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State takes the lead by exposing quacks in our health system

I WAS proud to be a journalist this week. In an unprecedented move, the entire medical board will be axed. Queensland will get a specialist health ombudsman.

This follows a long campaign by this newspaper to expose incompetence and wrongdoing by medical practitioners.

We could not have reported the tragedies and cover-ups without a handful of courageous whistleblowers who dared to tell the truth.

Toni Hoffman and Christine Cameron are career nurses while Jo Barber was a medical board investigator and a former detective.

Each had a burning desire to tell the truth about failures in the medical system that caused harm to patients in their care.

They were brave enough and impolite enough to point out the health watchdogs had no teeth.

NEWS BCM 20/10/2010. Former Bundaberg Base Hospital nurse turn whistleblower Christine Cameron. Photographer: Liam Kidston.

Health Minister Lawrence Springborg and AMA chief Dr Alex Markwell used the same phrase recently when they said many genuine complaints "fell through the cracks".

We've been saying that for years.

Now Parliament has been told that five doctors face prosecution.

The whistleblowers all suffered for speaking out.

By doing so, they did much more than provide comfort to the walking wounded and families who lost loved ones to medical blundering.

27 Feb 2007 Whistleblower nurse Toni Hoffman at home with her dogs Ming & Sam. PicPaul/Beutel headshot medical animals

The whistleblowers succeeded in changing the system.

Springborg this week moved to demolish the Queensland Board of the Medical Board of Australia, one of the bodies which investigates complaints.

The dramatic changes to the administration of health complaints in this state followed malpractice revelations in The Courier-Mail and The Sunday Mail.

Our reporting forced an investigation by the Crime and Misconduct Commission and a series of inquiries and reviews by retired judges, doctors and nurses.

They all found evidence of wrongdoing.

Cases of doctors engaging in conduct ranging from criminal negligence to gross incompetence and laziness were revealed in documents tabled in Parliament.

It was hardly news to readers of The Courier-Mail.

The inquiries all pointed in the same direction: Queenslanders were let down by the system, public and private.

The latest inquiry made some astonishing findings.

An investigative panel headed by barrister and former intensive-care nurse Kim Forrester reported that in one case it took 2368 days, or nearly 6 years, to reach a decision following a complaint.

The Forrester report tabled in Parliament said 60 per cent of the files it examined were not handled in a manner that was timely and/or appropriate and/or in compliance with legislative objectives.

Give the Borg his due. He acted swiftly.

Previous health ministers who must have known of many of these gross failures either turned a blind eye, buried their heads in the sand or shoved the cases in the too-hard basket - pick your own cliche.

Springborg said victims of medical mishaps had been treated appallingly.

He used words such as "disturbing' and "outrageous".

The Forrester report was tabled alongside the findings of senior lawyer Jeffrey Hunter, who recommended that police consider criminal charges against six medical practitioners.

"These reports paint a deeply disturbing picture of dysfunctionality in the handling of health-related complaints," Springborg said.

"In a majority of cases, delays meant that doctors . . . continued to practise without their competency being assessed and in the absence of safeguards, supervision or monitoring."

The Forrester report also was a stinging rebuke of the role of the Australian Health Practitioner Regulation Agency, a federal body.

Said Springborg: "In relation to the appropriateness of decisions, the Forrester panel found clear evidence that in processes followed by AHPRA, the Medical Board did not provide adequate protection for the public."

He said work on the two reviews was delayed when AHPRA and the Medical Board initially declined to release the relevant files due to confidentiality and privacy concerns.

"I will discuss the ramifications of these findings with my fellow state health ministers and the Commonwealth Minister," Springborg said.

So federal Health Minister Tanya Plibersek has now been dragged into the controversy.

Will she insist AHPRA explain why it initially refused to co-operate with the Queensland investigations? Did the delays cause further suffering to patients?

And what is happening in other states? No one could believe the only incompetent doctors practise in Queensland. It's a national problem.

Springborg said legislation to create a national regulatory scheme for health professions across Australia supplanted state-based arrangements in 2009.

He has expressed doubts about the federal agency's transparency and accountability.

"There is much to gain from a uniform national approach to credentialing and registration. But it has to be underpinned by an effective and accountable complaints referral, handling and investigation system," he said.

It's not the end of this story; it's just the beginning.

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Barrister and former intensive care nurse Dr Kim Forrester lead the review panel

SEX, DRUGS AND CASH FUEL DOCTOR VIOLATIONS

DOCTORS raped and rorted their patients, according to the Forrester report tabled in State Parliament this week .

One swapped scripts for sex. Another allegedly persuaded patients to invest in a "monetary scheme" which subsequently failed.

There were 29 "violations of a sexual nature" in the past six years and many complaints took too long to investigate and went unresolved, said the panel, led by Dr Kim Forrester, a barrister and former intensive care nurse.

The doctor facing rape charges fled abroad, the report revealed.

"The Queensland Police Service assessed that there was sufficient prima facie evidence to issue a warrant for the practitioner's arrest on two charges of rape of his patients should the practitioner return to Australia," it said.

The report also highlighted the case of a vulnerable patient with a history of drug abuse who traded sexual contacts for prescriptions for benzodiazepams, or Valium.

Investigations into the complaints were unsatisfactory and in some cases dragged on for years. Patients were therefore denied justice.

There were 87 complaints of official misconduct.

"The nature of the issues dealt with were wide ranging; and specific allegations were often very difficult to assess and investigate," the report said.

"Examples of allegations within this category included fraudulent issue of certificates, inaccurate reporting and medico-legal assessments, fraudulent entries in medical records, unauthorised access to medical records, fraudulent claims for home and practice visits, coercion of patients to make unwise financial investments, breaches of supervisory duties or regulatory conditions and unacceptable communication/behaviour such as rudeness, intoxication and lewdness."

As well there were "allegations of inappropriate prescribing, the practitioner being intoxicated while treating patients, adverse surgical outcomes, suspension of hospital accreditation and breaching existing conditions".

There were also allegations of serious lapses of care.

A doctor did not realise an elderly patient had a broken hip because he neglected to order an X-ray.

"It appears the practitioner only examined the patient's knee," said the report.

Another doctor failed to diagnose an aggressive cancer for nearly a year.

Dozens of cases piled up without being properly investigated.

Some extracts: "A former patient made a complaint alleging that the practitioner had a consensual sexual relationship with her, and made uninvited sexual advances during a consultation."

At first the medical board found there was insufficient evidence to discipline the doctor.

It later rescinded its decision at the behest of the Health Quality and Complaints Commission. Nothing happened for nearly a year.

" The investigation took 11 months to report and a further four months for the final decision of the board to be implemented. No conditions were imposed, or undertakings made, during the 833 days of the case history," the report said.

The report said another practitioner engaged in a sexual relationship with a patient over a period of at least seven years.

"Further, the practitioner had inappropriately touched two other patients and had had sexual relationships with another two patients.

"A period of 13 months elapsed before the first recommendation was made. An investigation was conducted and it was determined that there was sufficient evidence to form a reasonable belief that the practitioner had engaged in a sexual relationship and that a disciplinary matter existed.

"Furthermore it was shown that the practitioner had provided a sworn statement to the board which was later proven to be false. The matter was referred to Queensland Civil and Administrative Tribunal."

Another doctor was accused of assaulting a colleague and being "aggressive and intimidating" towards others.

"It was believed the practitioner had a history of bipolar disorder and some colleagues believed the practitioner was showing signs of a manic condition, while others did not," the report said.

"The practitioner had practised medicine in Queensland for several decades and had two previous unfounded complaints, one in 1998 and one in 1999.

 
 

"However the board was unable to progress investigation of the matters in relation to the assault/bullying allegations as the complainants would not assist in the investigation and there were no other avenues of inquiry available."

One doctor was accused of fraud after he offered to "look after" $75,000 belonging to a patient.

"Further it was alleged that no receipt was offered, the money was retained in a personal account and the patient was given small amounts of their money when they requested. Following a dispute, due to separation issues between the practitioner and his wife, the money became unavailable to the patient.

"On investigation it was concluded that the practitioner's partner was the person responsible for the situation."

The file was marked NFA - no further action.

In another case, a practitioner "used coercion" to convince patients to invest money in an overseas investment scheme which failed.

In compiling her report, Forrester was assisted by James Houston, the director of medical services at Greenslopes Private Hospital, and Elizabeth Davies, chair of the Queensland Nursing Council.