Crisis of confidence in public health

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The crisis of public confidence in the administration of the public health can only be addressed by a full and open inquiry, says Professor Paddy Dewan.

Prof Paddy Dewan is holding a rally outside the Victorian Parliament on 22 January over concerns about the administration of public health.

THE MEDICAL BOARD reassures the community that it “protects patients and guides doctors”.  That it may well do for some, but there are many mistakes made, health-care dollars wasted and medical careers ruined, aggrieved families denied reassurance, while not enough public good is done.

In the State of Victoria, in November, we saw the Victorian Civil and Administrative Tribunal (VCAT) adding to the dysfunction, by allowing cocaine using surgeons to continue to operate, while they “punish” me for having raised concerns about the veracity of the Medical Board’s processes —disguised by a finding over one case eight years ago.

How can a surgeon be guilty of professional misconduct and allowed to continue to practice medicine?

In my case, why would VCAT insist that a non-surgeon be charged with teaching a surgeon how to gain surgical consent?

The reasons given are that the surgery that I performed on a boy in 2004 was successful, was appropriate for his condition, and was not associated with any complications and with the consent of the family; the VCAT panel manipulated the facts to come up with a different set of conclusions; the real reason for the guilty finding being that the Medical Board has failed to investigate more than 100 scenarios I have presented, some of which sound like the case of Helen Stanley-Clarke presented recently. You will see a similar story in “Pauline’s Story”, which is one of the inappropriately handled cases presented to the Medical Board by me.

The financial burden of our poorly managed system is enormous.

In 2010 to 2011, the Medical Board spent more than $5 million in legal fees, which does not include the costs of running the processes before the lawyers get involved. Much of this money is wasted, as seen by Helen Stanley-Clarke’s case and amplified by the Jayant Patel saga in Bundaberg. In the Patel case, millions were spent from the public purse, and a poor job was done by the legal team running the case, leaving the case open to challenge. The only tangible outcome seems that the Medical Board are able to make life hard for overseas trained doctors, but with no real change in the prospect of patients.

The ongoing “psychological imprisonment” includes the Medical Board leaving false information on their website about my registration. The site , which on the 11th December recorded that I had undertaken to not operate on a megarectum, which I had only committed to so that the medical board would not convene an immediate action committee meeting to try to suspend my registration on the further false allegation by an anonymous surgeon.

Supporters at Prof Dewan's October 5 hearing. (Image courtesy Vince de la Pena.)

My situation can be reinterpreted: VCAT, seeing that I have been of good character, had no complications in the 2004 case, have strong support from doctors and patients, should be allowed to continue to practice medicine. Nice try. The case now just concluded has been running since a false claim by Dr Michael Harari in 2006. I have been sacked, or had my right to work reduced in a number of hospitals on the basis of the claim before the Medical Board, and my ability to do complex surgery in Australia severely limited — not because of my ability, but because of a false allegation.

How has the public been protected by such action?

There are several cases around Australia that have resulted in harm being done to patients by a rogue doctor, doctors being treated abusively for having challenged medical administrators and patients not receiving appropriate review of adverse events or complaints. Certainly, it seems that dollars and the rule of lawyers controls the medical quality agenda.

To allow the public to be heard, a protest rally is being held on the steps of the Victorian Parliament at 4pm, 22nd January 2013 — PROTECTING PATIENTS AND GUIDING DOCTORS. The dress code is BLACK for CODE BLACK, which is a personal emergency in a hospital.  The public, who have found medical management not being patient-centric, and all doctors interested in a CARING medical environment will want to attend.

There is a crisis of confidence in health-care that can be solved, at least in part by developing a new paradigm that includes developing a better culture of caring, and:

  1. Default to compulsory mediation at all levels of dispute

  2. Medical evidence not legal opinion

  3. Appropriate rules of evidence

  4. Accountability of “judges”

  5. Accountability of “witnesses”

  6. Accountability of “complainant”

  7. Financial accountability for AHPRA’s legal costs.

  8. A public inquiry into this matter is vital and in the public interest.

    This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Australia License

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