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Summary Report of the Bundaberg Hospital Public Inquiry on Dr.Jayant Patel (Queensland) Summary report of Bundaberg Hospital Public Inquiry on Dr.Jayant Patel (Queensland). Introduction Dr.Jayant Patel was appointed as a surgeon by the Queensland Health work at the Bundaberg Base Hospital as the Director of Surgery in the year 2003 (Wunner, 2010). The Queensland Health appointed him to perform the duties of a surgeon despite that he had no qualifications as a surgical specialist. Without the necessary qualifications Dr.Jayant Patel was incompetent in his job. This summary report is based on the major issues that were raised relating to the incompetence of Dr.Jayant Patel in as surgical doctor. The Associated Press (2013) describes that, as a practicing surgeon, Dr.Jayant Patel was involved in many inadequacies such as; unhygienic and altering medical records that were identified by nurses and other doctors in the hospital. Dr.Jayant Patel was feared by nurses who referred him as Dr. Death and would hide their patients when he was on duty. Due to his inadequacy in practice, Dr.Jayant Patel is linked with the death of eighty-seven patients among whom thirteen of them died under his care in the Bundaberg Base Hospital (Sandall, 2010). Dr.Jayant Patel’s malpractices in his job were first reported by Toni Hoffman who worked in the hospital as a senior nurse. The nurse had identified Dr.Jayant Patel surgical procedures as sloppy and dangerous. Toni Hoffman reported the matter concerning the doctors’ clinical practice to Stuart Copeland who was the Shadow Minister for Health in Queensland. This saw Stuart Copeland raise the issue in the Queens parliament during question time. The inadequacies of Patel were also raise by Rob Messenger, the Burnett Member of Parliament, who called for Patel’s suspension during his speech at the Legislative Assembly (Parliament of Queensland, 2010). Patel’s clinical malpractices were also reported by a journalist who worked for the Courier Mail, Hedley Thomas. The journalist published claims from patients who had reported their injury and death that resulted from Patel’s surgical operations. The journalist won the Walkley Award by uncovering the past incidents of Patel’s medical practice. The public enquiry was convened for the purpose of responding to public discontent of Dr.Jayant Patel medical misconduct at the hospital in Bundaberg. The inquiry charged Dr.Jayant Patel with different cases including; murder for one patient, negligence that caused harm to patients and fraud that was related to his appointment by the Queensland Health as a surgical doctor without surgical qualifications. After the court proceedings, Dr.Jayant Patel was released as a result of bureaucrats within Townsville who called for the shutting down of the inquiry alleging that it was bias against them (Australian Broadcasting Corporation, 2013). Summary of Key Information The Bundaberg Hospital Commission of Inquiry involves an investigation on the following issues; Dr.Jayant Patel’s clinical practice incompetence that led to a large number of patient deaths as well as injury that resulted from the doctor’s negligence. Provide evidence for the bureaucratic system which is accused of malaise as well as cover-up Incompetent Queensland health authorities Investigate on the Medical systems that are failing and organizations that are not able to report incidents The inquiry was also aimed at investigating the effectiveness of hospitals in the health care system in Australia and especially in regions where there is scarcity of doctors investigate on the challenges that the health care system is facing due to resources as well as expertise shortages for meeting demands of the community investigate on claims of unhearing system that could turn a deaf on the screams of patients protests Information about the Issues Dr.Jayant Patel’s Clinical Malpractices The medical practice of Patel was incompetence and led to a large number of patient deaths as well as injury that resulted from the doctor’s negligence. Evidence from the inquiry reported by patients demonstrated Dr.Jayant Patel’s incompetence in his job. Patients said that, there were surgical blunders in Dr.Jayant Patel’s surgical operations that led to the death of their loved ones. Within the first few months of his work, Dr.Jayant Patel was reported to have removed a woman’s leg that had diabetes and completely forgot to review her health progress. After the sixth day, the woman had developed to a semi-comatose and gangrenous condition. Nurses were alarmed by the conduct of Dr.Jayant Patel and did not want him to perform any surgical operations on their patients (The Associated Press, 2013). Toni Hoffman who was a senior nurse in the hospital said that, she had witnessed a man who died of bleeding internally as a result of being stubbed by Dr.Jayant Patel fifty times with the use of a large needle while trying to drain fluid from the patients’ heart. The surgeon also performed a heart surgery on a man who was in deep pain as a result of not being anaesthetised; he also operated on a cancer patient who was too sick to be operated on. The death of the patient resulted from Patel’s negligence to detect obvious breast cancers. The surgeon would also puncture other parts of the body when performing surgery. The nurse said that, they would see patients die on daily basis and they could not do anything. Bureaucratic System The inquiry provided evidence for the bureaucratic system that was accused of malaise as well as cover-up for Patel’s medical misconduct. Even after the court had established that Dr.Jayant Patel had a medical fraud case to answer, two bureaucrats who were senior in the Queensland Health made an application for the shutting down of the enquiry by Supreme Court. They alleged that the inquiry was bias against them. After evidence for the allegations was provided by other witnesses, the Supreme Court gave a ruling that favoured the two bureaucrats Darren Keating and Peter Leck (Australian Broadcasting Corporation, 2013). The bureaucratic system in Queensland Health supported the malpractices of Dr. Patel and would not question him. The surgeon continued operating despite the cloud over him and would tell the other medical practitioners in the hospital that, no one could touch him. He was protected by the senior bureaucrats who lastly approved his air ticket to varnish after resigning. In the inquiry, Peter Leck argued that, he did not remember signing the air ticket for Patel since it had no importance to him. After Leck was accused of having the knowledge that Patel was not a qualified surgeon, he said that he never checked Patel’s credentials. Leck, further argued that it is not his role to check whether doctors in the hospitals are qualified surgeons (Brisbane Times, 2013). When Leck was questioned of the delays in investigating the complaints that were presented by Hooffman, he argued that, since he was not a clinician, it was the role of the medical services director to worry that patients were dying. Another bureaucrat in the Queensland Health, Darren Keating, provided Patel with a letter thanking him for the services he provided. This was not in order since Darren was aware that, Patel’s surgical practice was incompetent and alarming. It is evident that, the Queensland Health contributes to the bureaucracy experienced in the scandal. Incompetent Queensland health Authorities Marks (2013) notes that, Dr.Jayant Patel was hired by the authorities in Queensland health based on curriculum vitae that was deceitful. They did not check the doctor’s qualifications or the referees to establish the validity of Patel’s License to practice as a surgeon. His License was invalidated in New York and also restricted in Oregon as a result of his negligence in the medical practice. The Queensland health authorities appointed Dr.Jayant Patel ignoring complains that had been raised concerning his medical practice in the past. In Brisbane, the surgeon had also been found guilty of three manslaughter cases and another one for a grievous bodily harm. The authorities ignored the past medical practice history of the surgeon and appointed him. No one ever asked the body responsible for registering surgeons in Australia to assess the credentials of Patel. It is evident that, the medical board had failed to check the credentials of Patel. Failure of Medical Systems The Medical systems were failing and organizations were not able to report incidents. The enquiry found that, the management structure in the hospital is dysfunctional. The reason is that there was no cooperation among workers and between the management and the medical workers. This resulted to unreliable medical records. Nurses were unable to take any action against Patel’s despite the fact that they were aware of his misconduct (Australian Broadcasting Corporation, 2013). After reporting the incidents, no action would be taken against Patel. Patients were dying out of negligence of Patel and took a lot of time for those in authorities to recognize and take action. The health system in Queensland was flawed and there were no better systems that checking quality as well as medical audits that would expose the Bundaberg hospital problems in advance. Even after doctors and nurses report the incompetence of Patel, the professional bodies in Queensland never pursue the matter (Healy, 2013). Inefficiency of the Hospital and Scarcity of Doctors Inefficiency in hospitals was experienced as a result of scarcity of doctors in the health care system in Australia. According to the Brisbane Times (2013), the groups of doctors in Queensland had a responsibility of providing enough doctors since they have the mandate of controlling the number of specialists in the health care system. As demonstrated in the enquiry, lack of enough doctors was as a result of few university colleges that operated like a closed shop. The doctors said that, few surgeons in the region were as a result of the government failing to provide funds for surgeon training institutions. It was also difficulty for the health care system to establish whether the treatment provided by Patel contributed to the death of patients. It was not easy to determine the kind of care that the surviving patients have received. The reason is that, none of the patients were provided with Patel’s credentials that he was not a qualified surgeon. This would have enabled them make an informed consent before going for a surgery. Resource and Expertise Shortages The health care system was facing many challenges due to resources as well as expertise shortages for meeting demands of the community. According to the enquiry, the health care system in Queensland is facing the challenge of dealing with an increased population with resources and expertise that are limited. This is evident in Bundaberg hospital where the numbers of beds were falling from two hundred and sixteen to one hundred and thirty eight. Therefore, there is a high demand of beds in the hospital. The health care system in Queensland is presented by an environment of budgets that are tight, procedures that are expensive, demand that is growing and medical skills that are scarce (The Kaiser Papers, 2012). This has led to trading of surgeons like resources that are precious on the international market. There is also an increasing pressure of hospitals to meet budget and generate revenue and Patel worked to achieve this target. Unsupportive Health Care System There were claims of unhearing system that could turn a deaf on the screams of patient’s protests. According to the enquiry, a senior nurse at the Bundaberg Hospital was heard raising the problems in the hospital to local politicians but she could not be heard. Dr. Miach was the director of medicine and a specialist of renal in the hospital. He had reported Patel’s incompetence to the hospital management earlier. However, no action was taken and instead, he was ignored. Brisbane Times (2013) notes that, whenever Dr. Miach made an effort to report hospital matters, the hospital management would caution him that the hospital was a business. After Toni Hoffman, a senior nurse in the hospital, reported of scenarios that were very disturbing in the Intensive Care Unit, no one was there to respond to her complains. She was later accused of being racist since she was unable to manage the difficult personality of Patel. Hoffman even went further and threatened to hang herself to draw attention of the hospital management but no one heard her. Even after the news she presented about the thirteen death incidences reached the Parliament, it took long for investigations to be launched in relation to these complains. Conclusions The Bundaberg Hospital Commission of Inquiry provides evidence of how the health system, the system of governance and the medical practice in Australia are questionable. How Patel was appointed as a surgeon in the hospital by the Queensland Health is inappropriate. He had a low profile as a medical personnel, he had intellectual incompetence together with incredible credentials. The officials of the health system were bureaucratic and supported Patel in his misconduct. The hospital administration was incompetent since it did not oversee that everything was going on well among the patients and the medical staff. These questionable events resulted to the continual medical misconduct of Dr. Jayant Patel that led to the massive deaths of patients in the hospital. Recommendations For events to have worked right, the Queensland Health system should have launched an investigation on Patel’s qualification as a surgeon. The medical board should not have registered Patel without considering his past records as a surgeon. It was recommended that, the Medical Practitioners Registration Act 2001 to be changed. The medical registration process in Queensland should also be changed. The implementation of these actions will ensure that improvements in the health care systems are achieved for the purpose of providing quality care to patients. References The Associated Press. (2013). Jayant Patel, former Portland-area surgeon, walks free after getting suspended sentence in Australia. Retrieved from http://www.oregonlive.com/pacific-northwest-news/index.ssf/2013/11/jayant_patel_former_portland-a.html Australian Broadcasting Corporation. (2013). Jayant Patel Walks Free From Manslaughter Retrial. Retrieved from http://www.abc.net.au/7.30/content/2013/s3715030.htm Brisbane Times. (2013). Timeline: Jayant Patel Allegations. Queensland. Retreived from http://www.brisbanetimes.com.au/queensland/timeline-jayant-patel-allegations-20131115-2xloi.html Healy, J. (2013). Improving Health Care Safety and Quality: Reluctant Regulators. Ashgate Publishing. pp.34-35. The Kaiser Papers. (2012). Jayant Patel Articles. Retrieved from http://nwnews.kaiserpapers.org/ Marks, K. (2013). Doctor Death’ Jayant Patel Escapes With Fraud Conviction and Plans Return to Work. Retrieved from http://www.independent.co.uk/news/world/australasia/doctor-death-jayant-patel-escapes-with-fraud-conviction-and-plans-return-to-work-8957992.html MDA National. (2009). First Defence Jmos + Doctors in Training Summer 2009. Retrieved From http://www.mdanational.com.au/media/46471/mdan11364%20304%2013%20first%20defence_web.pdf The Parliament of Queensland. (2010). Complaint Matters In Relation to Dr Gerald Joseph Fitzgerald. Queensland Parliament. Retrieved from http://www.parliament.qld.gov.au/Documents/TableOffice/TabledPapers/2010/5310T3306.pdf Sandall, R. (2010). Jayant Patel — The Full Story. Retrieved from http://www.rogersandall.com/jayant-patel-the-full-story/ Wunner, B. (2010). Dr. Death' shockwaves ripple through Australia. Bundaberg, Australia (CNN). Retrieved from http://edition.cnn.com/2010/WORLD/asiapcf/10/28/australia.doctor/ Read More