Speaker 1: My name is Headley Thomas. Sick to Death is based
Speaker 1: on my book of the same name, and it's the
Speaker 1: true story of doctor Jayant Patel's lies and manipulation and
Speaker 1: the herculean effort it took to finally stop him. We've
Speaker 1: used voice actors throughout this series, and on occasion the
Speaker 1: real people from the story have read their words for us.
Speaker 1: It is brought to you by me and the Australian
Speaker 1: Chapter fifteen Fortuitous. We had just switched off the lights
Speaker 1: and settled into bed when the house shook with a
Speaker 1: series of bangs. It was ten thirty pm on twenty
Speaker 1: three October two thousand and two. Outside the dust from
Speaker 1: an eerie freak storm swirled across the city of Brisbane,
Speaker 1: but in our bedroom, tiny splinters of glass sprayed our hair,
Speaker 1: faces and the bed sheets. Our daughter, Sarah, they'n eighteen
Speaker 1: months old, awoke screaming. One of four zero point four
Speaker 1: to five caliber bullets had exploded through the bedroom window
Speaker 1: thirty centimeters above our heads. It continued through the bathroom wall,
Speaker 1: shattering plaster tiles and a mirror. Another bullet ripped into
Speaker 1: the toy room, close to the eye level of my
Speaker 1: son Alexander. Then three another ricocheted off the top of
Speaker 1: the car port. The path of the fourth bullet was
Speaker 1: never established. It took several minutes to comprehend what had happened.
Speaker 1: Our neighbors Chris and Louise, had seen a car spating off.
Speaker 1: I asked, tree had fallen on the house in the storm.
Speaker 1: No Headley, you've been shot at. I ran back upstairs
Speaker 1: and called Triple O. Our sanctuary in a quiet street
Speaker 1: in a semi rule enclave on the western outskirts of
Speaker 1: Brisbane was soon full of police dogs and ballistics experts,
Speaker 1: and then the media came. We wrapped up the children,
Speaker 1: packed overnight bags and left. A shooting at an investigative
Speaker 1: journalist's home was, according to the media commentators, unprecedented in Australia.
Speaker 1: Police narrowed a long list of suspects down to those
Speaker 1: with a definite motive, arising from a number of stories
Speaker 1: I had written in the Courier Mail exposing various scams.
Speaker 1: For three weeks we remained in Tasmania, touring, talking about
Speaker 1: our future and trying to be rational about suspicious looking
Speaker 1: people who drove too close to our higher car or
Speaker 1: looked at us strangely in the streets of Hobart, Lonceston
Speaker 1: and Strawn. I considered quitting journalism. We could grow vegetables
Speaker 1: instead in a mountain village behind the Sunshine Coast, or
Speaker 1: take up a safe pr type job in a distant
Speaker 1: corner of Rupert Murdoch's news corporation, perhaps in London or
Speaker 1: New York. We were grateful for the compassion of John Hartigan,
Speaker 1: the company's Sydney Bay CEO, and Lachlan Murdoch, rupert son,
Speaker 1: both of whom pledged support when it seemed I was
Speaker 1: losing my way. Ruth and I were appalled at the
Speaker 1: cowardly act of the shooting, and I became angry with
Speaker 1: people who seemed oblivious to our pain. Days after the shooting,
Speaker 1: strangers emailed and telephone to urge me to step up
Speaker 1: my work, to look at their particular issues to solve
Speaker 1: their problems. The level of self interest disgusted me. Let
Speaker 1: them put themselves and their families in the line of fire.
Speaker 1: Until that point, my career had been charmed. At the
Speaker 1: age of twenty two, I had worked in the company's
Speaker 1: London office while my friends went backpacking on shoe string
Speaker 1: budgets I was paid to travel through Europe and the
Speaker 1: Middle East, reporting momentous events including the fall of the
Speaker 1: Berlin Wall, the violent revolution in Romania, and the First
Speaker 1: Golf War. I had covered epic sporting contests Wimbledon, the
Speaker 1: British Open, Golf, the French Open, and Silly's squabbles within
Speaker 1: the royal family. The London assignment was followed by six
Speaker 1: years in Hong Kong. In nineteen ninety nine, after witnessing
Speaker 1: the handover of the British Colony to China, Ruth and
Speaker 1: I had returned to Australia with our baby boy. We
Speaker 1: started raising a family in Queensland. In the three years
Speaker 1: before October two thousand and two, I had been toiling
Speaker 1: as an investigative journalist at the Courier Mail property scams,
Speaker 1: crooked lawyers, venal politicians and dangerous doctors. They were all
Speaker 1: grissed for the mill. Some of these stories had made
Speaker 1: a difference, but after the shooting, I doubted I would
Speaker 1: care as much again about any of it. Journalism had
Speaker 1: put my wife and children in peril. After much soul
Speaker 1: searching and counseling, we decided to stay in Brisbane. We
Speaker 1: decided to stay in journalism. We would have lost more,
Speaker 1: we reasoned by giving up our home and profession. I
Speaker 1: returned to reporting, but I dreaded the constant reminders of
Speaker 1: our trauma. Did they ever catch the bastard who shot
Speaker 1: up your house? Although those who asked were well intentioned,
Speaker 1: the question aggravated us all the same. It forced us
Speaker 1: to relive something that we did not want to revisit,
Speaker 1: and to mumble clumsily a reply to the contacts, acquaintances
Speaker 1: and sticky beaks who believed they had a right to
Speaker 1: discuss it. The question forced me to fight the tears
Speaker 1: welling in my eyes. It forced both of us to
Speaker 1: face reality that the police had got next to nowhere,
Speaker 1: despite a heavily promoted investigation and the personal overseeing of
Speaker 1: the Police Commissioner Bob Atkinson. Almost a year after the shooting,
Speaker 1: the Courier Males editor David Fagan asked me to start
Speaker 1: working on a major project, an investigation and series of
Speaker 1: articles about health and the public hospital system. As he
Speaker 1: briefed me on the project, I privately weighed the risk
Speaker 1: of reprisals low. The assignment was actually a lucky break
Speaker 1: in Brisbane in the exquisitely appointed lestrange terrorists office of
Speaker 1: doctor Ingrid Tall, the new head of the Australian Medical
Speaker 1: Association's Queensland branch. I explained the potential angles Ingrid Tall
Speaker 1: held ambitions to be a Liberal Party petitian. Her role
Speaker 1: in the Northern branch of one of Australia's most powerful
Speaker 1: trade unions was a stepping stone. I used the meeting
Speaker 1: with Tall to stress the seriousness of the articles on
Speaker 1: health I was preparing. The major series I planned would
Speaker 1: not be possible without her cooperation. I wanted to examine
Speaker 1: public hospital waiting lists, abominable conditions in emergency departments, morale,
Speaker 1: a lack of funding, and a vacuum of political leadership.
Speaker 1: There was much more I suspected, hence my appeal too
Speaker 1: Tall to involve her colleagues in medical centers and hospitals
Speaker 1: throughout the state. They held knowledge that the government spin
Speaker 1: doctors would render themselves dizzy trying to control. Near the
Speaker 1: end of our one PM meeting, Ingrid Tall raised a
Speaker 1: new topic.
Speaker 2: There are also serious concerns about overseas trained doctors.
Speaker 1: My response was at first dismissive. The issue smacked of racism.
Speaker 1: To my knowledge, it had not been raised publicly as
Speaker 1: a serious problem in the past. Taul pressed her point.
Speaker 2: No, it is a serious issue. Some of our members
Speaker 2: have good information about it. I can put you in
Speaker 2: touch with doctor marsh Godsall, who knows it better than anyone.
Speaker 1: Dr Godsall, who practiced in Central Queensland, knew my wife
Speaker 1: Ruth's father, doctor Ian Matthewson, who practiced in Mackay. When
Speaker 1: I returned to my office in Bowen Hills, another family
Speaker 1: related medical contact from Mackay promised to help me crack
Speaker 1: the waiting list s fiasco.
Speaker 3: Waiting lists sob manipulated by administrators to put themselves in
Speaker 3: the best light. You have heard the saying lies, damn
Speaker 3: lies and statistics.
Speaker 1: Over the weekend I researched the subject of medical negligence
Speaker 1: an extracted part of a judgment by Lord Denning and
Speaker 1: then in a judge of the House of Lords in
Speaker 1: Britain from a famous case Roe versus Minister of Health.
Speaker 1: The relevant passage.
Speaker 4: Read, it is so easy to be wise after the
Speaker 4: event and to condemn as negligence that which was only
Speaker 4: a misadventure. We ought always to be on our guard
Speaker 4: against it, especially in cases against hospitals and doctors. Medical
Speaker 4: science has conferred great benefits on mankind, but these benefits
Speaker 4: are attended by considerable risks. Every surgical operation is attended
Speaker 4: by risks. We cannot take the benefits without taking the risks.
Speaker 4: Every advance and technique is also attended by risks. Doctors,
Speaker 4: like the rest of us, have to learn by experience,
Speaker 4: and experience often teaches in a hard way.
Speaker 1: After the weekend, Doctor Godsall contacted me to emphasize the
Speaker 1: concerns about overseas trained doctors. He told me that the
Speaker 1: single biggest issue in the public health system was Queensland's
Speaker 1: dependency on them.
Speaker 3: We are also concerned that appropriate qualifications, including language skills,
Speaker 3: are not being ensured. This means the public is potentially
Speaker 3: and increasingly at risk from doctors with less than the
Speaker 3: skills required to work here, though they may be adequate
Speaker 3: in the environment in which they were trained, and who
Speaker 3: did not have the communication ability which is expected from
Speaker 3: those selected for Australian medical schools. This in turn means
Speaker 3: the public purse is exposed to litigation.
Speaker 1: Godsaw mentioned a report by Bob Birell, a Melbourne academic.
Speaker 1: I found it on the internet. The report was alarming.
Speaker 1: Having at first been less than enthusiastic, I knew now
Speaker 1: that an investigation of the Overseas Trained Doctors or OTD
Speaker 1: had no real potential. It might be the backbone of
Speaker 1: the series. Doctor Godswall also hinted that Queensland Health knew
Speaker 1: all too well about the dangers. One of its senior advisors,
Speaker 1: doctor Dennis Lennox, had produced an important report. Doctor Godswall
Speaker 1: suggested that the report had been deliberately smothered. As my
Speaker 1: interest sawed, I told Godswill that the story would become
Speaker 1: a priority. I was determined to see the report by
Speaker 1: doctor Lennox. Doctor Godswall told.
Speaker 3: Me, I do not think that many appreciate the situation
Speaker 3: or are aware of it. For example, you seemed incredulous
Speaker 3: this morning when I told you of the lack of
Speaker 3: vetting of the skills and qualifications.
Speaker 1: Godswall kept giving Over several days. He sent me emails
Speaker 1: and he telephoned with new snippets of information.
Speaker 3: I send you this to help put things in perspective
Speaker 3: for you, as if you were not living with these
Speaker 3: things on a daily bank. It is very easy to
Speaker 3: misinterpret or be misled. I'm telling everybody they can speak
Speaker 3: to you on and off the record and you will
Speaker 3: respect their request. Those with queens and Health positions feel
Speaker 3: threatened because of the retribution that can be their lot.
Speaker 1: He offered names and telephone numbers of other doctors with
Speaker 1: insight into the issue. He urged me to investigate a
Speaker 1: death at a hospital in Charters Towers. He suggested I
Speaker 1: talk to a pharmacist in Mackay. He mentioned a GP
Speaker 1: in Bunderberg who had employed doctors from overseas, and he
Speaker 1: hinted again at this explosive secret report, adding.
Speaker 3: If QHS try to snow you, it'll be difficult to
Speaker 3: get people to speak because of the code of conduct.
Speaker 1: After interviewing two overseas trained doctors, I could see the
Speaker 1: story being a potential blockbuster. These doctors were stunned at
Speaker 1: the lack of screening of their qualifications and their competence.
Speaker 1: I told Godzill they reflect your concerns, I wrote to him.
Speaker 1: No doubt the spin from Queensland Health will be that
Speaker 1: if the system is working so poorly, why are there
Speaker 1: no or few complaints and why no adverse outcomes. I
Speaker 1: think that if your contacts can point to some events
Speaker 1: in which an overseas trained doctor's conduct has produced a
Speaker 1: bigger problem. It would lend more credibility to the issue.
Speaker 1: I also tried to impress on doctor Godwill that a
Speaker 1: story involving clinicians merely expressing concern would have little or
Speaker 1: no impact. If he and his colleagues wanted to change
Speaker 1: the situation, they needed to think about cause and effect.
Speaker 1: They needed to reveal cases involving negligent clinical conduct with
Speaker 1: adverse consequences for patients. The word went around sections of
Speaker 1: the medical community for a few days. I was urged
Speaker 1: to talk to doctor Chris Blenken, a leading orthopedic surgeon
Speaker 1: and the president of the Australian Orthopedics Association's Queensland branch.
Speaker 1: Although his brother Max was a senior journalist in Canberra,
Speaker 1: doctor Blenkin's professional contact with journalists had been limited before
Speaker 1: he heard from me, but he spoke frankly and strongly.
Speaker 1: He cited a crisis at the public hospital in Harvey Bay,
Speaker 1: about three hundred kilometers north of Brisbane, involving two Fiji
Speaker 1: trained doctors being held out as consultants in orthopedic surgery.
Speaker 1: Neither had done the training demanded of Australian surgeons, nor
Speaker 1: had they been assessed or accredited by peers. Since their
Speaker 1: arrival at the hospital, they had not been properly supervised. Inevitably,
Speaker 1: their lack of competence had raised concerns in the medical field. Orthopods,
Speaker 1: as they are known, are often the butt of jokes.
Speaker 1: If cardiac surgery is a fine art, orthopedic surgery is
Speaker 1: roadside laboring. It can quite literally involve a hammer, nails
Speaker 1: and brute force. When I pressed Blenken on the Harvey
Speaker 1: Bay situation, he promised to check into it more thoroughly.
Speaker 1: He called me a few days later and said he
Speaker 1: was sincerely worried. The dangers at the hospital, he explained,
Speaker 1: were unacceptable. He detailed two of the most recent adverse
Speaker 1: outcomes in Harvey Bay, a femur that exploded because the
Speaker 1: pin was nailed in wrongly and a hip fractured on
Speaker 1: the operating table.
Speaker 5: You have to see it to believe it. It highlights
Speaker 5: the problems that occur when we drop standards. You are
Speaker 5: better off with no one than someone who is bad,
Speaker 5: because it is possible to do so much damage. The
Speaker 5: community expects a reasonable standard, but the damage done far
Speaker 5: outweighs any benefit. In providing a service. Who knows why
Speaker 5: the medical superintendent and a district manager have gone down
Speaker 5: this path. They probably think a doctor is a doctor.
Speaker 1: I decided it was imperative. I talked to a number
Speaker 1: of doctors in different fields and in different parts of Queensland.
Speaker 1: I didn't want the story to lack credibility for a
Speaker 1: failure to gauge a variety of views. In Atherton, North, Queensland,
Speaker 1: doctor Bruce Cameron told me that a large number of
Speaker 1: doctors coming from overseas were simply unsuitable without significant upskilling.
Speaker 1: He told me that there may be some situations where
Speaker 1: no doctor is safer than a bad doctor. Doctor Drew
Speaker 1: spat a GP at Bunderberg's Burnett Medical Center, described the
Speaker 1: need to introduce a formal program of screening and mentoring.
Speaker 1: He said to me, I don't want to sound racist.
Speaker 1: We welcome these people here. In a situation where there
Speaker 1: is a shortage of Australian doctors, we need to ensure
Speaker 1: they have the skills. Doctor David Malloy, who would become
Speaker 1: the next Australian Medical Association Queensland president, called for systems
Speaker 1: to measure the experience and skills of overseas trained doctors.
Speaker 6: As the health system tightens with the emphasis on meeting budgets,
Speaker 6: nobody is available to evaluate the doctors when they hit
Speaker 6: the hospitals. Our natural inclination is to protect the medical system,
Speaker 6: but the fact is, where there are language problems and
Speaker 6: people are asked to work above their level, the potential
Speaker 6: for adverse outcomes has to be so much greater. Everyone
Speaker 6: knew this was a bit of a powder keg. I
Speaker 6: think we have been afraid to approach it because of
Speaker 6: a fear of being seen as elitist and racist.
Speaker 1: Anxious for the two Fiji trained doctors to have an
Speaker 1: opportunity to comment, I telephoned one. He rejected the concerns
Speaker 1: and told of the community's gratitude for their work. We
Speaker 1: are not specialists. We are not saying that our qualifications
Speaker 1: mean we should be recognized as specialists. I don't think
Speaker 1: I have a lack of experience. Within a few days
Speaker 1: of hearing for the first time about the issue, I
Speaker 1: received a fax from a confidential source. Somebody had sent
Speaker 1: me the July two thousand and three report by doctor
Speaker 1: Dennis Lennox, the senior Queensland Health Workforce Advisor. It ran
Speaker 1: for eighteen pages and seemed complete. But for a signature,
Speaker 1: I turned to the executive summary, which said what I
Speaker 1: already knew, A chronic shortage of Australian graduates had resulted
Speaker 1: in an increasingly heavy reliance on overseas trained doctors. My
Speaker 1: faith in doctor Godswill rose as I read the warnings.
Speaker 7: Evidence is increasing of increased risk of OTD recruits being
Speaker 7: insufficiently assessed and prepared for practice in Queensland under pressure
Speaker 7: of recruitment of such increasingly large numbers of otds. Some
Speaker 7: recent experience of overseas trained doctors without the competence or
Speaker 7: capability for medical practice in Queensland presages adverse outcomes for patients, employees,
Speaker 7: community and medical profession.
Speaker 1: Doctor Lennox had done his homework. He mapped out a
Speaker 1: policy and tactical response, embracing a comprehensive assessment and management process,
Speaker 1: bridging courses for doctors not up to scratch, Australian Medical
Speaker 1: Council examinations and fellowship of the relevant medical colleges. Lennox
Speaker 1: wrote that these options would ensure that doctors from overseas
Speaker 1: were appropriately qualified.
Speaker 7: It also protects the community from incompetent medical practice and
Speaker 7: consequent adverse outcomes.
Speaker 1: The report was the smoking gun of this story. It
Speaker 1: evinced evidence that Queensland Health knew of the concerns because
Speaker 1: they had been this stilled and emphasized by one of
Speaker 1: its managers. I felt even more strongly about the seriousness
Speaker 1: of the story, but I decided not to show my
Speaker 1: hand too soon. On twenty one October, I wrote to
Speaker 1: my former colleague from the Courier Mail, Steve Rouse, who
Speaker 1: managed communications for the then Health Minister Wendy Edmund. As
Speaker 1: a seasoned political reporter before crossing to what we call
Speaker 1: the dark side, Rouse was one of the better advisors
Speaker 1: in the Beady government's army of spinners. He was also
Speaker 1: my main point of contact for the series I had
Speaker 1: been asked to produce. I explained to Steve Rouse some
Speaker 1: of the issues I wanted dealt with in interviews with
Speaker 1: Wendy Edmund, the Minister, and her Director General, Dr Rob Stable.
Speaker 1: I told him that I sought information to address the
Speaker 1: claims of clinicians and patients that the waiting lists are
Speaker 1: misleading because they don't indicate the waiting time for the
Speaker 1: appointments for assessments for surgery. I also flagged my interest
Speaker 1: in the bigger picture issues. I wrote, for example, what
Speaker 1: the community might want or expect versus what it is
Speaker 1: prepared to pay for, and the increasing tensions arising out
Speaker 1: of strife of interests with what clinicians would like to
Speaker 1: do for patients versus administrators who are responsible for the budgets.
Speaker 1: The secrecy issues being raised constantly by the doctors and
Speaker 1: nurses concerned me. I emailed Steve Rouss about it. I wrote,
Speaker 1: a number of clinicians claim that when they identify serious
Speaker 1: issues relating to public health, the problems are denied or
Speaker 1: not addressed seriously. They claim as cans doctors claimed earlier
Speaker 1: this year that only by speaking out can they alert
Speaker 1: the public to what is really going on, but they
Speaker 1: risk their jobs by doing so. They say that this
Speaker 1: puts them in an impossible situation. Can you address this
Speaker 1: please with reference to the Code of Conduct, why it
Speaker 1: restricts the doctors from whistleblowing and why in Queensland Health's view,
Speaker 1: the doctors are no different from any other public servant
Speaker 1: when it comes to highlighting internal issues. On the matter
Speaker 1: of overseas trained doctors, I decided not to disclose that
Speaker 1: I had already been leaked the sensitive Dennis Lennox Report. Instead,
Speaker 1: I ask for information that addresses the number of overseas
Speaker 1: trained doctors in Queensland in both the private and public sector,
Speaker 1: the extent to which the system relies on them, and
Speaker 1: the due diligence undertaken to ensure they're sufficiently skilled. I
Speaker 1: ask does the Minister believe that the current arrangements are
Speaker 1: adequate or is she concerned that doctors without appropriate experience
Speaker 1: or skills are slipping into an undermanned sector because of
Speaker 1: the chronic shortage. What can be done to ensure that
Speaker 1: adverse out comes are minimized. Steve Rouse confirmed my appointments
Speaker 1: for interviews or briefings with the Director General, Doctor Rob Stable,
Speaker 1: his probable successor, Dr Steve Buckland, and Minister Wendy Edmund
Speaker 1: for Monday twenty seven October. Files and folders stuffed with
Speaker 1: documents about Queensland Health covered the kitchen table as I
Speaker 1: worked the telephone and read again the Lennox Report on
Speaker 1: overseas doctors. When it came time to go to the
Speaker 1: nineteenth floor of the Queensland Health Building in Charlotte Street
Speaker 1: on the afternoon of twenty seven October I was well
Speaker 1: prepared in just a few days. Rob Stable, who took
Speaker 1: most of the questions while Buckland listened and occasionally added something,
Speaker 1: would be out of the top job in Queensland Health.
Speaker 1: He was leaving for a new role in the private sector,
Speaker 1: heading up Bond University on the Gold Coast. Dr Stable
Speaker 1: told me we.
Speaker 8: Have some very good over these trained doctors in this state,
Speaker 8: but we are finding that where we need to recruit them,
Speaker 8: some don't have the same degree of language skills. The
Speaker 8: pool of Australian medicine has not kept pace with the demand.
Speaker 8: The market has changed and we do everything practical, interviewing them,
Speaker 8: checking references, giving clinical scenarios. We have this situation. We
Speaker 8: have to provide services. We have hurdles in place. It's
Speaker 8: been reported to us that their communication skills have not
Speaker 8: been very good, but we have noticed this ourselves with
Speaker 8: the applicants. This is a no win. The politicians don't
Speaker 8: accept that we can't have doctors. Is no service better
Speaker 8: than taking the risk that one or two cases per
Speaker 8: year of the six hundred we get in the public
Speaker 8: system in Queensland are not up to scratch.
Speaker 1: Doctor Buckland seemed perplexed we are not in the business
Speaker 1: of causing harm and seeing adverse outcomes. My meeting with
Speaker 1: Wendy Edmund covered a range of topics played the problems
Speaker 1: facing health. Generally, there would always be people, she told me,
Speaker 1: who were like Chicken little talking about the sky falling in.
Speaker 1: It was her way of saying that the public health
Speaker 1: system was in good shape, despite the regular reports from
Speaker 1: clinicians and patients to the contrary. A few hours after
Speaker 1: meeting Stable Buckland and Edmund, I sent a note asking
Speaker 1: further questions about the situation at Harvey Bay. Was it
Speaker 1: the only public hospital at which the qualifications of overseas
Speaker 1: trained doctors were not recognized by the respective colleges? I asked, Also,
Speaker 1: can you copy to me a report by Queensland Health
Speaker 1: doctor Dennis Lennox earlier this year into issues arising from
Speaker 1: overseas doctors. Kato O'Donnell, who handled Queensland Health's official responses
Speaker 1: to some of our queries.
Speaker 2: Told me this report has no official status and was
Speaker 2: not accepted or endorsed by Queensland Health Executive.
Speaker 1: Doctor Buckland and the Medical Board of Queensland had received
Speaker 1: doctor Lennox's report, They had read it and they had
Speaker 1: buried it Chapter sixteen Discredit. November two thousand and three,
Speaker 1: the last patient left doctor Ross Cartmill's waiting room on
Speaker 1: wickham Terrace above the lights of the city's office building,
Speaker 1: sometime after seven pm. A urologist with a successful private practice,
Speaker 1: Cartmill was also a visiting medical officer, meaning he gave
Speaker 1: some of his time for relatively minimal financial return to
Speaker 1: look after patients and to mentor junior doctors in Brisbane
Speaker 1: public hospitals. For many specialists, like Cartmell, the motive for
Speaker 1: doing part time work in the public system was altruistic.
Speaker 1: They were giving something back to hospitals which had been
Speaker 1: their training ground years earlier. But doctor Cartmell was now
Speaker 1: gravely worried about the performance and sustainability of public health care.
Speaker 1: I took notes as he vented his spleen.
Speaker 9: The first fact the community needs to understand is that
Speaker 9: doctors are afraid they'll be sacked if they talk openly
Speaker 9: about what is actually happening in public hospitals. The second
Speaker 9: fact is that if doctors could talk openly, Queenslanders would
Speaker 9: hear that their public health system is chronically underfunded and
Speaker 9: suffers from an acute lack of staff and beds. It
Speaker 9: means people who need surgery wait much longer than they should,
Speaker 9: and some people never get operations that would change their lives.
Speaker 9: Doctors and medical staff are frustrated because they feel unable
Speaker 9: to tell the community the whole story. The culture prevents
Speaker 9: people from hearing about the deficiencies. The doctors are told
Speaker 9: they must report their concerns internally, but we've reached the
Speaker 9: point where we believe that reporting upwards will not make
Speaker 9: any difference anymore. Every so often, when someone breaks ranks,
Speaker 9: there's a crackdown and severe reprimand.
Speaker 1: I had been hearing similar complaints from some of the
Speaker 1: most senior clinicians in Queensland. Many were fearful that they
Speaker 1: might be seen meeting me. We went to unusual links
Speaker 1: to avoid detection, as they told me about a corporate
Speaker 1: culture that stamped violently on whistleblowers. One of Queensland's top
Speaker 1: specialists wanted to provide evidence of a clinical disaster in
Speaker 1: a hospital, but he insisted on a secret rendezvous in
Speaker 1: a car in a backstreet. Six months earlier, Health Minister
Speaker 1: Wendy Edmund had turned on doctors in the North Queensland
Speaker 1: city of Cairnes after they protested publicly about cuts in
Speaker 1: the services at the hospital. Wendy Edmund made a statement
Speaker 1: to stay Parliament in May two thousand and three.
Speaker 10: There will always be some winges and I will meet
Speaker 10: with the wines and talk to them.
Speaker 1: The doctors who had funded advertisements in the Cairns Posts
Speaker 1: to make their point were threatened with discipline, reaction and dismissal.
Speaker 1: On three November two thousand and three. I reported this
Speaker 1: in the Courier Mail. If only half the concerns about
Speaker 1: the clinical standards of some of the overseas doctors imported
Speaker 1: into Australia in the past few years are true, it
Speaker 1: would have serious ramifications for patients and the profession. Senior
Speaker 1: medical specialists, rural gps and doctors in the public hospital
Speaker 1: system believed that the failure of registration boards and the
Speaker 1: state and federal governments in checking the competence of imported
Speaker 1: overseas doctors could end up costing the community dearly. I
Speaker 1: knew that many health professionals were also angry that the government,
Speaker 1: led by Premier Peter Beatty, continued to promote itself for
Speaker 1: supposedly reducing the waiting times for surgery in hospitals as
Speaker 1: the Health Minister Wendy Edmund and Premier Beatty lauded themselves
Speaker 1: for achieving their best ever results for elective surgery, the
Speaker 1: clinicians insisted that the claims were a gross misrepresentation of
Speaker 1: the truth. Doctors were sure that an independent audit of
Speaker 1: the results would prove that the public was being told lies.
Speaker 1: I looked at the situation overseas and elsewhere in Australia.
Speaker 1: In the United Kingdom, the National Audit Office had identified
Speaker 1: what it called deliberate manipulation or misstatement of the fears
Speaker 1: in public hospitals in nine major districts. In New South Wales,
Speaker 1: the Independent Commission against Corruption was bringing charges after the
Speaker 1: discovery that a number of major public hospitals had falsified
Speaker 1: and misrepresented waitingless data. I mentioned the concerns to Queensland's
Speaker 1: Order to General Len Scanlon and sent him data, but
Speaker 1: he showed little interest in investigating. On seventeen November, my
Speaker 1: interview with doctor Cartmill was published in The Courier Mail
Speaker 1: with an article about the alleged manipulation by Queensland Health
Speaker 1: of waitingless data in Queensland. Documents taken by the politicians
Speaker 1: to Cabinet remain exempt from disclosure for thirty years. This
Speaker 1: law has been routinely exploited by politicians who have thwarted
Speaker 1: Freedom of information applications and concealed sensitive documents from public
Speaker 1: scrutiny by taking those documents into cabinet. Health Minister Edmund
Speaker 1: had taken waiting lists data to cabinet, ensuring their concealment
Speaker 1: for thirty years. She sent me a statement.
Speaker 10: Which said Queensland waiting times for elective surgery are not misleading.
Speaker 1: Another prominent article I wrote revealed how patients needing urgent
Speaker 1: surgery had been left disfigured by aggressive cancers after operations
Speaker 1: were canceled because of a lack of intensive care beds
Speaker 1: in hospitals. The next day I wrote about eleaked memo.
Speaker 1: It was written by doctor Phil Kay, an emergency department
Speaker 1: head who was furious that administrators had decided to close
Speaker 1: the gynecology unit in one of Queensland's largest hospitals. Our articles,
Speaker 1: part of the Courier Mals series on the health system,
Speaker 1: were causing top level angst. Minister Wendy Edmund's efforts to
Speaker 1: keep health off the front page had failed. Her staff
Speaker 1: feed the series might do significant harm to the image
Speaker 1: of the Beaty government. Just a few months out from
Speaker 1: the February two thousand and four state election, the Career
Speaker 1: Mail's editor, David Fagan, received an angry letter from Hendrik Gout,
Speaker 1: Queensland Health's executive manager for Media and Communications. Gout began
Speaker 1: by expressing what he.
Speaker 11: Called his sincere concern about the ethics and behavior of
Speaker 11: Hedley Thomas over the past few days.
Speaker 1: He described me as an.
Speaker 11: Unprincipled, unprofessional, unscrupulous journalist.
Speaker 1: In the eighteen November message, Gout said.
Speaker 11: Either the Minister's office is lying or one of your
Speaker 11: own reporters has a pinocchio nose. Hedley is making a
Speaker 11: practice of this.
Speaker 1: After examining my actions and double checking the facts of
Speaker 1: the stories, I realized that doctor Cartmell and the other
Speaker 1: doctors were right. The culture of fear and loathing in
Speaker 1: Queensland Health was thriving. It was an organization with serious
Speaker 1: fundamental shortcomings which were being camouflaged by glossy pr and
Speaker 1: aggressive shoot the messenger strategies. It was little wonder that
Speaker 1: many clinicians were afraid to tell the truth. A number
Speaker 1: of the doctors, professional administrators and former health chiefs had
Speaker 1: made a persuasive public case that the health system was
Speaker 1: in crisis. They were adamant that the public was being
Speaker 1: conned into believing that it had one of the finest
Speaker 1: systems in the world. In fact, spending on health in
Speaker 1: Queensland was the lowest per capita in Australia. The underfunding
Speaker 1: of more than one billion dollars a year had produced
Speaker 1: huge gaps. Doctors and health professionals had little incentive to
Speaker 1: remain in a system which treated them and their patients
Speaker 1: so poorly. The drain of experienced professionals, cutbacks on beds
Speaker 1: in hospitals, the rationing of care, and the punishment of
Speaker 1: administrators who did not churn through waiting lists while making
Speaker 1: budget had set Queensland Health up for a painful fall.
Speaker 1: When doctor Steve Buckland sought the top job as Director
Speaker 1: General a few months after the Courier mal series, he
Speaker 1: wrote a confidential letter acknowledging that Queensland Health's focus on
Speaker 1: fiscal management had suppressed its ability. In his job application, he.
Speaker 12: Wrote, this has also resulted in a disaffected workforce, a
Speaker 12: lack of innovative problem solving, strained relationships with other government agencies,
Speaker 12: and a lack of public confidence in the system's capability.
Speaker 1: Publicly, however, the message from Queensland Health and its political
Speaker 1: sponsors was the exact opposite. Chapter seventeen. Starting over. Long
Speaker 1: before the first European explorers ventured almost four hundred kilometers
Speaker 1: north of Brisbane to identify future settlements and farming opportunities,
Speaker 1: a local Aboriginal tribe known as the Bunder had the
Speaker 1: area to themselves. The government assistant surveyor James Charles Burnett
Speaker 1: visited in the eighteen forties, but failed to appreciate the
Speaker 1: potential of the rich volcanic soil. The oversight meant that
Speaker 1: the Bunder people were left alone for another two decades.
Speaker 1: The first white settlers, brothers John and Gavin Stewart, arrived
Speaker 1: on Christmas Day eighteen sixty six and began to raise
Speaker 1: the hardwoods. They were followed by European migrants keen to
Speaker 1: exploit the fertile black soil and the readily available water
Speaker 1: source of the Burnett River. Their success attracted industry and commerce.
Speaker 1: The settlement started to thrive. As the German word for
Speaker 1: town was berg, the area was named Thunderberg. It owed
Speaker 1: its burgeoning prosperity to sugar cane and the toil of outsiders.
Speaker 1: Dark skinned Kannakers brought to workers bonded slaves in the
Speaker 1: cane fields for a meager wage, a roof over their
Speaker 1: heads and food. They were indentured for three years. To
Speaker 1: the plantation owners, the conditions were invariably dreadful. In eighteen
Speaker 1: eighty one, when the General hospital opened beside the Burnett River,
Speaker 1: it comprised four rooms, a cottage and a separate ward
Speaker 1: for the Kannakers. The following year, dozens of labourers from
Speaker 1: Ceylon now Sri Lanka arrived in Bunderberg under work contracts,
Speaker 1: but the demand for cheap labour was still unmet. The
Speaker 1: Bunderberg and District's Historical Museum reported for the.
Speaker 13: Next thirty years Melanesian and Polynesian islanders provided almost the
Speaker 13: complete field labour for cane plantations and farms. At one stage,
Speaker 13: three thousand lived in the district.
Speaker 1: Bunderberg is famous for its rum, a product of its
Speaker 1: sugar cane, and a record breaking aviator, Bert Hinkler. In
Speaker 1: February nineteen twenty eight, he flew from England to Australia
Speaker 1: in fifteen days, an extraordinary feat at the time the
Speaker 1: son of a local mill worker. His achievement lifted the
Speaker 1: town's spirits. The sugar cane plantations were still thriving when JR.
Speaker 1: Patel arrived in two thousand and three, and Bunderberg still
Speaker 1: relied heavily on imported labor, but now the most valuable
Speaker 1: imports were overseas trained doctors. A medical workforce crisis serious
Speaker 1: throughout Australia but dire in regional Queensland due to inferior
Speaker 1: salaries and conditions, meant that the overseas doctors were the
Speaker 1: backbone of the public hospital on Bourbong Street. Although the
Speaker 1: doctors coming from third world countries were financially better off
Speaker 1: in Australia, they were easily exploited. Their employers knew that
Speaker 1: the foreign doctors could be forced to return to their
Speaker 1: own countries if their working visas were not renewed. Unlike
Speaker 1: Australian doctors who could change jobs after a dispute with management,
Speaker 1: the overseas trained doctors were at a distinct disadvantage. It
Speaker 1: made some of them more willing to follow orders and
Speaker 1: less likely to ask difficult questions. J. N. Patel had
Speaker 1: little time for Bunderberg's history and its natural attractions, the
Speaker 1: outlying resort islands, the beaches and the largest mainland turtle
Speaker 1: hatchery in Australia. Unlike his predecessors, doctor Charles Nankevell and
Speaker 1: doctor Sam Baker, Patel delighted in being overburdened with surgical
Speaker 1: work he spent most of his time at the hospital.
Speaker 1: But whereas most of the other overseas trained doctors were submissive,
Speaker 1: Patel displayed bravado. He worked hard, and he exerted his
Speaker 1: influence over management. One of his confidants was Pam Samra,
Speaker 1: whom he saw at least four times a week at
Speaker 1: her restaurant, the Indian Curry Bazaar near the Sugarland shopping
Speaker 1: Center in tackle Van Street. They chatted freely and often
Speaker 1: about his career, his life in the United States, and
Speaker 1: his efforts at the hospital. She was alarmed to hear
Speaker 1: from him one day that he had not slept for
Speaker 1: thirty hours because of the continuous work. She told him.
Speaker 14: Those hours are ridiculous.
Speaker 15: You shouldn't be doing that.
Speaker 14: What are you working so hard for?
Speaker 3: Take a break?
Speaker 14: Patel replied, there are no other doctors to do the
Speaker 14: work I've been asking for. Backup for months. Nobody listens
Speaker 14: to me, But then I've been paid forty thousand dollars
Speaker 14: and bonuses for getting through the waiting lists.
Speaker 1: In truth, Patel had been arriving at the hospital before
Speaker 1: the other doctors so that he could beat them to
Speaker 1: the patients. He was creating work for himself. If doctor
Speaker 1: Martin Carter arrived at seven thirty am, Patel would be
Speaker 1: there the next day at seven am. If Carter responded
Speaker 1: by coming in at seven am, Patel trumped him with
Speaker 1: a six thirty am start. Carter gave up. At this rate,
Speaker 1: he would have been lying in wait for the surgeon
Speaker 1: and coming to work at midnight. Patel was intrigued by
Speaker 1: the circumstances of Pam Sam and her husband Jindi. In
Speaker 1: accordance with the custom and tradition of India's Punjab state,
Speaker 1: their marriage was arranged despite Pam having been born and
Speaker 1: raised in Australia. It was a happy and prosperous union.
Speaker 1: Patel lied to the married.
Speaker 14: Father, I have no kids, I've never been married. The
Speaker 14: only woman in my life is my mother in India.
Speaker 1: He told how he visited the old woman at the
Speaker 1: ancestral home in Jamnagar as often as possible. He sent
Speaker 1: funds to make her privileged life more comfortable.
Speaker 3: Why doesn't she move to America.
Speaker 1: Asked Samra, but Patel said his mother would be unhappy
Speaker 1: in the United States, away from her friends and relatives.
Speaker 1: Patel dressed smartly, often in a suit and tie. He
Speaker 1: tipped generously, usually rounding a thirty five dollar bill for
Speaker 1: his takeaway meals to fifty dollars. He ordered only vegetarian
Speaker 1: dishes and told her he was vegetarian. Sama heard from
Speaker 1: others though, that he ate meat elsewhere. Although he was
Speaker 1: occasionally arrogant, Samara nevertheless enjoyed their chats. Nobody else in
Speaker 1: the town spent as much on food at the Curry
Speaker 1: Bazaar as doctor Patel. He was their best customer. At
Speaker 1: least once a week after work, he would bring a
Speaker 1: group of nurses or student doctors to the upstairs dining area.
Speaker 1: He enjoyed the company of doctor Jim Gaffield, who had
Speaker 1: also arrived from the United States, and the young doctor
Speaker 1: Anthony Athanasiov, an Australian graduate. Patel usually paid for the
Speaker 1: groups he brought to the restaurant. Pam Samra suspected that
Speaker 1: he was lonely. She regarded him as a hopeless flirt.
Speaker 1: He often had a hand on the lower back of
Speaker 1: one of the nurses. Although he would make the occasional proposition,
Speaker 1: the physical contact was never so overt that it led
Speaker 1: to a rebuke. When he was not entertaining the medical
Speaker 1: and nursing staff, he wanted to talk to Samra about
Speaker 1: her life. She wondered if he was attracted to her.
Speaker 1: Petel's two bedroom apartment in Sapphire Lodge at Bagara was
Speaker 1: tidy but never clean. The cigarettes he chain spoke had
Speaker 1: left a pungent smell. The bathroom and toilet were always dirty.
Speaker 1: On one occasion, Carol Elliot, the owner's sister, went to
Speaker 1: the apartment to do some cleaning as part of an
Speaker 1: ongoing arrangement. The sheets needed washing. She removed Patetel's things
Speaker 1: from the machine to do another load. He walked in
Speaker 1: and began screaming and abusing the shocked woman in front
Speaker 1: of her two grandchildren. Patel was enraged. His tirade could
Speaker 1: be heard up and down Miller Street. Who took my
Speaker 1: washing out of here? It should have been obvious to
Speaker 1: him that Eliot had removed a few towels. You have
Speaker 1: not business. I'm a very impottant doctor.
Speaker 14: I'm the head doctor the best hospital.
Speaker 16: How did you don't worry about it? You just go
Speaker 16: to the hospital and I will make sure that towels
Speaker 16: go on the line to dry.
Speaker 1: The encounter had upset her grandson, Elliot was worried that
Speaker 1: it would influence the boy's view of dark skinned people.
Speaker 9: Why did that black man scream at you, Gran?
Speaker 16: He's not a nice man. Not all people that color
Speaker 16: are like him.
Speaker 1: When Patel's wife, Kashowre, and daughter came to visit from
Speaker 1: the US, he kept them away from the restaurant he
Speaker 1: had told others that he was single. Elliot felt sorry
Speaker 1: for Kishore, a medical practitioner in Portland. During a chance meeting,
Speaker 1: Patel introduced his daughter and beamed with pride as he
Speaker 1: praised her as the family's next doctor. She would be
Speaker 1: graduating soon from medical school, but Patel scarcely acknowledged his wife,
Speaker 1: the demure woman was him. Elliot walked away, wondering what
Speaker 1: made him tick. Chapter eighteen Doctors Germs late two thousand
Speaker 1: and three to early two thousand and four. Joanne Turner
Speaker 1: hovered over the patients in the renal unit at Bunderberg
Speaker 1: Hospital and waited for a tube to visibly redden a
Speaker 1: telltale sign of blood being drawn from the internal jugular
Speaker 1: just above the heart's right atrium. Everything looked satisfactory, the
Speaker 1: catheters with tubes burrowing into the chest, the two patients
Speaker 1: whose blood needed regular cleansing, the hemodialysis machine, which would
Speaker 1: return the blood with fewer impurities and provide the patients
Speaker 1: with a lease of life. Turner frowned. The catheters, which
Speaker 1: had been surgically implanted by Jayan Patel, not working. They
Speaker 1: appeared to be blocked. Effective hemodialysis with a permacath type
Speaker 1: catheter required a blood flow rate of more than two
Speaker 1: hundred milli liters a minute, but Turner could not obtain
Speaker 1: a drop. Patel arrived in the renal unit within minutes
Speaker 1: of being paged. When Turner explained the difficulty that she
Speaker 1: was experiencing, the surgeon.
Speaker 14: Erupted, flush it, sister, just get in there and flush it.
Speaker 1: Turner was immediately uneasy. She knew it was unsafe to
Speaker 1: flush the catheter until the removal of the heperin lock.
Speaker 1: A dose of an anticoagulant drug called heperin, which stops
Speaker 1: blood from clotting at the end of the catheter. A
Speaker 1: low pressure injection of saline from a syringe is used
Speaker 1: to flush a catheter, but only after the removal of
Speaker 1: the hepperin lock. She had set up two sters, one
Speaker 1: for each patient. Patel had neither washed his hands nor
Speaker 1: put on sterile gloves. When he took the bung from
Speaker 1: the end of the catheter connected to the first patient,
Speaker 1: He picked up the sterile syringe and tried, unsuccessfully to
Speaker 1: take blood from the line. To Turner's alarm, he then
Speaker 1: moved with the same syringe to the other patient. Turner
Speaker 1: had never seen anything like it. Strict infection control measures
Speaker 1: in hospitals were critical in the renal unit, where the
Speaker 1: chronic disease suppressed the patient's immune systems. The catheters were
Speaker 1: perfect conduits for blood. They were also perfect conduits for bacteria.
Speaker 1: Pointing to the other sterile tray, she said.
Speaker 15: This is the patient's set up.
Speaker 1: But how did you tactfully tell the director of surgery
Speaker 1: that his modus operandi was wrong and might be lethal.
Speaker 1: Turner did her best. Aren't you going to wash your hands?
Speaker 1: She urged him to put on the sterile gloves, sister,
Speaker 1: I don't have jumps. She thought at first that he
Speaker 1: was joking. Nobody would seriously believe such a comment, least
Speaker 1: of all a doctor, But Peatell neither smiled nor corrected himself.
Speaker 14: I'm doing you a fever.
Speaker 1: The look on his face told Turner that he was
Speaker 1: annoyed at her attempts to insist on the gloves. He
Speaker 1: performed the procedure on the second patient with his bare hands.
Speaker 1: Linette Yeoman, one of the other nurses working the early shift,
Speaker 1: watched dumbfounded. She wondered how someone with so much experience
Speaker 1: could fail to appreciate the serious risk he pose to
Speaker 1: the ill patients. A third nurse, Caroline Waters, walked off
Speaker 1: in disgust. At the end of the shift, the nurses
Speaker 1: spoke to their manager, Robin Pollock. When Patel first arrived
Speaker 1: at the hospital, he had little to do with the
Speaker 1: renal unit, but this had changed when he started inserting
Speaker 1: catheters in August. During his regular stops in Pollock's office,
Speaker 1: he invariably turned the conversation from the patients to her
Speaker 1: personal life. The visits were usually uncomfortable for Pollock. She
Speaker 1: asked her staff to telephone if Patel stayed in her
Speaker 1: office more than a few minutes, the RUSS usually worked.
Speaker 1: Pollock had another reason to feel uncomfortable. She had been
Speaker 1: concerned for some weeks about complications with catheters implanted by Patel.
Speaker 1: Four patients had had peritoneal dialysis catheters placed by Patel,
Speaker 1: one in August, two in September, and one in October,
Speaker 1: and each had suffered unnecessarily. In three of the patients,
Speaker 1: there were chronic infections at the exitsites. The fourth patient,
Speaker 1: whose catheter did not drain or flow properly, needed surgical intervention.
Speaker 1: Some of the catheters had moved internally and ended up
Speaker 1: in the wrong position. After the nurses explained the events
Speaker 1: of the morning and Patel's handling of the patients, Pollock
Speaker 1: was aghast, fearing that a patient might die. She raised
Speaker 1: the issues with Gail Alma, the nurse responsible for infection control. Alma,
Speaker 1: who had previously tried to tackle the wound Dahesion's problems,
Speaker 1: arranged the meeting with doctor Darren Keating two days later.
Speaker 1: Lindsey Druce was also worried. The clinical nurse had returned
Speaker 1: from maternity leave to find a rash of problems in
Speaker 1: the renal unit, it seemed to dreuce that many of
Speaker 1: the problems were due to Patel's positioning of the catheters.
Speaker 1: Every one was either facing up or sideways. This meant
Speaker 1: that when the patients sh hour and moved around, it
Speaker 1: was inevitable that fluids and grit would collect in the catheters.
Speaker 1: As the fluids and debris could not drain or fall
Speaker 1: away from the exit site, the risks of infection from
Speaker 1: organisms thriving in the moist warm environment soared. When Aylmer
Speaker 1: and Pollock went to see Darren Keating on twenty seven November,
Speaker 1: he wanted facts and figures, not anecdotal feedback. They repeated
Speaker 1: Patel's bizarre comment about not having germs. Keating asked how
Speaker 1: often infections were occurring and how many cases involved Patel.
Speaker 15: You know, if I really need to go further with this,
Speaker 15: I need data to support what you're saying.
Speaker 1: When he spoke to Patel after the meeting with the nurses,
Speaker 1: the surgeon was affronted. He denied that there had been problems.
Speaker 1: He told Keating the nurses were wrong, and he stopped coming.
Speaker 1: By Pollock as far as Keating was concerned the work
Speaker 1: ethic of Patel and the great strides he was already
Speaker 1: making and reducing the waiting list for surgery made him indispensable,
Speaker 1: despite the growing concerns of the staff who had been too.
Speaker 1: Keating he lauded Patel in a two December two thousand
Speaker 1: and three performance report.
Speaker 15: Doctor Patel effectively utilizes his broad knowledge, skill and experience
Speaker 15: in general surgery to provide high quality of patient care.
Speaker 15: He is a willing and enthusiastic leader. He also brings
Speaker 15: understanding of clinical management subjects to appropriate forums.
Speaker 1: Keating chose the heading performance better than expected to give
Speaker 1: Patel a tick in nine out of eleven areas, including
Speaker 1: his clinical skills, knowledge base, judgment, communication, teamwork, and professional responsibility.
Speaker 1: After just a months in the job, Patel had his
Speaker 1: boss wrapped around his little finger. But doctor Peter Meak,
Speaker 1: the nephrologist in charge of the renal unit, was rapidly
Speaker 1: losing confidence in Patel by late two thousand and three.
Speaker 1: The catheter problems, coupled with several other factors. Petel's insistence
Speaker 1: that he could perform any procedure and the almost inevitable
Speaker 1: complications had made Peter Miak increasingly weary. Some of Patel's
Speaker 1: procedures were just cruel. When Philip Knopp, a patient suffering
Speaker 1: kidney failure, needed an operation in August to draw fluid
Speaker 1: away from his heart, it was decided that Patel would
Speaker 1: do a pery cardial window, a procedure that involved cutting
Speaker 1: a hole in the chest to insert a drain. The
Speaker 1: buildup of fluid threatened to squeeze Knop's heart and cause
Speaker 1: it to fail. Although a fine needle had been used
Speaker 1: to draw the blood he fluid from the Perry cardial sack.
Speaker 1: Miak realized that it would take the removal of a
Speaker 1: little bit of the Perry cardian to eradicate the problem.
Speaker 1: Meac hardly ever went to theater, but he decided to
Speaker 1: watch Patel's handiwork on Knop. Meac winced Knop was screaming
Speaker 1: and moaning and clearly felt excruciating pain. Dr Patel had
Speaker 1: elected to do the invasive operation without anesthetic, contrary to
Speaker 1: normal practice. When Peter Meak tried to transfer his patient
Speaker 1: south away from Patel for the catheter procedures, he was
Speaker 1: told by a doctor at the Royal Brisbane Hospital, we
Speaker 1: are not going to do it. Here. We don't have
Speaker 1: the time, we don't have the capacity. He asked doctor
Speaker 1: Jim Gaffield, the plastic surgeon who had arrived from the
Speaker 1: United States soon after Patel, for help.
Speaker 15: Look, this is not the sort of thing I'm used to.
Speaker 1: I prefer not to do them. Robin Pollock had another idea.
Speaker 1: She reached out to Brian Graham, who worked for a
Speaker 1: company with a contract to supply renal products to the hospitals.
Speaker 1: The company, backs To Healthcare, was offering programs to train staff.
Speaker 1: Pollock had told Graham about the run of complications with
Speaker 1: catheters implanted on Petel's patients. She knew Patel was not
Speaker 1: interested in hearing from the nurses. Perhaps he would respond, though,
Speaker 1: to an offer from Graham to provide support or education
Speaker 1: on placement technique. Brian Graham met Patel in the renal
Speaker 1: unit and explained the program.
Speaker 14: Patel pounced, well, you can fly me to Brisbane, you
Speaker 14: can mine and din me. You can put me up
Speaker 14: somewhere nice, and then I might listen to what you
Speaker 14: have to say.
Speaker 1: Graham decided that Dr Patel was a lost cause. On
Speaker 1: sixteen December, Eric Nagel returned to the hospital for surgery
Speaker 1: to correct a catheter placement that Patel had bungled when
Speaker 1: inserting it the previous month because it had not been
Speaker 1: tunneled correctly. During the first operation, the catheter was facing
Speaker 1: sideways instead of downwards. Internally, it had flipped up under
Speaker 1: Nagel's liver. An X ray showed the internal part of
Speaker 1: the catheter had migrated, resulting in impeter drainage. For the
Speaker 1: much needed hemodialysis to work, Nagel's old catheter needed to
Speaker 1: be removed and replaced with a new one. Nagel and
Speaker 1: his wife Linda were reassured on the eve of surgery.
Speaker 1: They believed that it would be a routine procedure conducted
Speaker 1: under a general anesthetic in the operating theater. They knew
Speaker 1: nothing of the nurse's concerns over doctor Patel, nor did
Speaker 1: they know about doctor Peter Meak's misgivings. Lindsey Dreus watched
Speaker 1: Nagel being wheeled off the theater. It was the last
Speaker 1: time she saw him. A guidewire used by doctor Patel
Speaker 1: poked a hole through the main blood vessel going to
Speaker 1: Nagle's heart. The bleeding took place inside his perry cardial sack.
Speaker 1: Nagel's blood pressure dropped suddenly. As Patel and doctor Martin
Speaker 1: Carter the top anesetis tried frantically to rectify the situation,
Speaker 1: Nagle suffered a heart attack, his thoracic vein was punctured.
Speaker 1: He bled to death. None of the distraught nurses in
Speaker 1: the renal unit could recall anyone else ever dying during
Speaker 1: the placement of a catheter. When Nagle's widow returned days
Speaker 1: later for an explanation anything that might help her understand
Speaker 1: why a supposedly routine procedure had killed her husband, the
Speaker 1: nurses were at a loss. For Peter Miak, it was
Speaker 1: the last straw. He decided that Patel would not perform
Speaker 1: any more catheter operations on his patients.
Speaker 3: If I have to send them to Brisbane, so be it.
Speaker 1: Before going on extended leave in January, Peter Meak told
Speaker 1: a replacement nephrologist, doctor Martin.
Speaker 3: Knapp, keep doctor Patel away from the renal patients.
Speaker 1: Drews completed her report on complications from catheter placements. It
Speaker 1: showed that Battell had a one hundred percent failure rate
Speaker 1: six catheter placements and multiple complications. All of the patients
Speaker 1: were adversely affected. One was dead. With Peter Miak overseas
Speaker 1: and Brisbane refusing to receive Bunderberg's patients, Pollock became desperate.
Speaker 1: She had seen yet another complication arising from Patel's handiwork.
Speaker 1: She and Druce went to see Patrick Martin, the acting
Speaker 1: director of nursing, to explain the problems, the directive from
Speaker 1: Meak and the uncertain future for patients needing catheters. Patrick
Speaker 1: Martin had little time for doctor Patel. There was something amiss,
Speaker 1: something about the surgeon's personality that made Martin wary. He
Speaker 1: took the nurse's concerns to Darren Keating, but Keating said.
Speaker 15: If the nurses want to play with the big boys,
Speaker 15: then they need to provide the evidence and bring it on.
Speaker 1: Eventually, Pollock, Druce, and Peter Meak found a way to
Speaker 1: bypass Patel. The patients from the renal unit who needed
Speaker 1: catheter placements would go to a nearby private hospital where
Speaker 1: another surgeon performed the operations. There were no more problems,
Speaker 1: but even this highly unusual arrangement did not result in
Speaker 1: the surgeon's clinical expertise being reviewed or questioned by management.
Speaker 1: Tony Hoffman went to see Bunderberg Hospital DiscT Trick manager
Speaker 1: Peter Leck at the end of February two thousand and
Speaker 1: four to tell him about the concerns over Patel.
Speaker 17: I just want to make you aware.
Speaker 1: She gave Leck a document headed Intensive Care Unit issues
Speaker 1: with ventilated patients. The document dealt with the worries about esophagectomies,
Speaker 1: the refusal of Patel to transfer his patients to larger
Speaker 1: and better equipped hospitals, and the compromising of their care.
Speaker 1: In the document, Hoffman warned.
Speaker 17: On several occasions when Dr Petell's patients have been in
Speaker 17: the ICU, he has refused to transfer his patient to Brisbane,
Speaker 17: even when the patients have deteriorated and have been in
Speaker 17: ICU for much longer than twenty four to forty eight hours.
Speaker 17: Dodor Pitateell has repeatedly threatened to resign, not put any
Speaker 17: elective surgery in ICU, and go straight to Peter Leck.
Speaker 1: Tony Hoffman added that doctor Pittel bow that his efforts
Speaker 1: so far had earned half a million dollars for the hospital.
Speaker 1: Keating was short tempered when Peter Leck asked him about
Speaker 1: the issues.
Speaker 15: If this keeps going, Dr Patel will leave.
Speaker 1: Peter Leck, who mislaid his copy of the document a
Speaker 1: short time later, told Hoffman that if she wanted to
Speaker 1: do something about it, she would need to come and
Speaker 1: see him, lodge a formal complaint, and let the matter
Speaker 1: be progressed through official channels. Hoffman asked Peter Leck not
Speaker 1: to do anything about Patel just yet. She wanted another
Speaker 1: chance to resolve it with doctor Martin Carter's help. The
Speaker 1: hospital administrators had become not just highly dependent on Patel,
Speaker 1: they were also saving money. Keating had encouraged him to
Speaker 1: apply for a half time position as an associate professor
Speaker 1: in surgery at the University of Queensland School of Medicine.
Speaker 1: The criteria called for demonstrated expert knowledge and clinical experience
Speaker 1: in one or more of the surgical disciplines. When Keating
Speaker 1: sat on the three person selection panel with a physician,
Speaker 1: doctor lou Davies, and a senior lecturer in surgery, doctor
Speaker 1: Peter Bore, the decision was unanimous. In late two thousand
Speaker 1: and three, Patel was appointed and given the authority to
Speaker 1: teach full time students. His salary and other benefits from
Speaker 1: this role of more than eighty thousand dollars a year
Speaker 1: were remitted to the coffers of Bunderberg Hospital. Darren Keating
Speaker 1: and Peter Leck congratulated themselves on their business and management
Speaker 1: acumen the hospital was humming. Sick to Death is written
Speaker 1: and presented by me Headley Thomas, the Australian's national Chief correspondent.
Speaker 1: Claire Harvey is The Australian's editorial director. Audio editing, production
Speaker 1: and music have been done by Jasper Leik with assistance
Speaker 1: from Leah Sammaglu and Neil Sutherland. Our producer is Christain Amias.
Speaker 1: Production management by Stephanie Coombs. Artwork by Sean Callanan. Thanks
Speaker 1: to Ryan Osland, Matthew Condon, Karina Berger, Ellie Dudley, David Murray,
Speaker 1: Dominique McDermott, Zach Sculander and all our family, friends and
Speaker 1: colleagues who helped in this series and contributed voice acting
Speaker 1: and special thanks to Tony Hoffman and Rob Messenger. Subscribers
Speaker 1: to The Australian here new episodes of Sick to Death
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