted industry and commerce.

528
00:37:16,120 --> 00:37:20,000
Speaker 1: The settlement started to thrive. As the German word for

529
00:37:20,200 --> 00:37:26,160
Speaker 1: town was berg, the area was named Thunderberg. It owed

530
00:37:26,200 --> 00:37:30,360
Speaker 1: its burgeoning prosperity to sugar cane and the toil of outsiders.

531
00:37:30,920 --> 00:37:34,719
Speaker 1: Dark skinned Kannakers brought to workers bonded slaves in the

532
00:37:34,760 --> 00:37:39,439
Speaker 1: cane fields for a meager wage, a roof over their

533
00:37:39,480 --> 00:37:42,640
Speaker 1: heads and food. They were indentured for three years. To

534
00:37:42,719 --> 00:37:50,080
Speaker 1: the plantation owners, the conditions were invariably dreadful. In eighteen

535
00:37:50,200 --> 00:37:54,120
Speaker 1: eighty one, when the General hospital opened beside the Burnett River,

536
00:37:54,280 --> 00:37:58,240
Speaker 1: it comprised four rooms, a cottage and a separate ward

537
00:37:58,280 --> 00:38:03,560
Speaker 1: for the Kannakers. The following year, dozens of labourers from

538
00:38:03,800 --> 00:38:08,520
Speaker 1: Ceylon now Sri Lanka arrived in Bunderberg under work contracts,

539
00:38:08,719 --> 00:38:12,719
Speaker 1: but the demand for cheap labour was still unmet. The

540
00:38:12,760 --> 00:38:16,960
Speaker 1: Bunderberg and District's Historical Museum reported for the.

541
00:38:16,920 --> 00:38:21,160
Speaker 13: Next thirty years Melanesian and Polynesian islanders provided almost the

542
00:38:21,200 --> 00:38:25,440
Speaker 13: complete field labour for cane plantations and farms. At one stage,

543
00:38:25,560 --> 00:38:27,480
Speaker 13: three thousand lived in the district.

544
00:38:28,800 --> 00:38:32,319
Speaker 1: Bunderberg is famous for its rum, a product of its

545
00:38:32,360 --> 00:38:37,640
Speaker 1: sugar cane, and a record breaking aviator, Bert Hinkler. In

546
00:38:37,680 --> 00:38:41,520
Speaker 1: February nineteen twenty eight, he flew from England to Australia

547
00:38:41,600 --> 00:38:46,480
Speaker 1: in fifteen days, an extraordinary feat at the time the

548
00:38:46,520 --> 00:38:49,640
Speaker 1: son of a local mill worker. His achievement lifted the

549
00:38:49,680 --> 00:38:54,800
Speaker 1: town's spirits. The sugar cane plantations were still thriving when JR.

550
00:38:54,920 --> 00:38:58,800
Speaker 1: Patel arrived in two thousand and three, and Bunderberg still

551
00:38:58,800 --> 00:39:03,680
Speaker 1: relied heavily on imported labor, but now the most valuable

552
00:39:03,719 --> 00:39:09,719
Speaker 1: imports were overseas trained doctors. A medical workforce crisis serious

553
00:39:09,840 --> 00:39:14,080
Speaker 1: throughout Australia but dire in regional Queensland due to inferior

554
00:39:14,160 --> 00:39:18,080
Speaker 1: salaries and conditions, meant that the overseas doctors were the

555
00:39:18,120 --> 00:39:23,160
Speaker 1: backbone of the public hospital on Bourbong Street. Although the

556
00:39:23,239 --> 00:39:27,319
Speaker 1: doctors coming from third world countries were financially better off

557
00:39:27,360 --> 00:39:32,359
Speaker 1: in Australia, they were easily exploited. Their employers knew that

558
00:39:32,400 --> 00:39:35,080
Speaker 1: the foreign doctors could be forced to return to their

559
00:39:35,120 --> 00:39:39,880
Speaker 1: own countries if their working visas were not renewed. Unlike

560
00:39:39,960 --> 00:39:44,080
Speaker 1: Australian doctors who could change jobs after a dispute with management,

561
00:39:44,400 --> 00:39:49,360
Speaker 1: the overseas trained doctors were at a distinct disadvantage. It

562
00:39:49,520 --> 00:39:52,520
Speaker 1: made some of them more willing to follow orders and

563
00:39:52,680 --> 00:39:58,120
Speaker 1: less likely to ask difficult questions. J. N. Patel had

564
00:39:58,160 --> 00:40:02,400
Speaker 1: little time for Bunderberg's history and its natural attractions, the

565
00:40:02,440 --> 00:40:06,960
Speaker 1: outlying resort islands, the beaches and the largest mainland turtle

566
00:40:07,000 --> 00:40:12,960
Speaker 1: hatchery in Australia. Unlike his predecessors, doctor Charles Nankevell and

567
00:40:13,040 --> 00:40:18,120
Speaker 1: doctor Sam Baker, Patel delighted in being overburdened with surgical

568
00:40:18,200 --> 00:40:22,000
Speaker 1: work he spent most of his time at the hospital.

569
00:40:22,960 --> 00:40:26,960
Speaker 1: But whereas most of the other overseas trained doctors were submissive,

570
00:40:27,360 --> 00:40:31,640
Speaker 1: Patel displayed bravado. He worked hard, and he exerted his

571
00:40:31,760 --> 00:40:38,000
Speaker 1: influence over management. One of his confidants was Pam Samra,

572
00:40:38,640 --> 00:40:40,960
Speaker 1: whom he saw at least four times a week at

573
00:40:41,000 --> 00:40:44,840
Speaker 1: her restaurant, the Indian Curry Bazaar near the Sugarland shopping

574
00:40:44,880 --> 00:40:49,800
Speaker 1: Center in tackle Van Street. They chatted freely and often

575
00:40:49,840 --> 00:40:53,120
Speaker 1: about his career, his life in the United States, and

576
00:40:53,160 --> 00:40:57,080
Speaker 1: his efforts at the hospital. She was alarmed to hear

577
00:40:57,120 --> 00:40:59,600
Speaker 1: from him one day that he had not slept for

578
00:40:59,640 --> 00:41:04,440
Speaker 1: thirty hours because of the continuous work. She told him.

579
00:41:04,400 --> 00:41:05,919
Speaker 14: Those hours are ridiculous.

580
00:41:06,000 --> 00:41:07,040
Speaker 15: You shouldn't be doing that.

581
00:41:07,680 --> 00:41:09,120
Speaker 14: What are you working so hard for?

582
00:41:09,560 --> 00:41:10,240
Speaker 3: Take a break?

583
00:41:10,960 --> 00:41:14,360
Speaker 14: Patel replied, there are no other doctors to do the

584
00:41:14,400 --> 00:41:18,240
Speaker 14: work I've been asking for. Backup for months. Nobody listens

585
00:41:18,280 --> 00:41:20,880
Speaker 14: to me, But then I've been paid forty thousand dollars

586
00:41:20,880 --> 00:41:23,319
Speaker 14: and bonuses for getting through the waiting lists.

587
00:41:24,120 --> 00:41:27,600
Speaker 1: In truth, Patel had been arriving at the hospital before

588
00:41:27,640 --> 00:41:29,840
Speaker 1: the other doctors so that he could beat them to

589
00:41:29,920 --> 00:41:35,480
Speaker 1: the patients. He was creating work for himself. If doctor

590
00:41:35,520 --> 00:41:39,279
Speaker 1: Martin Carter arrived at seven thirty am, Patel would be

591
00:41:39,320 --> 00:41:43,440
Speaker 1: there the next day at seven am. If Carter responded

592
00:41:43,480 --> 00:41:46,719
Speaker 1: by coming in at seven am, Patel trumped him with

593
00:41:46,800 --> 00:41:51,560
Speaker 1: a six thirty am start. Carter gave up. At this rate,

594
00:41:51,640 --> 00:41:53,920
Speaker 1: he would have been lying in wait for the surgeon

595
00:41:54,080 --> 00:41:58,120
Speaker 1: and coming to work at midnight. Patel was intrigued by

596
00:41:58,120 --> 00:42:03,040
Speaker 1: the circumstances of Pam Sam and her husband Jindi. In

597
00:42:03,080 --> 00:42:06,840
Speaker 1: accordance with the custom and tradition of India's Punjab state,

598
00:42:07,400 --> 00:42:10,759
Speaker 1: their marriage was arranged despite Pam having been born and

599
00:42:10,920 --> 00:42:15,320
Speaker 1: raised in Australia. It was a happy and prosperous union.

600
00:42:16,280 --> 00:42:18,319
Speaker 1: Patel lied to the married.

601
00:42:18,000 --> 00:42:22,080
Speaker 14: Father, I have no kids, I've never been married. The

602
00:42:22,120 --> 00:42:25,080
Speaker 14: only woman in my life is my mother in India.

603
00:42:25,440 --> 00:42:27,920
Speaker 1: He told how he visited the old woman at the

604
00:42:28,000 --> 00:42:32,279
Speaker 1: ancestral home in Jamnagar as often as possible. He sent

605
00:42:32,400 --> 00:42:35,160
Speaker 1: funds to make her privileged life more comfortable.

606
00:42:35,960 --> 00:42:37,680
Speaker 3: Why doesn't she move to America.

607
00:42:38,080 --> 00:42:42,080
Speaker 1: Asked Samra, but Patel said his mother would be unhappy

608
00:42:42,120 --> 00:42:45,800
Speaker 1: in the United States, away from her friends and relatives.

609
00:42:46,360 --> 00:42:50,759
Speaker 1: Patel dressed smartly, often in a suit and tie. He

610
00:42:50,880 --> 00:42:54,719
Speaker 1: tipped generously, usually rounding a thirty five dollar bill for

611
00:42:54,800 --> 00:42:59,680
Speaker 1: his takeaway meals to fifty dollars. He ordered only vegetarian

612
00:42:59,719 --> 00:43:04,359
Speaker 1: dishes and told her he was vegetarian. Sama heard from

613
00:43:04,400 --> 00:43:08,640
Speaker 1: others though, that he ate meat elsewhere. Although he was

614
00:43:08,719 --> 00:43:14,120
Speaker 1: occasionally arrogant, Samara nevertheless enjoyed their chats. Nobody else in

615
00:43:14,200 --> 00:43:17,080
Speaker 1: the town spent as much on food at the Curry

616
00:43:17,120 --> 00:43:22,239
Speaker 1: Bazaar as doctor Patel. He was their best customer. At

617
00:43:22,320 --> 00:43:25,040
Speaker 1: least once a week after work, he would bring a

618
00:43:25,080 --> 00:43:28,880
Speaker 1: group of nurses or student doctors to the upstairs dining area.

619
00:43:29,960 --> 00:43:32,920
Speaker 1: He enjoyed the company of doctor Jim Gaffield, who had

620
00:43:32,960 --> 00:43:36,640
Speaker 1: also arrived from the United States, and the young doctor

621
00:43:36,680 --> 00:43:42,440
Speaker 1: Anthony Athanasiov, an Australian graduate. Patel usually paid for the

622
00:43:42,480 --> 00:43:46,880
Speaker 1: groups he brought to the restaurant. Pam Samra suspected that

623
00:43:46,920 --> 00:43:50,640
Speaker 1: he was lonely. She regarded him as a hopeless flirt.

624
00:43:51,000 --> 00:43:53,640
Speaker 1: He often had a hand on the lower back of

625
00:43:53,719 --> 00:43:57,799
Speaker 1: one of the nurses. Although he would make the occasional proposition,

626
00:43:58,120 --> 00:44:01,439
Speaker 1: the physical contact was never so overt that it led

627
00:44:01,480 --> 00:44:05,720
Speaker 1: to a rebuke. When he was not entertaining the medical

628
00:44:05,760 --> 00:44:08,960
Speaker 1: and nursing staff, he wanted to talk to Samra about

629
00:44:09,000 --> 00:44:12,640
Speaker 1: her life. She wondered if he was attracted to her.

630
00:44:14,040 --> 00:44:18,200
Speaker 1: Petel's two bedroom apartment in Sapphire Lodge at Bagara was

631
00:44:18,280 --> 00:44:22,160
Speaker 1: tidy but never clean. The cigarettes he chain spoke had

632
00:44:22,239 --> 00:44:26,560
Speaker 1: left a pungent smell. The bathroom and toilet were always dirty.

633
00:44:27,360 --> 00:44:31,040
Speaker 1: On one occasion, Carol Elliot, the owner's sister, went to

634
00:44:31,120 --> 00:44:33,600
Speaker 1: the apartment to do some cleaning as part of an

635
00:44:33,640 --> 00:44:39,120
Speaker 1: ongoing arrangement. The sheets needed washing. She removed Patetel's things

636
00:44:39,160 --> 00:44:42,640
Speaker 1: from the machine to do another load. He walked in

637
00:44:42,680 --> 00:44:45,640
Speaker 1: and began screaming and abusing the shocked woman in front

638
00:44:45,640 --> 00:44:50,359
Speaker 1: of her two grandchildren. Patel was enraged. His tirade could

639
00:44:50,360 --> 00:44:53,000
Speaker 1: be heard up and down Miller Street. Who took my

640
00:44:53,160 --> 00:44:55,960
Speaker 1: washing out of here? It should have been obvious to

641
00:44:56,040 --> 00:44:59,480
Speaker 1: him that Eliot had removed a few towels. You have

642
00:44:59,560 --> 00:45:01,640
Speaker 1: not business. I'm a very impottant doctor.

643
00:45:01,920 --> 00:45:03,640
Speaker 14: I'm the head doctor the best hospital.

644
00:45:03,840 --> 00:45:06,480
Speaker 16: How did you don't worry about it? You just go

645
00:45:06,600 --> 00:45:08,920
Speaker 16: to the hospital and I will make sure that towels

646
00:45:09,000 --> 00:45:10,160
Speaker 16: go on the line to dry.

647
00:45:11,080 --> 00:45:15,239
Speaker 1: The encounter had upset her grandson, Elliot was worried that

648
00:45:15,280 --> 00:45:18,240
Speaker 1: it would influence the boy's view of dark skinned people.

649
00:45:19,040 --> 00:45:21,480
Speaker 9: Why did that black man scream at you, Gran?

650
00:45:22,640 --> 00:45:25,760
Speaker 16: He's not a nice man. Not all people that color

651
00:45:25,840 --> 00:45:27,120
Speaker 16: are like him.

652
00:45:27,760 --> 00:45:31,440
Speaker 1: When Patel's wife, Kashowre, and daughter came to visit from

653
00:45:31,520 --> 00:45:35,200
Speaker 1: the US, he kept them away from the restaurant he

654
00:45:35,280 --> 00:45:39,680
Speaker 1: had told others that he was single. Elliot felt sorry

655
00:45:39,760 --> 00:45:45,440
Speaker 1: for Kishore, a medical practitioner in Portland. During a chance meeting,

656
00:45:45,480 --> 00:45:48,880
Speaker 1: Patel introduced his daughter and beamed with pride as he

657
00:45:48,960 --> 00:45:52,880
Speaker 1: praised her as the family's next doctor. She would be

658
00:45:52,960 --> 00:45:58,640
Speaker 1: graduating soon from medical school, but Patel scarcely acknowledged his wife,

659
00:45:58,920 --> 00:46:03,520
Speaker 1: the demure woman was him. Elliot walked away, wondering what

660
00:46:03,680 --> 00:46:16,160
Speaker 1: made him tick. Chapter eighteen Doctors Germs late two thousand

661
00:46:16,239 --> 00:46:21,840
Speaker 1: and three to early two thousand and four. Joanne Turner

662
00:46:21,880 --> 00:46:25,000
Speaker 1: hovered over the patients in the renal unit at Bunderberg

663
00:46:25,120 --> 00:46:28,759
Speaker 1: Hospital and waited for a tube to visibly redden a

664
00:46:28,880 --> 00:46:32,719
Speaker 1: telltale sign of blood being drawn from the internal jugular

665
00:46:33,440 --> 00:46:39,040
Speaker 1: just above the heart's right atrium. Everything looked satisfactory, the

666
00:46:39,120 --> 00:46:42,960
Speaker 1: catheters with tubes burrowing into the chest, the two patients

667
00:46:42,960 --> 00:46:48,239
Speaker 1: whose blood needed regular cleansing, the hemodialysis machine, which would

668
00:46:48,280 --> 00:46:51,920
Speaker 1: return the blood with fewer impurities and provide the patients

669
00:46:51,920 --> 00:46:56,799
Speaker 1: with a lease of life. Turner frowned. The catheters, which

670
00:46:56,800 --> 00:47:01,879
Speaker 1: had been surgically implanted by Jayan Patel, not working. They

671
00:47:01,920 --> 00:47:07,840
Speaker 1: appeared to be blocked. Effective hemodialysis with a permacath type

672
00:47:07,880 --> 00:47:11,040
Speaker 1: catheter required a blood flow rate of more than two

673
00:47:11,200 --> 00:47:15,760
Speaker 1: hundred milli liters a minute, but Turner could not obtain

674
00:47:15,840 --> 00:47:20,280
Speaker 1: a drop. Patel arrived in the renal unit within minutes

675
00:47:20,320 --> 00:47:24,279
Speaker 1: of being paged. When Turner explained the difficulty that she

676
00:47:24,440 --> 00:47:26,960
Speaker 1: was experiencing, the surgeon.

677
00:47:26,800 --> 00:47:30,520
Speaker 14: Erupted, flush it, sister, just get in there and flush it.

678
00:47:31,440 --> 00:47:36,080
Speaker 1: Turner was immediately uneasy. She knew it was unsafe to

679
00:47:36,120 --> 00:47:39,759
Speaker 1: flush the catheter until the removal of the heperin lock.

680
00:47:40,280 --> 00:47:44,680
Speaker 1: A dose of an anticoagulant drug called heperin, which stops

681
00:47:44,719 --> 00:47:47,960
Speaker 1: blood from clotting at the end of the catheter. A

682
00:47:48,000 --> 00:47:51,640
Speaker 1: low pressure injection of saline from a syringe is used

683
00:47:51,640 --> 00:47:55,040
Speaker 1: to flush a catheter, but only after the removal of

684
00:47:55,080 --> 00:48:01,399
Speaker 1: the hepperin lock. She had set up two sters, one

685
00:48:01,480 --> 00:48:05,759
Speaker 1: for each patient. Patel had neither washed his hands nor

686
00:48:05,800 --> 00:48:08,680
Speaker 1: put on sterile gloves. When he took the bung from

687
00:48:08,680 --> 00:48:11,480
Speaker 1: the end of the catheter connected to the first patient,

688
00:48:12,560 --> 00:48:16,040
Speaker 1: He picked up the sterile syringe and tried, unsuccessfully to

689
00:48:16,080 --> 00:48:20,279
Speaker 1: take blood from the line. To Turner's alarm, he then

690
00:48:20,400 --> 00:48:24,560
Speaker 1: moved with the same syringe to the other patient. Turner

691
00:48:24,640 --> 00:48:29,400
Speaker 1: had never seen anything like it. Strict infection control measures

692
00:48:29,400 --> 00:48:32,560
Speaker 1: in hospitals were critical in the renal unit, where the

693
00:48:32,640 --> 00:48:37,839
Speaker 1: chronic disease suppressed the patient's immune systems. The catheters were

694
00:48:37,960 --> 00:48:44,480
Speaker 1: perfect conduits for blood. They were also perfect conduits for bacteria.

695
00:48:44,600 --> 00:48:47,759
Speaker 1: Pointing to the other sterile tray, she said.

696
00:48:48,280 --> 00:48:49,600
Speaker 15: This is the patient's set up.

697
00:48:50,480 --> 00:48:53,880
Speaker 1: But how did you tactfully tell the director of surgery

698
00:48:53,960 --> 00:48:56,960
Speaker 1: that his modus operandi was wrong and might be lethal.

699
00:48:57,760 --> 00:49:01,480
Speaker 1: Turner did her best. Aren't you going to wash your hands?

700
00:49:02,600 --> 00:49:06,360
Speaker 1: She urged him to put on the sterile gloves, sister,

701
00:49:06,480 --> 00:49:10,120
Speaker 1: I don't have jumps. She thought at first that he

702
00:49:10,280 --> 00:49:14,919
Speaker 1: was joking. Nobody would seriously believe such a comment, least

703
00:49:14,920 --> 00:49:19,880
Speaker 1: of all a doctor, But Peatell neither smiled nor corrected himself.

704
00:49:20,800 --> 00:49:22,160
Speaker 14: I'm doing you a fever.

705
00:49:23,640 --> 00:49:26,520
Speaker 1: The look on his face told Turner that he was

706
00:49:26,680 --> 00:49:31,160
Speaker 1: annoyed at her attempts to insist on the gloves. He

707
00:49:31,200 --> 00:49:34,800
Speaker 1: performed the procedure on the second patient with his bare hands.

708
00:49:36,320 --> 00:49:40,400
Speaker 1: Linette Yeoman, one of the other nurses working the early shift,

709
00:49:40,560 --> 00:49:45,279
Speaker 1: watched dumbfounded. She wondered how someone with so much experience

710
00:49:45,320 --> 00:49:48,360
Speaker 1: could fail to appreciate the serious risk he pose to

711
00:49:48,400 --> 00:49:53,719
Speaker 1: the ill patients. A third nurse, Caroline Waters, walked off

712
00:49:53,760 --> 00:49:59,640
Speaker 1: in disgust. At the end of the shift, the nurses

713
00:49:59,680 --> 00:50:04,000
Speaker 1: spoke to their manager, Robin Pollock. When Patel first arrived

714
00:50:04,040 --> 00:50:06,120
Speaker 1: at the hospital, he had little to do with the

715
00:50:06,160 --> 00:50:10,440
Speaker 1: renal unit, but this had changed when he started inserting

716
00:50:10,520 --> 00:50:15,600
Speaker 1: catheters in August. During his regular stops in Pollock's office,

717
00:50:15,680 --> 00:50:19,680
Speaker 1: he invariably turned the conversation from the patients to her

718
00:50:19,719 --> 00:50:24,480
Speaker 1: personal life. The visits were usually uncomfortable for Pollock. She

719
00:50:24,640 --> 00:50:27,680
Speaker 1: asked her staff to telephone if Patel stayed in her

720
00:50:27,719 --> 00:50:31,400
Speaker 1: office more than a few minutes, the RUSS usually worked.

721
00:50:32,600 --> 00:50:36,839
Speaker 1: Pollock had another reason to feel uncomfortable. She had been

722
00:50:36,880 --> 00:50:41,760
Speaker 1: concerned for some weeks about complications with catheters implanted by Patel.

723
00:50:42,920 --> 00:50:47,560
Speaker 1: Four patients had had peritoneal dialysis catheters placed by Patel,

724
00:50:48,000 --> 00:50:51,759
Speaker 1: one in August, two in September, and one in October,

725
00:50:52,160 --> 00:50:57,440
Speaker 1: and each had suffered unnecessarily. In three of the patients,

726
00:50:57,560 --> 00:51:02,560
Speaker 1: there were chronic infections at the exitsites. The fourth patient,

727
00:51:02,800 --> 00:51:07,680
Speaker 1: whose catheter did not drain or flow properly, needed surgical intervention.

728
00:51:08,719 --> 00:51:11,880
Speaker 1: Some of the catheters had moved internally and ended up

729
00:51:11,920 --> 00:51:16,000
Speaker 1: in the wrong position. After the nurses explained the events

730
00:51:16,040 --> 00:51:19,480
Speaker 1: of the morning and Patel's handling of the patients, Pollock

731
00:51:19,719 --> 00:51:24,200
Speaker 1: was aghast, fearing that a patient might die. She raised

732
00:51:24,239 --> 00:51:30,240
Speaker 1: the issues with Gail Alma, the nurse responsible for infection control. Alma,

733
00:51:30,440 --> 00:51:33,960
Speaker 1: who had previously tried to tackle the wound Dahesion's problems,

734
00:51:34,200 --> 00:51:37,600
Speaker 1: arranged the meeting with doctor Darren Keating two days later.

735
00:51:38,760 --> 00:51:43,120
Speaker 1: Lindsey Druce was also worried. The clinical nurse had returned

736
00:51:43,160 --> 00:51:46,360
Speaker 1: from maternity leave to find a rash of problems in

737
00:51:46,440 --> 00:51:50,040
Speaker 1: the renal unit, it seemed to dreuce that many of

738
00:51:50,080 --> 00:51:53,319
Speaker 1: the problems were due to Patel's positioning of the catheters.

739
00:51:54,200 --> 00:51:58,799
Speaker 1: Every one was either facing up or sideways. This meant

740
00:51:58,840 --> 00:52:01,680
Speaker 1: that when the patients sh hour and moved around, it

741
00:52:01,880 --> 00:52:06,040
Speaker 1: was inevitable that fluids and grit would collect in the catheters.

742
00:52:07,360 --> 00:52:10,600
Speaker 1: As the fluids and debris could not drain or fall

743
00:52:10,680 --> 00:52:13,920
Speaker 1: away from the exit site, the risks of infection from

744
00:52:14,040 --> 00:52:20,000
Speaker 1: organisms thriving in the moist warm environment soared. When Aylmer

745
00:52:20,120 --> 00:52:23,759
Speaker 1: and Pollock went to see Darren Keating on twenty seven November,

746
00:52:23,960 --> 00:52:29,880
Speaker 1: he wanted facts and figures, not anecdotal feedback. They repeated

747
00:52:29,920 --> 00:52:35,200
Speaker 1: Patel's bizarre comment about not having germs. Keating asked how

748
00:52:35,200 --> 00:52:39,360
Speaker 1: often infections were occurring and how many cases involved Patel.

749
00:52:40,800 --> 00:52:43,160
Speaker 15: You know, if I really need to go further with this,

750
00:52:43,560 --> 00:52:45,560
Speaker 15: I need data to support what you're saying.

751
00:52:47,040 --> 00:52:50,360
Speaker 1: When he spoke to Patel after the meeting with the nurses,

752
00:52:50,480 --> 00:52:55,000
Speaker 1: the surgeon was affronted. He denied that there had been problems.

753
00:52:55,440 --> 00:52:59,240
Speaker 1: He told Keating the nurses were wrong, and he stopped coming.

754
00:52:59,280 --> 00:53:04,080
Speaker 1: By Pollock as far as Keating was concerned the work

755
00:53:04,080 --> 00:53:07,560
Speaker 1: ethic of Patel and the great strides he was already

756
00:53:07,640 --> 00:53:12,200
Speaker 1: making and reducing the waiting list for surgery made him indispensable,

757
00:53:13,680 --> 00:53:17,359
Speaker 1: despite the growing concerns of the staff who had been too.

758
00:53:17,440 --> 00:53:21,480
Speaker 1: Keating he lauded Patel in a two December two thousand

759
00:53:21,520 --> 00:53:22,840
Speaker 1: and three performance report.

760
00:53:23,840 --> 00:53:28,480
Speaker 15: Doctor Patel effectively utilizes his broad knowledge, skill and experience

761
00:53:28,560 --> 00:53:32,240
Speaker 15: in general surgery to provide high quality of patient care.

762
00:53:32,760 --> 00:53:35,959
Speaker 15: He is a willing and enthusiastic leader. He also brings

763
00:53:36,040 --> 00:53:39,920
Speaker 15: understanding of clinical management subjects to appropriate forums.

764
00:53:41,520 --> 00:53:45,879
Speaker 1: Keating chose the heading performance better than expected to give

765
00:53:45,880 --> 00:53:49,880
Speaker 1: Patel a tick in nine out of eleven areas, including

766
00:53:49,920 --> 00:53:57,600
Speaker 1: his clinical skills, knowledge base, judgment, communication, teamwork, and professional responsibility.

767
00:53:59,080 --> 00:54:02,400
Speaker 1: After just a months in the job, Patel had his

768
00:54:02,520 --> 00:54:07,480
Speaker 1: boss wrapped around his little finger. But doctor Peter Meak,

769
00:54:07,840 --> 00:54:11,240
Speaker 1: the nephrologist in charge of the renal unit, was rapidly

770
00:54:11,280 --> 00:54:15,400
Speaker 1: losing confidence in Patel by late two thousand and three.

771
00:54:15,480 --> 00:54:20,439
Speaker 1: The catheter problems, coupled with several other factors. Petel's insistence

772
00:54:20,480 --> 00:54:24,520
Speaker 1: that he could perform any procedure and the almost inevitable

773
00:54:24,520 --> 00:54:30,200
Speaker 1: complications had made Peter Miak increasingly weary. Some of Patel's

774
00:54:30,239 --> 00:54:35,719
Speaker 1: procedures were just cruel. When Philip Knopp, a patient suffering

775
00:54:35,800 --> 00:54:39,240
Speaker 1: kidney failure, needed an operation in August to draw fluid

776
00:54:39,280 --> 00:54:42,919
Speaker 1: away from his heart, it was decided that Patel would

777
00:54:42,920 --> 00:54:47,200
Speaker 1: do a pery cardial window, a procedure that involved cutting

778
00:54:47,239 --> 00:54:51,480
Speaker 1: a hole in the chest to insert a drain. The

779
00:54:51,520 --> 00:54:55,160
Speaker 1: buildup of fluid threatened to squeeze Knop's heart and cause

780
00:54:55,200 --> 00:54:59,200
Speaker 1: it to fail. Although a fine needle had been used

781
00:54:59,239 --> 00:55:02,400
Speaker 1: to draw the blood he fluid from the Perry cardial sack.

782
00:55:03,120 --> 00:55:05,880
Speaker 1: Miak realized that it would take the removal of a

783
00:55:05,920 --> 00:55:09,160
Speaker 1: little bit of the Perry cardian to eradicate the problem.

784
00:55:10,200 --> 00:55:13,680
Speaker 1: Meac hardly ever went to theater, but he decided to

785
00:55:13,719 --> 00:55:20,120
Speaker 1: watch Patel's handiwork on Knop. Meac winced Knop was screaming

786
00:55:20,200 --> 00:55:25,560
Speaker 1: and moaning and clearly felt excruciating pain. Dr Patel had

787
00:55:25,560 --> 00:55:30,759
Speaker 1: elected to do the invasive operation without anesthetic, contrary to

788
00:55:30,840 --> 00:55:35,960
Speaker 1: normal practice. When Peter Meak tried to transfer his patient

789
00:55:36,160 --> 00:55:39,960
Speaker 1: south away from Patel for the catheter procedures, he was

790
00:55:40,000 --> 00:55:43,239
Speaker 1: told by a doctor at the Royal Brisbane Hospital, we

791
00:55:43,320 --> 00:55:45,400
Speaker 1: are not going to do it. Here. We don't have

792
00:55:45,520 --> 00:55:49,959
Speaker 1: the time, we don't have the capacity. He asked doctor

793
00:55:50,040 --> 00:55:53,279
Speaker 1: Jim Gaffield, the plastic surgeon who had arrived from the

794
00:55:53,360 --> 00:55:55,880
Speaker 1: United States soon after Patel, for help.

795
00:55:56,880 --> 00:55:59,719
Speaker 15: Look, this is not the sort of thing I'm used to.

796
00:56:00,320 --> 00:56:04,560
Speaker 1: I prefer not to do them. Robin Pollock had another idea.

797
00:56:05,200 --> 00:56:08,000
Speaker 1: She reached out to Brian Graham, who worked for a

798
00:56:08,040 --> 00:56:11,759
Speaker 1: company with a contract to supply renal products to the hospitals.

799
00:56:12,640 --> 00:56:17,280
Speaker 1: The company, backs To Healthcare, was offering programs to train staff.

800
00:56:18,360 --> 00:56:21,600
Speaker 1: Pollock had told Graham about the run of complications with

801
00:56:21,719 --> 00:56:26,880
Speaker 1: catheters implanted on Petel's patients. She knew Patel was not

802
00:56:27,080 --> 00:56:31,320
Speaker 1: interested in hearing from the nurses. Perhaps he would respond, though,

803
00:56:31,360 --> 00:56:35,040
Speaker 1: to an offer from Graham to provide support or education

804
00:56:35,440 --> 00:56:39,760
Speaker 1: on placement technique. Brian Graham met Patel in the renal

805
00:56:39,880 --> 00:56:41,600
Speaker 1: unit and explained the program.

806
00:56:42,320 --> 00:56:45,680
Speaker 14: Patel pounced, well, you can fly me to Brisbane, you

807
00:56:45,719 --> 00:56:47,960
Speaker 14: can mine and din me. You can put me up

808
00:56:47,960 --> 00:56:50,400
Speaker 14: somewhere nice, and then I might listen to what you

809
00:56:50,480 --> 00:56:51,560
Speaker 14: have to say.

810
00:56:52,080 --> 00:56:56,359
Speaker 1: Graham decided that Dr Patel was a lost cause. On

811
00:56:56,440 --> 00:57:00,160
Speaker 1: sixteen December, Eric Nagel returned to the hospital for surgery

812
00:57:00,200 --> 00:57:03,560
Speaker 1: to correct a catheter placement that Patel had bungled when

813
00:57:03,640 --> 00:57:07,640
Speaker 1: inserting it the previous month because it had not been

814
00:57:07,719 --> 00:57:11,880
Speaker 1: tunneled correctly. During the first operation, the catheter was facing

815
00:57:12,040 --> 00:57:17,160
Speaker 1: sideways instead of downwards. Internally, it had flipped up under

816
00:57:17,240 --> 00:57:21,120
Speaker 1: Nagel's liver. An X ray showed the internal part of

817
00:57:21,160 --> 00:57:26,560
Speaker 1: the catheter had migrated, resulting in impeter drainage. For the

818
00:57:26,640 --> 00:57:30,880
Speaker 1: much needed hemodialysis to work, Nagel's old catheter needed to

819
00:57:30,880 --> 00:57:34,720
Speaker 1: be removed and replaced with a new one. Nagel and

820
00:57:34,800 --> 00:57:38,360
Speaker 1: his wife Linda were reassured on the eve of surgery.

821
00:57:39,280 --> 00:57:42,600
Speaker 1: They believed that it would be a routine procedure conducted

822
00:57:42,720 --> 00:57:46,919
Speaker 1: under a general anesthetic in the operating theater. They knew

823
00:57:47,000 --> 00:57:51,280
Speaker 1: nothing of the nurse's concerns over doctor Patel, nor did

824
00:57:51,280 --> 00:57:56,720
Speaker 1: they know about doctor Peter Meak's misgivings. Lindsey Dreus watched

825
00:57:56,800 --> 00:58:00,480
Speaker 1: Nagel being wheeled off the theater. It was the last

826
00:58:00,480 --> 00:58:05,160
Speaker 1: time she saw him. A guidewire used by doctor Patel

827
00:58:05,280 --> 00:58:07,960
Speaker 1: poked a hole through the main blood vessel going to

828
00:58:08,040 --> 00:58:13,400
Speaker 1: Nagle's heart. The bleeding took place inside his perry cardial sack.

829
00:58:14,640 --> 00:58:19,440
Speaker 1: Nagel's blood pressure dropped suddenly. As Patel and doctor Martin

830
00:58:19,600 --> 00:58:23,920
Speaker 1: Carter the top anesetis tried frantically to rectify the situation,

831
00:58:25,240 --> 00:58:30,040
Speaker 1: Nagle suffered a heart attack, his thoracic vein was punctured.

832
00:58:30,520 --> 00:58:34,280
Speaker 1: He bled to death. None of the distraught nurses in

833
00:58:34,360 --> 00:58:38,080
Speaker 1: the renal unit could recall anyone else ever dying during

834
00:58:38,120 --> 00:58:43,200
Speaker 1: the placement of a catheter. When Nagle's widow returned days

835
00:58:43,280 --> 00:58:47,320
Speaker 1: later for an explanation anything that might help her understand

836
00:58:47,360 --> 00:58:51,920
Speaker 1: why a supposedly routine procedure had killed her husband, the

837
00:58:52,040 --> 00:58:56,600
Speaker 1: nurses were at a loss. For Peter Miak, it was

838
00:58:56,680 --> 00:59:00,480
Speaker 1: the last straw. He decided that Patel would not perform

839
00:59:00,680 --> 00:59:03,880
Speaker 1: any more catheter operations on his patients.

840
00:59:05,040 --> 00:59:07,200
Speaker 3: If I have to send them to Brisbane, so be it.

841
00:59:08,760 --> 00:59:12,960
Speaker 1: Before going on extended leave in January, Peter Meak told

842
00:59:13,040 --> 00:59:15,920
Speaker 1: a replacement nephrologist, doctor Martin.

843
00:59:15,680 --> 00:59:19,440
Speaker 3: Knapp, keep doctor Patel away from the renal patients.

844
00:59:20,840 --> 00:59:26,040
Speaker 1: Drews completed her report on complications from catheter placements. It

845
00:59:26,160 --> 00:59:29,240
Speaker 1: showed that Battell had a one hundred percent failure rate

846
00:59:30,080 --> 00:59:35,360
Speaker 1: six catheter placements and multiple complications. All of the patients

847
00:59:35,400 --> 00:59:42,520
Speaker 1: were adversely affected. One was dead. With Peter Miak overseas

848
00:59:42,920 --> 00:59:47,720
Speaker 1: and Brisbane refusing to receive Bunderberg's patients, Pollock became desperate.

849
00:59:49,000 --> 00:59:53,480
Speaker 1: She had seen yet another complication arising from Patel's handiwork.

850
00:59:54,440 --> 00:59:58,280
Speaker 1: She and Druce went to see Patrick Martin, the acting

851
00:59:58,320 --> 01:00:01,960
Speaker 1: director of nursing, to explain the problems, the directive from

852
01:00:02,040 --> 01:00:07,560
Speaker 1: Meak and the uncertain future for patients needing catheters. Patrick

853
01:00:07,640 --> 01:00:12,240
Speaker 1: Martin had little time for doctor Patel. There was something amiss,

854
01:00:12,760 --> 01:00:18,320
Speaker 1: something about the surgeon's personality that made Martin wary. He

855
01:00:18,360 --> 01:00:23,200
Speaker 1: took the nurse's concerns to Darren Keating, but Keating said.

856
01:00:23,440 --> 01:00:25,400
Speaker 15: If the nurses want to play with the big boys,

857
01:00:25,440 --> 01:00:27,800
Speaker 15: then they need to provide the evidence and bring it on.

858
01:00:29,200 --> 01:00:33,400
Speaker 1: Eventually, Pollock, Druce, and Peter Meak found a way to

859
01:00:33,480 --> 01:00:37,600
Speaker 1: bypass Patel. The patients from the renal unit who needed

860
01:00:37,640 --> 01:00:41,880
Speaker 1: catheter placements would go to a nearby private hospital where

861
01:00:41,920 --> 01:00:46,440
Speaker 1: another surgeon performed the operations. There were no more problems,

862
01:00:46,960 --> 01:00:50,800
Speaker 1: but even this highly unusual arrangement did not result in

863
01:00:50,880 --> 01:00:55,280
Speaker 1: the surgeon's clinical expertise being reviewed or questioned by management.

864
01:00:57,120 --> 01:01:00,680
Speaker 1: Tony Hoffman went to see Bunderberg Hospital DiscT Trick manager

865
01:01:00,720 --> 01:01:03,680
Speaker 1: Peter Leck at the end of February two thousand and

866
01:01:03,800 --> 01:01:07,480
Speaker 1: four to tell him about the concerns over Patel.

867
01:01:07,880 --> 01:01:09,520
Speaker 17: I just want to make you aware.

868
01:01:10,960 --> 01:01:15,120
Speaker 1: She gave Leck a document headed Intensive Care Unit issues

869
01:01:15,160 --> 01:01:20,760
Speaker 1: with ventilated patients. The document dealt with the worries about esophagectomies,

870
01:01:21,280 --> 01:01:24,720
Speaker 1: the refusal of Patel to transfer his patients to larger

871
01:01:24,960 --> 01:01:28,439
Speaker 1: and better equipped hospitals, and the compromising of their care.

872
01:01:29,480 --> 01:01:31,800
Speaker 1: In the document, Hoffman warned.

873
01:01:32,120 --> 01:01:35,720
Speaker 17: On several occasions when Dr Petell's patients have been in

874
01:01:35,760 --> 01:01:40,480
Speaker 17: the ICU, he has refused to transfer his patient to Brisbane,

875
01:01:40,960 --> 01:01:44,040
Speaker 17: even when the patients have deteriorated and have been in

876
01:01:44,320 --> 01:01:48,080
Speaker 17: ICU for much longer than twenty four to forty eight hours.

877
01:01:48,360 --> 01:01:52,600
Speaker 17: Dodor Pitateell has repeatedly threatened to resign, not put any

878
01:01:52,640 --> 01:01:56,160
Speaker 17: elective surgery in ICU, and go straight to Peter Leck.

879
01:01:57,400 --> 01:02:01,480
Speaker 1: Tony Hoffman added that doctor Pittel bow that his efforts

880
01:02:01,520 --> 01:02:05,160
Speaker 1: so far had earned half a million dollars for the hospital.

881
01:02:05,800 --> 01:02:09,280
Speaker 1: Keating was short tempered when Peter Leck asked him about

882
01:02:09,320 --> 01:02:09,920
Speaker 1: the issues.

883
01:02:10,840 --> 01:02:13,400
Speaker 15: If this keeps going, Dr Patel will leave.

884
01:02:14,880 --> 01:02:18,480
Speaker 1: Peter Leck, who mislaid his copy of the document a

885
01:02:18,520 --> 01:02:21,720
Speaker 1: short time later, told Hoffman that if she wanted to

886
01:02:21,760 --> 01:02:24,240
Speaker 1: do something about it, she would need to come and

887
01:02:24,280 --> 01:02:27,760
Speaker 1: see him, lodge a formal complaint, and let the matter

888
01:02:27,840 --> 01:02:33,000
Speaker 1: be progressed through official channels. Hoffman asked Peter Leck not

889
01:02:33,080 --> 01:02:37,320
Speaker 1: to do anything about Patel just yet. She wanted another

890
01:02:37,440 --> 01:02:41,320
Speaker 1: chance to resolve it with doctor Martin Carter's help. The

891
01:02:41,360 --> 01:02:45,640
Speaker 1: hospital administrators had become not just highly dependent on Patel,

892
01:02:46,200 --> 01:02:50,520
Speaker 1: they were also saving money. Keating had encouraged him to

893
01:02:50,560 --> 01:02:54,440
Speaker 1: apply for a half time position as an associate professor

894
01:02:54,560 --> 01:02:58,760
Speaker 1: in surgery at the University of Queensland School of Medicine.

895
01:02:59,800 --> 01:03:05,560
Speaker 1: The criteria called for demonstrated expert knowledge and clinical experience

896
01:03:05,720 --> 01:03:10,920
Speaker 1: in one or more of the surgical disciplines. When Keating

897
01:03:11,080 --> 01:03:14,400
Speaker 1: sat on the three person selection panel with a physician,

898
01:03:14,800 --> 01:03:18,960
Speaker 1: doctor lou Davies, and a senior lecturer in surgery, doctor

899
01:03:19,000 --> 01:03:24,080
Speaker 1: Peter Bore, the decision was unanimous. In late two thousand

900
01:03:24,080 --> 01:03:27,520
Speaker 1: and three, Patel was appointed and given the authority to

901
01:03:27,600 --> 01:03:32,000
Speaker 1: teach full time students. His salary and other benefits from

902
01:03:32,040 --> 01:03:34,720
Speaker 1: this role of more than eighty thousand dollars a year

903
01:03:34,840 --> 01:03:39,880
Speaker 1: were remitted to the coffers of Bunderberg Hospital. Darren Keating

904
01:03:40,000 --> 01:03:44,400
Speaker 1: and Peter Leck congratulated themselves on their business and management

905
01:03:44,400 --> 01:03:59,000
Speaker 1: acumen the hospital was humming. Sick to Death is written

906
01:03:59,120 --> 01:04:04,360
Speaker 1: and presented by me Headley Thomas, the Australian's national Chief correspondent.

907
01:04:04,960 --> 01:04:10,280
Speaker 1: Claire Harvey is The Australian's editorial director. Audio editing, production

908
01:04:10,720 --> 01:04:14,560
Speaker 1: and music have been done by Jasper Leik with assistance

909
01:04:14,640 --> 01:04:20,120
Speaker 1: from Leah Sammaglu and Neil Sutherland. Our producer is Christain Amias.

910
01:04:20,400 --> 01:04:27,040
Speaker 1: Production management by Stephanie Coombs. Artwork by Sean Callanan. Thanks

911
01:04:27,080 --> 01:04:32,960
Speaker 1: to Ryan Osland, Matthew Condon, Karina Berger, Ellie Dudley, David Murray,

912
01:04:33,320 --> 01:04:38,720
Speaker 1: Dominique McDermott, Zach Sculander and all our family, friends and

913
01:04:38,920 --> 01:04:42,960
Speaker 1: colleagues who helped in this series and contributed voice acting

914
01:04:43,440 --> 01:04:49,400
Speaker 1: and special thanks to Tony Hoffman and Rob Messenger. Subscribers

915
01:04:49,440 --> 01:04:53,240
Speaker 1: to The Australian here new episodes of Sick to Death

916
01:04:53,600 --> 01:04:57,880
Speaker 1: first at Sick to Death podcast dot com and on

917
01:04:58,160 --> 01:05:03,800
Speaker 1: Apple Podcasts. You can get exclusive access to photographs, videos,

918
01:05:04,040 --> 01:05:24,160
Speaker 1: timelines and more at the website