WEBVTT - Episode 4: Doctor’s Germs 0:00:04.400 --> 0:00:08.240 My name is Headley Thomas. Sick to Death is based 0:00:08.240 --> 0:00:10.480 on my book of the same name, and it's the 0:00:10.560 --> 0:00:15.040 true story of doctor Jayant Patel's lies and manipulation and 0:00:15.080 --> 0:00:19.000 the herculean effort it took to finally stop him. We've 0:00:19.079 --> 0:00:23.239 used voice actors throughout this series, and on occasion the 0:00:23.360 --> 0:00:26.640 real people from the story have read their words for us. 0:00:27.800 --> 0:00:30.560 It is brought to you by me and the Australian 0:00:42.240 --> 0:00:50.080 Chapter fifteen Fortuitous. We had just switched off the lights 0:00:50.120 --> 0:00:52.559 and settled into bed when the house shook with a 0:00:52.640 --> 0:01:00.360 series of bangs. It was ten thirty pm on twenty 0:01:00.360 --> 0:01:05.440 three October two thousand and two. Outside the dust from 0:01:05.440 --> 0:01:09.600 an eerie freak storm swirled across the city of Brisbane, 0:01:09.800 --> 0:01:13.920 but in our bedroom, tiny splinters of glass sprayed our hair, 0:01:14.360 --> 0:01:19.520 faces and the bed sheets. Our daughter, Sarah, they'n eighteen 0:01:19.560 --> 0:01:23.720 months old, awoke screaming. One of four zero point four 0:01:23.760 --> 0:01:27.199 to five caliber bullets had exploded through the bedroom window 0:01:27.360 --> 0:01:32.480 thirty centimeters above our heads. It continued through the bathroom wall, 0:01:32.800 --> 0:01:38.240 shattering plaster tiles and a mirror. Another bullet ripped into 0:01:38.240 --> 0:01:40.480 the toy room, close to the eye level of my 0:01:40.680 --> 0:01:45.080 son Alexander. Then three another ricocheted off the top of 0:01:45.160 --> 0:01:48.440 the car port. The path of the fourth bullet was 0:01:48.560 --> 0:01:53.840 never established. It took several minutes to comprehend what had happened. 0:01:54.360 --> 0:01:58.000 Our neighbors Chris and Louise, had seen a car spating off. 0:01:59.240 --> 0:02:02.400 I asked, tree had fallen on the house in the storm. 0:02:03.680 --> 0:02:08.600 No Headley, you've been shot at. I ran back upstairs 0:02:08.600 --> 0:02:13.040 and called Triple O. Our sanctuary in a quiet street 0:02:13.120 --> 0:02:16.000 in a semi rule enclave on the western outskirts of 0:02:16.000 --> 0:02:21.000 Brisbane was soon full of police dogs and ballistics experts, 0:02:21.040 --> 0:02:25.040 and then the media came. We wrapped up the children, 0:02:25.160 --> 0:02:30.160 packed overnight bags and left. A shooting at an investigative 0:02:30.200 --> 0:02:35.639 journalist's home was, according to the media commentators, unprecedented in Australia. 0:02:36.880 --> 0:02:40.160 Police narrowed a long list of suspects down to those 0:02:40.200 --> 0:02:43.160 with a definite motive, arising from a number of stories 0:02:43.200 --> 0:02:47.120 I had written in the Courier Mail exposing various scams. 0:02:48.280 --> 0:02:52.480 For three weeks we remained in Tasmania, touring, talking about 0:02:52.480 --> 0:02:55.639 our future and trying to be rational about suspicious looking 0:02:55.680 --> 0:02:58.840 people who drove too close to our higher car or 0:02:58.880 --> 0:03:02.200 looked at us strangely in the streets of Hobart, Lonceston 0:03:02.520 --> 0:03:08.200 and Strawn. I considered quitting journalism. We could grow vegetables 0:03:08.240 --> 0:03:12.000 instead in a mountain village behind the Sunshine Coast, or 0:03:12.080 --> 0:03:14.840 take up a safe pr type job in a distant 0:03:14.880 --> 0:03:18.920 corner of Rupert Murdoch's news corporation, perhaps in London or 0:03:19.000 --> 0:03:23.680 New York. We were grateful for the compassion of John Hartigan, 0:03:23.800 --> 0:03:27.799 the company's Sydney Bay CEO, and Lachlan Murdoch, rupert son, 0:03:28.240 --> 0:03:30.680 both of whom pledged support when it seemed I was 0:03:30.720 --> 0:03:34.640 losing my way. Ruth and I were appalled at the 0:03:34.639 --> 0:03:37.280 cowardly act of the shooting, and I became angry with 0:03:37.360 --> 0:03:42.320 people who seemed oblivious to our pain. Days after the shooting, 0:03:42.480 --> 0:03:45.720 strangers emailed and telephone to urge me to step up 0:03:45.760 --> 0:03:49.040 my work, to look at their particular issues to solve 0:03:49.160 --> 0:03:54.480 their problems. The level of self interest disgusted me. Let 0:03:54.480 --> 0:03:57.800 them put themselves and their families in the line of fire. 0:04:01.240 --> 0:04:04.480 Until that point, my career had been charmed. At the 0:04:04.480 --> 0:04:06.920 age of twenty two, I had worked in the company's 0:04:06.960 --> 0:04:11.200 London office while my friends went backpacking on shoe string 0:04:11.280 --> 0:04:13.840 budgets I was paid to travel through Europe and the 0:04:13.840 --> 0:04:17.279 Middle East, reporting momentous events including the fall of the 0:04:17.320 --> 0:04:21.480 Berlin Wall, the violent revolution in Romania, and the First 0:04:21.520 --> 0:04:27.200 Golf War. I had covered epic sporting contests Wimbledon, the 0:04:27.240 --> 0:04:31.400 British Open, Golf, the French Open, and Silly's squabbles within 0:04:31.440 --> 0:04:35.840 the royal family. The London assignment was followed by six 0:04:35.960 --> 0:04:39.840 years in Hong Kong. In nineteen ninety nine, after witnessing 0:04:39.880 --> 0:04:43.039 the handover of the British Colony to China, Ruth and 0:04:43.080 --> 0:04:46.640 I had returned to Australia with our baby boy. We 0:04:46.680 --> 0:04:50.520 started raising a family in Queensland. In the three years 0:04:50.520 --> 0:04:53.880 before October two thousand and two, I had been toiling 0:04:53.920 --> 0:04:58.480 as an investigative journalist at the Courier Mail property scams, 0:04:58.600 --> 0:05:03.520 crooked lawyers, venal politicians and dangerous doctors. They were all 0:05:03.720 --> 0:05:08.000 grissed for the mill. Some of these stories had made 0:05:08.040 --> 0:05:12.279 a difference, but after the shooting, I doubted I would 0:05:12.320 --> 0:05:16.480 care as much again about any of it. Journalism had 0:05:16.520 --> 0:05:20.680 put my wife and children in peril. After much soul 0:05:20.800 --> 0:05:24.919 searching and counseling, we decided to stay in Brisbane. We 0:05:25.040 --> 0:05:28.839 decided to stay in journalism. We would have lost more, 0:05:29.120 --> 0:05:33.200 we reasoned by giving up our home and profession. I 0:05:33.279 --> 0:05:36.719 returned to reporting, but I dreaded the constant reminders of 0:05:36.720 --> 0:05:40.200 our trauma. Did they ever catch the bastard who shot 0:05:40.279 --> 0:05:45.039 up your house? Although those who asked were well intentioned, 0:05:45.360 --> 0:05:49.600 the question aggravated us all the same. It forced us 0:05:49.640 --> 0:05:52.400 to relive something that we did not want to revisit, 0:05:52.520 --> 0:05:56.920 and to mumble clumsily a reply to the contacts, acquaintances 0:05:57.200 --> 0:06:00.159 and sticky beaks who believed they had a right to 0:06:00.160 --> 0:06:04.279 discuss it. The question forced me to fight the tears 0:06:04.360 --> 0:06:07.640 welling in my eyes. It forced both of us to 0:06:07.680 --> 0:06:11.480 face reality that the police had got next to nowhere, 0:06:11.520 --> 0:06:15.719 despite a heavily promoted investigation and the personal overseeing of 0:06:15.760 --> 0:06:20.920 the Police Commissioner Bob Atkinson. Almost a year after the shooting, 0:06:21.480 --> 0:06:25.040 the Courier Males editor David Fagan asked me to start 0:06:25.120 --> 0:06:28.920 working on a major project, an investigation and series of 0:06:29.040 --> 0:06:33.479 articles about health and the public hospital system. As he 0:06:33.560 --> 0:06:37.000 briefed me on the project, I privately weighed the risk 0:06:37.080 --> 0:06:42.560 of reprisals low. The assignment was actually a lucky break 0:06:43.400 --> 0:06:47.760 in Brisbane in the exquisitely appointed lestrange terrorists office of 0:06:47.839 --> 0:06:51.320 doctor Ingrid Tall, the new head of the Australian Medical 0:06:51.320 --> 0:06:57.400 Association's Queensland branch. I explained the potential angles Ingrid Tall 0:06:57.560 --> 0:07:01.760 held ambitions to be a Liberal Party petitian. Her role 0:07:01.880 --> 0:07:04.600 in the Northern branch of one of Australia's most powerful 0:07:04.640 --> 0:07:08.880 trade unions was a stepping stone. I used the meeting 0:07:08.920 --> 0:07:11.720 with Tall to stress the seriousness of the articles on 0:07:11.840 --> 0:07:16.160 health I was preparing. The major series I planned would 0:07:16.200 --> 0:07:20.760 not be possible without her cooperation. I wanted to examine 0:07:20.800 --> 0:07:26.960 public hospital waiting lists, abominable conditions in emergency departments, morale, 0:07:27.440 --> 0:07:30.960 a lack of funding, and a vacuum of political leadership. 0:07:32.160 --> 0:07:35.640 There was much more I suspected, hence my appeal too 0:07:35.760 --> 0:07:39.480 Tall to involve her colleagues in medical centers and hospitals 0:07:39.520 --> 0:07:44.080 throughout the state. They held knowledge that the government spin 0:07:44.160 --> 0:07:51.040 doctors would render themselves dizzy trying to control. Near the 0:07:51.160 --> 0:07:54.440 end of our one PM meeting, Ingrid Tall raised a 0:07:54.600 --> 0:07:55.560 new topic. 0:07:56.240 --> 0:07:59.440 There are also serious concerns about overseas trained doctors. 0:08:00.840 --> 0:08:06.280 My response was at first dismissive. The issue smacked of racism. 0:08:06.480 --> 0:08:09.280 To my knowledge, it had not been raised publicly as 0:08:09.280 --> 0:08:13.880 a serious problem in the past. Taul pressed her point. 0:08:14.360 --> 0:08:16.880 No, it is a serious issue. Some of our members 0:08:16.880 --> 0:08:19.200 have good information about it. I can put you in 0:08:19.200 --> 0:08:21.960 touch with doctor marsh Godsall, who knows it better than anyone. 0:08:23.240 --> 0:08:27.120 Dr Godsall, who practiced in Central Queensland, knew my wife 0:08:27.200 --> 0:08:32.640 Ruth's father, doctor Ian Matthewson, who practiced in Mackay. When 0:08:32.640 --> 0:08:36.280 I returned to my office in Bowen Hills, another family 0:08:36.360 --> 0:08:39.800 related medical contact from Mackay promised to help me crack 0:08:39.880 --> 0:08:41.359 the waiting list s fiasco. 0:08:42.559 --> 0:08:45.840 Waiting lists sob manipulated by administrators to put themselves in 0:08:45.880 --> 0:08:49.520 the best light. You have heard the saying lies, damn 0:08:49.559 --> 0:08:50.920 lies and statistics. 0:08:52.600 --> 0:08:56.240 Over the weekend I researched the subject of medical negligence 0:08:56.280 --> 0:08:59.720 an extracted part of a judgment by Lord Denning and 0:08:59.760 --> 0:09:02.080 then in a judge of the House of Lords in 0:09:02.120 --> 0:09:07.120 Britain from a famous case Roe versus Minister of Health. 0:09:07.760 --> 0:09:09.440 The relevant passage. 0:09:09.000 --> 0:09:13.560 Read, it is so easy to be wise after the 0:09:13.640 --> 0:09:17.600 event and to condemn as negligence that which was only 0:09:17.679 --> 0:09:21.199 a misadventure. We ought always to be on our guard 0:09:21.240 --> 0:09:27.120 against it, especially in cases against hospitals and doctors. Medical 0:09:27.160 --> 0:09:32.160 science has conferred great benefits on mankind, but these benefits 0:09:32.240 --> 0:09:37.920 are attended by considerable risks. Every surgical operation is attended 0:09:37.960 --> 0:09:42.520 by risks. We cannot take the benefits without taking the risks. 0:09:43.280 --> 0:09:48.640 Every advance and technique is also attended by risks. Doctors, 0:09:48.720 --> 0:09:51.600 like the rest of us, have to learn by experience, 0:09:52.200 --> 0:09:55.600 and experience often teaches in a hard way. 0:09:58.679 --> 0:10:03.080 After the weekend, Doctor Godsall contacted me to emphasize the 0:10:03.160 --> 0:10:07.360 concerns about overseas trained doctors. He told me that the 0:10:07.520 --> 0:10:11.400 single biggest issue in the public health system was Queensland's 0:10:11.440 --> 0:10:13.360 dependency on them. 0:10:13.720 --> 0:10:17.960 We are also concerned that appropriate qualifications, including language skills, 0:10:18.080 --> 0:10:21.680 are not being ensured. This means the public is potentially 0:10:21.880 --> 0:10:24.880 and increasingly at risk from doctors with less than the 0:10:24.920 --> 0:10:28.040 skills required to work here, though they may be adequate 0:10:28.080 --> 0:10:30.480 in the environment in which they were trained, and who 0:10:30.480 --> 0:10:33.480 did not have the communication ability which is expected from 0:10:33.520 --> 0:10:37.559 those selected for Australian medical schools. This in turn means 0:10:37.600 --> 0:10:39.800 the public purse is exposed to litigation. 0:10:41.480 --> 0:10:45.800 Godsaw mentioned a report by Bob Birell, a Melbourne academic. 0:10:46.480 --> 0:10:49.880 I found it on the internet. The report was alarming. 0:10:50.880 --> 0:10:54.960 Having at first been less than enthusiastic, I knew now 0:10:55.040 --> 0:10:59.439 that an investigation of the Overseas Trained Doctors or OTD 0:10:59.720 --> 0:11:03.360 had no real potential. It might be the backbone of 0:11:03.440 --> 0:11:08.920 the series. Doctor Godswall also hinted that Queensland Health knew 0:11:09.000 --> 0:11:13.600 all too well about the dangers. One of its senior advisors, 0:11:13.840 --> 0:11:19.199 doctor Dennis Lennox, had produced an important report. Doctor Godswall 0:11:19.280 --> 0:11:23.840 suggested that the report had been deliberately smothered. As my 0:11:23.960 --> 0:11:27.160 interest sawed, I told Godswill that the story would become 0:11:27.200 --> 0:11:30.640 a priority. I was determined to see the report by 0:11:30.640 --> 0:11:33.800 doctor Lennox. Doctor Godswall told. 0:11:33.520 --> 0:11:36.800 Me, I do not think that many appreciate the situation 0:11:37.200 --> 0:11:40.880 or are aware of it. For example, you seemed incredulous 0:11:40.880 --> 0:11:42.880 this morning when I told you of the lack of 0:11:43.000 --> 0:11:45.600 vetting of the skills and qualifications. 0:11:46.440 --> 0:11:50.760 Godswall kept giving Over several days. He sent me emails 0:11:50.800 --> 0:11:53.280 and he telephoned with new snippets of information. 0:11:54.559 --> 0:11:56.920 I send you this to help put things in perspective 0:11:56.960 --> 0:11:59.000 for you, as if you were not living with these 0:11:59.080 --> 0:12:01.760 things on a daily bank. It is very easy to 0:12:01.760 --> 0:12:06.079 misinterpret or be misled. I'm telling everybody they can speak 0:12:06.120 --> 0:12:08.760 to you on and off the record and you will 0:12:08.800 --> 0:12:12.920 respect their request. Those with queens and Health positions feel 0:12:12.960 --> 0:12:17.600 threatened because of the retribution that can be their lot. 0:12:18.679 --> 0:12:22.240 He offered names and telephone numbers of other doctors with 0:12:22.360 --> 0:12:26.120 insight into the issue. He urged me to investigate a 0:12:26.200 --> 0:12:30.160 death at a hospital in Charters Towers. He suggested I 0:12:30.240 --> 0:12:33.360 talk to a pharmacist in Mackay. He mentioned a GP 0:12:33.559 --> 0:12:37.920 in Bunderberg who had employed doctors from overseas, and he 0:12:38.040 --> 0:12:42.440 hinted again at this explosive secret report, adding. 0:12:42.760 --> 0:12:45.640 If QHS try to snow you, it'll be difficult to 0:12:45.640 --> 0:12:48.439 get people to speak because of the code of conduct. 0:12:49.600 --> 0:12:53.360 After interviewing two overseas trained doctors, I could see the 0:12:53.440 --> 0:12:58.560 story being a potential blockbuster. These doctors were stunned at 0:12:58.600 --> 0:13:02.480 the lack of screening of their qualifications and their competence. 0:13:03.480 --> 0:13:08.480 I told Godzill they reflect your concerns, I wrote to him. 0:13:09.120 --> 0:13:12.480 No doubt the spin from Queensland Health will be that 0:13:12.520 --> 0:13:15.720 if the system is working so poorly, why are there 0:13:15.840 --> 0:13:20.320 no or few complaints and why no adverse outcomes. I 0:13:20.440 --> 0:13:23.360 think that if your contacts can point to some events 0:13:23.440 --> 0:13:26.560 in which an overseas trained doctor's conduct has produced a 0:13:26.559 --> 0:13:31.760 bigger problem. It would lend more credibility to the issue. 0:13:31.840 --> 0:13:34.760 I also tried to impress on doctor Godwill that a 0:13:34.800 --> 0:13:39.280 story involving clinicians merely expressing concern would have little or 0:13:39.280 --> 0:13:43.960 no impact. If he and his colleagues wanted to change 0:13:44.000 --> 0:13:47.960 the situation, they needed to think about cause and effect. 0:13:48.880 --> 0:13:52.640 They needed to reveal cases involving negligent clinical conduct with 0:13:52.720 --> 0:13:57.720 adverse consequences for patients. The word went around sections of 0:13:57.760 --> 0:14:01.839 the medical community for a few days. I was urged 0:14:01.880 --> 0:14:05.760 to talk to doctor Chris Blenken, a leading orthopedic surgeon 0:14:06.080 --> 0:14:10.720 and the president of the Australian Orthopedics Association's Queensland branch. 0:14:11.800 --> 0:14:15.400 Although his brother Max was a senior journalist in Canberra, 0:14:15.880 --> 0:14:19.920 doctor Blenkin's professional contact with journalists had been limited before 0:14:19.960 --> 0:14:23.600 he heard from me, but he spoke frankly and strongly. 0:14:24.800 --> 0:14:28.360 He cited a crisis at the public hospital in Harvey Bay, 0:14:28.440 --> 0:14:32.600 about three hundred kilometers north of Brisbane, involving two Fiji 0:14:32.640 --> 0:14:36.640 trained doctors being held out as consultants in orthopedic surgery. 0:14:37.600 --> 0:14:41.120 Neither had done the training demanded of Australian surgeons, nor 0:14:41.200 --> 0:14:45.320 had they been assessed or accredited by peers. Since their 0:14:45.440 --> 0:14:50.320 arrival at the hospital, they had not been properly supervised. Inevitably, 0:14:50.400 --> 0:14:56.120 their lack of competence had raised concerns in the medical field. Orthopods, 0:14:56.360 --> 0:14:58.960 as they are known, are often the butt of jokes. 0:15:00.000 --> 0:15:04.520 If cardiac surgery is a fine art, orthopedic surgery is 0:15:04.640 --> 0:15:09.440 roadside laboring. It can quite literally involve a hammer, nails 0:15:09.640 --> 0:15:13.920 and brute force. When I pressed Blenken on the Harvey 0:15:13.920 --> 0:15:17.040 Bay situation, he promised to check into it more thoroughly. 0:15:18.120 --> 0:15:20.160 He called me a few days later and said he 0:15:20.280 --> 0:15:24.960 was sincerely worried. The dangers at the hospital, he explained, 0:15:25.040 --> 0:15:30.040 were unacceptable. He detailed two of the most recent adverse 0:15:30.080 --> 0:15:34.760 outcomes in Harvey Bay, a femur that exploded because the 0:15:34.880 --> 0:15:38.720 pin was nailed in wrongly and a hip fractured on 0:15:38.760 --> 0:15:39.880 the operating table. 0:15:41.320 --> 0:15:44.040 You have to see it to believe it. It highlights 0:15:44.040 --> 0:15:47.240 the problems that occur when we drop standards. You are 0:15:47.280 --> 0:15:50.120 better off with no one than someone who is bad, 0:15:50.440 --> 0:15:53.680 because it is possible to do so much damage. The 0:15:53.720 --> 0:15:57.400 community expects a reasonable standard, but the damage done far 0:15:57.480 --> 0:16:01.400 outweighs any benefit. In providing a service. Who knows why 0:16:01.440 --> 0:16:04.120 the medical superintendent and a district manager have gone down 0:16:04.160 --> 0:16:06.760 this path. They probably think a doctor is a doctor. 0:16:08.080 --> 0:16:10.800 I decided it was imperative. I talked to a number 0:16:10.800 --> 0:16:14.560 of doctors in different fields and in different parts of Queensland. 0:16:15.720 --> 0:16:18.560 I didn't want the story to lack credibility for a 0:16:18.600 --> 0:16:24.240 failure to gauge a variety of views. In Atherton, North, Queensland, 0:16:24.320 --> 0:16:26.920 doctor Bruce Cameron told me that a large number of 0:16:26.960 --> 0:16:32.600 doctors coming from overseas were simply unsuitable without significant upskilling. 0:16:33.600 --> 0:16:36.840 He told me that there may be some situations where 0:16:36.880 --> 0:16:41.120 no doctor is safer than a bad doctor. Doctor Drew 0:16:41.200 --> 0:16:45.640 spat a GP at Bunderberg's Burnett Medical Center, described the 0:16:45.720 --> 0:16:50.000 need to introduce a formal program of screening and mentoring. 0:16:50.880 --> 0:16:53.960 He said to me, I don't want to sound racist. 0:16:54.240 --> 0:16:57.320 We welcome these people here. In a situation where there 0:16:57.360 --> 0:17:00.960 is a shortage of Australian doctors, we need to ensure 0:17:01.080 --> 0:17:06.000 they have the skills. Doctor David Malloy, who would become 0:17:06.080 --> 0:17:11.080 the next Australian Medical Association Queensland president, called for systems 0:17:11.119 --> 0:17:15.160 to measure the experience and skills of overseas trained doctors. 0:17:16.280 --> 0:17:19.359 As the health system tightens with the emphasis on meeting budgets, 0:17:19.440 --> 0:17:22.440 nobody is available to evaluate the doctors when they hit 0:17:22.480 --> 0:17:26.920 the hospitals. Our natural inclination is to protect the medical system, 0:17:27.200 --> 0:17:29.679 but the fact is, where there are language problems and 0:17:29.720 --> 0:17:32.280 people are asked to work above their level, the potential 0:17:32.320 --> 0:17:35.920 for adverse outcomes has to be so much greater. Everyone 0:17:36.040 --> 0:17:38.320 knew this was a bit of a powder keg. I 0:17:38.359 --> 0:17:40.480 think we have been afraid to approach it because of 0:17:40.520 --> 0:17:43.040 a fear of being seen as elitist and racist. 0:17:45.320 --> 0:17:48.639 Anxious for the two Fiji trained doctors to have an 0:17:48.680 --> 0:17:53.840 opportunity to comment, I telephoned one. He rejected the concerns 0:17:54.080 --> 0:17:58.520 and told of the community's gratitude for their work. We 0:17:58.560 --> 0:18:02.520 are not specialists. We are not saying that our qualifications 0:18:02.600 --> 0:18:06.560 mean we should be recognized as specialists. I don't think 0:18:06.640 --> 0:18:11.320 I have a lack of experience. Within a few days 0:18:11.320 --> 0:18:14.359 of hearing for the first time about the issue, I 0:18:14.480 --> 0:18:19.359 received a fax from a confidential source. Somebody had sent 0:18:19.480 --> 0:18:22.639 me the July two thousand and three report by doctor 0:18:22.720 --> 0:18:28.480 Dennis Lennox, the senior Queensland Health Workforce Advisor. It ran 0:18:28.600 --> 0:18:32.600 for eighteen pages and seemed complete. But for a signature, 0:18:34.119 --> 0:18:36.919 I turned to the executive summary, which said what I 0:18:36.960 --> 0:18:41.480 already knew, A chronic shortage of Australian graduates had resulted 0:18:41.600 --> 0:18:46.320 in an increasingly heavy reliance on overseas trained doctors. My 0:18:46.600 --> 0:18:50.000 faith in doctor Godswill rose as I read the warnings. 0:18:51.280 --> 0:18:55.359 Evidence is increasing of increased risk of OTD recruits being 0:18:55.400 --> 0:18:59.720 insufficiently assessed and prepared for practice in Queensland under pressure 0:18:59.720 --> 0:19:04.280 of recruitment of such increasingly large numbers of otds. Some 0:19:04.320 --> 0:19:08.040 recent experience of overseas trained doctors without the competence or 0:19:08.080 --> 0:19:13.880 capability for medical practice in Queensland presages adverse outcomes for patients, employees, 0:19:14.000 --> 0:19:15.600 community and medical profession. 0:19:17.400 --> 0:19:21.399 Doctor Lennox had done his homework. He mapped out a 0:19:21.640 --> 0:19:27.600 policy and tactical response, embracing a comprehensive assessment and management process, 0:19:28.280 --> 0:19:32.960 bridging courses for doctors not up to scratch, Australian Medical 0:19:33.040 --> 0:19:39.600 Council examinations and fellowship of the relevant medical colleges. Lennox 0:19:39.640 --> 0:19:43.280 wrote that these options would ensure that doctors from overseas 0:19:43.359 --> 0:19:45.159 were appropriately qualified. 0:19:46.200 --> 0:19:49.359 It also protects the community from incompetent medical practice and 0:19:49.440 --> 0:19:51.040 consequent adverse outcomes. 0:19:52.280 --> 0:19:55.439 The report was the smoking gun of this story. It 0:19:55.560 --> 0:19:59.160 evinced evidence that Queensland Health knew of the concerns because 0:19:59.200 --> 0:20:02.280 they had been this stilled and emphasized by one of 0:20:02.320 --> 0:20:06.400 its managers. I felt even more strongly about the seriousness 0:20:06.400 --> 0:20:08.840 of the story, but I decided not to show my 0:20:09.000 --> 0:20:14.879 hand too soon. On twenty one October, I wrote to 0:20:14.920 --> 0:20:18.600 my former colleague from the Courier Mail, Steve Rouse, who 0:20:18.680 --> 0:20:23.680 managed communications for the then Health Minister Wendy Edmund. As 0:20:23.720 --> 0:20:27.360 a seasoned political reporter before crossing to what we call 0:20:27.440 --> 0:20:30.879 the dark side, Rouse was one of the better advisors 0:20:30.920 --> 0:20:34.720 in the Beady government's army of spinners. He was also 0:20:34.960 --> 0:20:37.800 my main point of contact for the series I had 0:20:37.800 --> 0:20:42.159 been asked to produce. I explained to Steve Rouse some 0:20:42.200 --> 0:20:44.920 of the issues I wanted dealt with in interviews with 0:20:45.040 --> 0:20:49.160 Wendy Edmund, the Minister, and her Director General, Dr Rob Stable. 0:20:50.280 --> 0:20:53.119 I told him that I sought information to address the 0:20:53.200 --> 0:20:56.640 claims of clinicians and patients that the waiting lists are 0:20:56.680 --> 0:21:00.600 misleading because they don't indicate the waiting time for the 0:21:00.640 --> 0:21:06.280 appointments for assessments for surgery. I also flagged my interest 0:21:06.359 --> 0:21:11.160 in the bigger picture issues. I wrote, for example, what 0:21:11.200 --> 0:21:14.560 the community might want or expect versus what it is 0:21:14.640 --> 0:21:18.600 prepared to pay for, and the increasing tensions arising out 0:21:18.640 --> 0:21:21.760 of strife of interests with what clinicians would like to 0:21:21.800 --> 0:21:26.400 do for patients versus administrators who are responsible for the budgets. 0:21:27.960 --> 0:21:31.679 The secrecy issues being raised constantly by the doctors and 0:21:31.840 --> 0:21:37.240 nurses concerned me. I emailed Steve Rouss about it. I wrote, 0:21:37.600 --> 0:21:40.920 a number of clinicians claim that when they identify serious 0:21:40.960 --> 0:21:44.679 issues relating to public health, the problems are denied or 0:21:44.720 --> 0:21:49.720 not addressed seriously. They claim as cans doctors claimed earlier 0:21:49.760 --> 0:21:52.920 this year that only by speaking out can they alert 0:21:52.960 --> 0:21:55.560 the public to what is really going on, but they 0:21:55.680 --> 0:21:59.320 risk their jobs by doing so. They say that this 0:21:59.400 --> 0:22:03.320 puts them in an impossible situation. Can you address this 0:22:03.440 --> 0:22:06.679 please with reference to the Code of Conduct, why it 0:22:06.760 --> 0:22:11.720 restricts the doctors from whistleblowing and why in Queensland Health's view, 0:22:12.280 --> 0:22:15.199 the doctors are no different from any other public servant 0:22:15.240 --> 0:22:19.879 when it comes to highlighting internal issues. On the matter 0:22:19.960 --> 0:22:23.399 of overseas trained doctors, I decided not to disclose that 0:22:23.480 --> 0:22:28.160 I had already been leaked the sensitive Dennis Lennox Report. Instead, 0:22:28.760 --> 0:22:32.240 I ask for information that addresses the number of overseas 0:22:32.280 --> 0:22:35.760 trained doctors in Queensland in both the private and public sector, 0:22:36.440 --> 0:22:38.840 the extent to which the system relies on them, and 0:22:38.880 --> 0:22:43.200 the due diligence undertaken to ensure they're sufficiently skilled. I 0:22:43.359 --> 0:22:47.160 ask does the Minister believe that the current arrangements are 0:22:47.280 --> 0:22:51.280 adequate or is she concerned that doctors without appropriate experience 0:22:51.480 --> 0:22:54.879 or skills are slipping into an undermanned sector because of 0:22:54.920 --> 0:22:59.080 the chronic shortage. What can be done to ensure that 0:22:59.280 --> 0:23:04.640 adverse out comes are minimized. Steve Rouse confirmed my appointments 0:23:04.680 --> 0:23:08.520 for interviews or briefings with the Director General, Doctor Rob Stable, 0:23:08.920 --> 0:23:13.760 his probable successor, Dr Steve Buckland, and Minister Wendy Edmund 0:23:13.800 --> 0:23:19.919 for Monday twenty seven October. Files and folders stuffed with 0:23:20.040 --> 0:23:23.560 documents about Queensland Health covered the kitchen table as I 0:23:23.640 --> 0:23:26.960 worked the telephone and read again the Lennox Report on 0:23:27.040 --> 0:23:30.679 overseas doctors. When it came time to go to the 0:23:30.800 --> 0:23:34.320 nineteenth floor of the Queensland Health Building in Charlotte Street 0:23:34.359 --> 0:23:37.560 on the afternoon of twenty seven October I was well 0:23:37.600 --> 0:23:42.040 prepared in just a few days. Rob Stable, who took 0:23:42.080 --> 0:23:46.200 most of the questions while Buckland listened and occasionally added something, 0:23:46.359 --> 0:23:48.879 would be out of the top job in Queensland Health. 0:23:49.880 --> 0:23:52.639 He was leaving for a new role in the private sector, 0:23:52.720 --> 0:23:56.840 heading up Bond University on the Gold Coast. Dr Stable 0:23:56.920 --> 0:23:58.640 told me we. 0:23:58.680 --> 0:24:01.600 Have some very good over these trained doctors in this state, 0:24:02.200 --> 0:24:04.960 but we are finding that where we need to recruit them, 0:24:05.440 --> 0:24:08.760 some don't have the same degree of language skills. The 0:24:08.800 --> 0:24:11.800 pool of Australian medicine has not kept pace with the demand. 0:24:12.400 --> 0:24:16.200 The market has changed and we do everything practical, interviewing them, 0:24:16.400 --> 0:24:21.359 checking references, giving clinical scenarios. We have this situation. We 0:24:21.440 --> 0:24:25.440 have to provide services. We have hurdles in place. It's 0:24:25.480 --> 0:24:28.119 been reported to us that their communication skills have not 0:24:28.280 --> 0:24:31.159 been very good, but we have noticed this ourselves with 0:24:31.240 --> 0:24:35.400 the applicants. This is a no win. The politicians don't 0:24:35.440 --> 0:24:39.000 accept that we can't have doctors. Is no service better 0:24:39.040 --> 0:24:41.240 than taking the risk that one or two cases per 0:24:41.320 --> 0:24:43.280 year of the six hundred we get in the public 0:24:43.320 --> 0:24:45.640 system in Queensland are not up to scratch. 0:24:46.880 --> 0:24:51.480 Doctor Buckland seemed perplexed we are not in the business 0:24:51.520 --> 0:24:56.480 of causing harm and seeing adverse outcomes. My meeting with 0:24:56.560 --> 0:25:00.960 Wendy Edmund covered a range of topics played the problems 0:25:01.000 --> 0:25:05.879 facing health. Generally, there would always be people, she told me, 0:25:05.960 --> 0:25:09.879 who were like Chicken little talking about the sky falling in. 0:25:10.840 --> 0:25:13.320 It was her way of saying that the public health 0:25:13.359 --> 0:25:16.920 system was in good shape, despite the regular reports from 0:25:16.960 --> 0:25:22.320 clinicians and patients to the contrary. A few hours after 0:25:22.400 --> 0:25:26.719 meeting Stable Buckland and Edmund, I sent a note asking 0:25:26.880 --> 0:25:31.439 further questions about the situation at Harvey Bay. Was it 0:25:31.560 --> 0:25:36.120 the only public hospital at which the qualifications of overseas 0:25:36.160 --> 0:25:42.919 trained doctors were not recognized by the respective colleges? I asked, Also, 0:25:43.560 --> 0:25:46.919 can you copy to me a report by Queensland Health 0:25:47.160 --> 0:25:51.440 doctor Dennis Lennox earlier this year into issues arising from 0:25:51.440 --> 0:25:58.160 overseas doctors. Kato O'Donnell, who handled Queensland Health's official responses 0:25:58.200 --> 0:25:59.920 to some of our queries. 0:25:59.480 --> 0:26:03.560 Told me this report has no official status and was 0:26:03.600 --> 0:26:07.359 not accepted or endorsed by Queensland Health Executive. 0:26:08.680 --> 0:26:12.440 Doctor Buckland and the Medical Board of Queensland had received 0:26:12.520 --> 0:26:16.680 doctor Lennox's report, They had read it and they had 0:26:16.680 --> 0:26:35.200 buried it Chapter sixteen Discredit. November two thousand and three, 0:26:35.359 --> 0:26:39.159 the last patient left doctor Ross Cartmill's waiting room on 0:26:39.200 --> 0:26:42.199 wickham Terrace above the lights of the city's office building, 0:26:42.280 --> 0:26:48.080 sometime after seven pm. A urologist with a successful private practice, 0:26:48.440 --> 0:26:52.840 Cartmill was also a visiting medical officer, meaning he gave 0:26:52.960 --> 0:26:56.359 some of his time for relatively minimal financial return to 0:26:56.400 --> 0:26:59.959 look after patients and to mentor junior doctors in Brisbane 0:27:00.240 --> 0:27:05.720 public hospitals. For many specialists, like Cartmell, the motive for 0:27:05.800 --> 0:27:09.120 doing part time work in the public system was altruistic. 0:27:10.000 --> 0:27:12.840 They were giving something back to hospitals which had been 0:27:12.880 --> 0:27:17.680 their training ground years earlier. But doctor Cartmell was now 0:27:17.800 --> 0:27:22.520 gravely worried about the performance and sustainability of public health care. 0:27:23.280 --> 0:27:25.760 I took notes as he vented his spleen. 0:27:27.160 --> 0:27:30.520 The first fact the community needs to understand is that 0:27:30.600 --> 0:27:34.080 doctors are afraid they'll be sacked if they talk openly 0:27:34.160 --> 0:27:38.679 about what is actually happening in public hospitals. The second 0:27:38.720 --> 0:27:42.760 fact is that if doctors could talk openly, Queenslanders would 0:27:42.800 --> 0:27:46.840 hear that their public health system is chronically underfunded and 0:27:46.920 --> 0:27:50.480