The recent acquittal of Dr Jayant Patel heralds the reassuring hope that the justice system in Australia is still independent, writes Dr Leong Ng.
"Medicine is, of all the Arts, the most noble; but, owing to the ignorance of those who practise it, and of those who, inconsiderately, form a judgment of them, it is at present far behind all the other arts."
Hippocrates, circa 400 BC
EVER SINCE I was first recruited to Australia from the UK in 2003, I have always been dubious about how the Australian system had treated (and is treating) some doctors from overseas. After 2004 and the publicity about Dr Jayant Patel, I too experienced it firsthand myself, after having received outstanding reports for my work. I had always believed that Dr Patel would not lose his case, but only his dignity, money and reputation — all of which are difficult to restore.
Recently, I rejoiced on learning that Patel had received some justice. I also met some Australians in a restaurant in regional Australia the evening of the day the Supreme Court verdict was delivered; they shared my joy that he had received some justice.
The recent acquittal of Dr Patel heralds the reassuring hope that the justice system in Australia is still independent — at least for some cases. However, the emotional fallout of those ‘affected’ ‒ the first group being the patients and carers in Bundaberg ‒ needs to be supported in a positive way. The other group are the Overseas Trained Doctors.
Whilst as a practising doctor I do have deep compassion for those affected and empathise with them, I am writing in an objective way about the facts. I ask those affected to try to put their emotions aside and think about whether there were serious systemic issues, that continue to haunt many of the Queensland Health managed hospitals, and which hitherto may have been concealed. I continue to empathise and sympathise with the Overseas Trained Doctors and other Australian doctors affected by the old boys’ club culture of the Australian medical fraternity.
There are some key issues which need to be highlighted:
- Everyone dies during a biological lifetime.
- The denial of death or the over expectation that medical science can and will extend life (or improve the quality of life) may be becoming increasingly unrealistic in modern times.
- If a sick person undergoes an intervention to purportedly achieve #2, there are always risks. The risks are routinely explained and weighed by the treating doctor in consultation with the patient and, if agreed, informed consent, as determined by the signing of a consent form is the outcome before the proposed intervention is initiated. It appears that Dr Patel’s patients had all given (and signed) informed consent.
- A sick person (and his/her advocates) can, at any time, rescind the consent and this has to be respected. But, for some interventions – like surgery, once commenced ‒ this may not be possible and one is faced with a predicted or unpredictable outcome.
- Denial can take many forms – this is well known to psychologists and doctors.
- The Royal Australasian College of Surgeons had audited Dr Patel’s work and declared that his operative outcomes were no different from an Australian trained surgeon. Despite its track record of inconsistent egregious actions against Overseas Trained Doctors, Dr Patel, although not a member of FRACS, appears to have been fairly treated.
- It is not a mystery how the original 80-odd charges got reduced to one single charge after the High Court freed Patel from a prison sentence on a miscarriage of justice.* Are allegedly false and frivolous allegations relevant in trying to prove that a justice system is just or another system grossly flawed? The current flavour of the prosecutors is MP Craig Thomson’s 150 odd charges — the more the better, it seems. Never mind the possible errors, they may be missed and the chances of a hit or two with multiple charges will be the highest. Wanting the proverbial pound of flesh seems to be naïve or malicious thinking.
In relation to Dr Patel:
A highly dysfunctional system?
In July 2012, the Queensland Parliamentary Committee overseeing the Crime and Misconduct Commission released into the public arena a document of public interest.
It emanated from an investigation into a former Medical Board investigator turned whistle blower’s disclosure about the internal happenings and functions of the Medical Board of Queensland, thereby implying improper conduct. Rightly so, this is now under further scrutiny.
This matter of public interest is of great concern not only for Queensland but the Commonwealth. It concerns the conduct of other previous State medical boards, now inherited by AHPRA. How well were/are their actions scrutinised? And, how well are the judicial systems surrounding them scrutinised?
There remains unfinished business with Dr Helen Tsigounis (QLD), Professor Paddy Dewan (VIC) as well as many overseas trained doctors — as detailed in Lost in the Labyrinth. Many jurisdictional laws of limitations cater for these delays ‒ legally termed “confirmation” and “disability” ‒ so that perpetrators (that is, Australian medical colleges and public sector bureaucrats) should not technically get away.
Mr Newman’s message to the public was this:
"It's now up to the Office of the Director of Public Prosecutions to determine the next course of action on outstanding charges, so public comment needs to be limited," he stated.
"But my heart does go out to those who have been affected personally by this case, and tonight my thoughts are with them.”
It is said that Dr Patel still faces two manslaughter, two grievous bodily harm, one attempted fraud and seven fraud charges from his time as a surgeon at Bundaberg Base Hospital.
Dr Vijay Mehta, a Texas based retired thoracic surgeon and academic has aptly condensed this political rhetoric in his website as
‘Do not embarrass the Crown like you did the last time. And if you do not have the case it is ok to drop it and not waste taxpayers' dollars!’
As an Australian taxpayer, I strongly agree with Dr Mehta but the point of my piece is to ask whether Dr Patel’s fundamental human rights had been abused all the while and now — by virtue of continued alleged psychological false imprisonment and also recent false physical imprisonment (as had happened with Dr Haneef, another Indian doctor who was falsely accused of being associated with terrorism).
This hot air is a likely to be surrogate measure of a grossly dysfunctional (and possibly corrupt) system where players are probably all lost in the labyrinth and desperately trying to conceal or deflect their own shortcomings.
A medical recruitment agent told me that a Queensland Health decision-maker had told him that ‘we can’t afford to take risks, after what happened with Patel’ — a day after Dr Patel had been found not guilty! It confirms that false information often sticks like mud and for a long time in the minds of bureaucrats. It appears that what is really risky to the patients are not “Dr Patels” but the system itself. It may actually cause harm!
I also wonder how the army of past mainstream media writers would now consider apologising or make amends to Dr Patel. Methinks, likely not, with the antipodean first boat people cultural arrogance of ‘we are the best and we are always correct’! However, the paradigm can and should be challenged — as Dr Haneef successfully did.
But I object to having to indirectly fund the making of amends for alleged bureaucratic incompetence and corruption — like the costly compensation for false imprisonment cases which may not end with Patel.
In the public interest, to establish the absolute truth, my view is that a Royal Commission on the regulation and public administration of medical practice may be in order.
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