Australia, July 09, 2005
Sean Parnell
Weekend Australian
SOLICITOR David
Watt, in documents lodged with the state Supreme Court
as part of a bid to shut down Queensland's Dr Death
inquiry, makes a point of mentioning the other agencies
that continue to investigate his client, hospital
manager Darren Keating.
Keating, who stood aside as director of medical services
at Bundaberg Base Hospital, has been widely condemned
for launching the court challenge and for accusing
inquiry commissioner Tony Morris QC of being biased
against him and of having prejudged the evidence.
Whether other parties, such as Bundaberg district
manager Peter Leck, join the challenge remains to
be seen, but Watt's mention of the other agencies
might be an attempt to remind the court and the general
public that the inquiry is not the only probe into
Indian-trained American surgeon Jayant Patel and the
troubled health system.
The inquiry has so far failed to gather any evidence
from Patel, forcing Morris to release an unexpected
interim report that recommends the former Bundaberg
director of surgery be charged with murder, negligence
causing harm, and fraud.
Police already had an interest in the case, however,
and their investigation only gained speed when they
recently received a report from a clinical audit team
led by vascular surgeon Peter Woodruff, who found
Patel had contributed to at least eight patient deaths.
Police will go to the US to gather evidence on past
disciplinary action against Patel to determine whether
he registered fraudulently in Queensland. Woodruff
is also on the panel of medical experts that will
help police determine whether the deaths and complications
linked to Patel warrant criminal charges.
Similarly, the Queensland Medical Board has appointed
an investigator who, in consultation with the Health
Rights Commission, will examine the Woodruff report
to determine what action it should take against Patel.
This will also provide a handy brief of evidence for
any lawsuits from Patel's patients.
The inquiry has so far failed to get to the heart
of the cultural problems in health, the bitter divisions
between nurses, doctors and managers and the apparent
failure of many staff to be accountable and make others
accountable.
Instead, Morris praised nurse Toni Hoffman and renal
specialist Peter Miach before their evidence was tested
and this week offered to make no adverse findings
against Keating and Leck (if they let the inquiry
continue) and director of nursing Linda Mulligan.
But the Crime and Misconduct Commission will still
hold public hearings into the handling of complaints
at Bundaberg and some in the anti-corruption agency
believe they, not Morris, should have taken the lead
in the first place.
The inquiry has so far failed to examine the secretive
relationship between Queensland Health and its political
masters, along with the history behind many of the
funding and policy decisions Morris has sought to
criticise. No senior bureaucrats, let alone ministers,
have been put in the witness box, and Premier Peter
Beattie and Health Minister Gordon Nuttall have avoided
answering certain questions in parliament and at press
conferences during the inquiry.
But in a budget estimates committee hearing on Thursday,
Nuttall was finally put under the spotlight when Opposition
health spokesman Stuart Copeland raised serious doubts
about the minister's claim to have never been told
about the problems with overseas-trained doctors.
The inquiry has so far failed to draw in the federal
Government, despite its role in deciding medical training
places, overseas recruitment, national standards,
funding through Medicare, the Australian Health Care
Agreement and private health sector reforms. But consultant
Peter Forster, as part of his parallel review of Queensland
Health, has been looking at the history of commonwealth
and state funding and policy decisions. To his credit,
Forster has also consulted widely; yesterday he finished
a state-wide tour and accepted final submissions from
interested parties.
The inquiry has also failed to garner any government
support for the sweeping reform suggestions made by
Morris. While the recommendations from the interim
report, revolving around registration practices and
the "area of need" scheme, have been or
will be implemented, Beattie and Nuttall refuse to
comment on the broader reform suggestions and instead
make their own.
But Forster has been afforded some respect by the
Government, at least, and Beattie makes it clear cabinet
will examine everyone's suggestions and implement
what it regards as the best.
The inquiry has, however, succeeded in providing
a forum for Patel's patients to have their say and
see, in what might be regarded as a televised show
trial, that those responsible for their pain and suffering
will be brought to justice.
In Morris, Beattie appointed a barrister, not a judge,
and is satisfied that he has taken charge of proceedings.
Normally, judges only ask clarifying questions and
wait until the end of proceedings to make their views
known, but Morris has sought to do so during the hearings
(as well as in several newspaper articles).
Some of Patel's patients and several media commentators
fear Keating's court challenge is an attempt to avoid
punishment and prevent justice being done. They should
take some comfort in that the other probes that continue
can be expected to lawfully, fairly and appropriately
establish the facts and see that justice is done.