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- [00:00]
Tony Morris
Katie I'm Katie Page, CEO of Harvey Norman.
- [00:03]
Hedley Thomas
Since 2018, Harvey Norman has been a
- [00:06]
Tony Morris
key partner in the Australians investigative podcasts such as Sick to Bronwyn Shandy's Story, the Teacher's Pet and the Night Driver. Harvey Norman are proud sponsors of the Australians podcast investigations and their award winning journalism.
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Hedley Thomas
My name is Hedley Thomas. Sick to Death is based on my book of the same name and it's the true story of Dr. Jayant Patel's lies and manipulation and the herculean effort it took to finally stop him. We've used voice actors throughout this series and on occasion the real people from the story have read their words for us. It is brought to you by me and the Australian. Chapter 55 ready, set, go late April 2005, in the weeks before the start of the inquiry's public hearings, statements and strategies were being hastily drafted in the Brisbane offices and boardrooms of dozens of solicitors and barristers. Weaknesses, strengths, points of law and proposed tactics needed careful analysis. The lawyers, most of whom could look forward to months of generous funding from the public purse for their efforts, knew the greatest peril for a client at a commission of inquiry was perjury lying. A finding of negligence was far preferable to a referral to the Director of Public Prosecutions for lying under oath. In a much earlier commission of inquiry that I had covered, led by retired Supreme Court justice Bill Carter QC into a police car stealing racket in 1992, confident witnesses were exposed as shameless liars during cross examination. Tony Hoffman had no experience of courtrooms and clever legal questioning. Whenever she called me to talk about how her formal statement was going, I implored her to leave nothing out. She was still concerned that her contact with me would be used against her. I told her, if they ask you in the inquiry about our contact, you have to tell them the truth. Tell them everything. Tony had heard that Dr. Jim Gaffield, the American plastic surgeon, was still supporting Jayan Patel, defending his surgery and refusing to accept the problems with the patients. I asked her, only half jokingly, if she thought the inquiry would exonerate Patel.
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Tony Hoffman
They can't. Even the chief health officer has talked about his complication and infection rates.
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Hedley Thomas
The hospital's key managers, Darren Keating, Peter Lech and Linda Mulligan, were on indefinite leave with full pay, and this meant they had a distinct advantage over other witnesses. They had the time to research and prepare documentation, weigh their options and finalise a detailed statement. Tony Hoffman told me, linda Mulligan has
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Tony Hoffman
been saying, I can't wait to get into this inquiry and see the truth come out.
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Hedley Thomas
Leck, however, was not in a good way. He had been fragile before. The truth about Patel's past came out in the Courier Mail. As the revelations mounted in the days afterwards, he became withdrawn and deeply depressed. When a leading Brisbane psychiatrist, Dr. Jeremy Butler, first saw him in May, a fortnight before the inquiry started, Peter Leck was suffering extreme anxiety and feelings of hopelessness. He told Butler he found it difficult to sleep. He was having trouble concentrating and remembering events. He looked haggard. Hoffman was concerned that the lawyers for Leck, Keating and Mulligan would unite to target her and destroy her credibility. Her solicitor, Gavin Hrabetsky, shared her concerns. He had asked her to ease up on the media interviews. In Perth, on the other side of Australia. Her young niece scampered into the kitchen and told Tony's sister in law that I just saw Auntie Tony on TV with her puppies. The little girl was scolded. Don't tell fibs, said her mum, Leanne Hoffman. But the child was right. The West Australian media was running hard on the story. Tony's brother Matthew was in Hawaii with his Australian Defence Force submarine crew when he spotted his sister on the COVID of the Bulletin magazine. Claire Forster, one of the top producers of the ABC's Australian Story program, had begun working on a documentary to depict the Bundaberg disaster. Not to be outdone, the Nine Network 60 Minutes invited Hoffman to fly to Oregon with reporter Paul Barry and a crew to confront Patel near his home. She wanted nothing to do with the plan, so they asked instead about any identifying features of Patel. Did he wear jewellery? Paul Barry planned to hire a private investigator who would need clues to track the surgeon. Apparently, his home address and swarthy Indian appearance were not sufficient clues. Hoffman remembered his watch. It was a Rolex. Patel was no longer answering the constantly ringing phone or opening the door at the family home in Portland. There would be no more interviews. A large sign reading please, no media person, newspaper, radio or television do not knock, please greeted visitors. Patel's chequered past in Oregon was now an open book. And there was still a clamour for more information in Jamnagar, India. His former colleagues were shocked to learn about the wrongdoing of one of the town's most famous and successful exports. He had returned to Jamnagar, near the Pakistani border, many times since emigrating to the United States in 1977. On each visit, he brought news of his successful career. Patel was clearly prospering. None of his friends suspected he had been in any trouble. Dr. Vikram Shah told an Indian television
- [06:53]
Dr. Peter Miak
outlet, I was shocked to Hear this news.
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Peter Beattie
Dr. Jayant Patel used to study with us and was a very bright student.
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Hedley Thomas
Patel's elderly mother, Maruda Laban, meant only to support her favourite son when she told the Express Indian newspaper. I am proud that My family has 14 doctors.
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Tony Hoffman
My children, grandchildren, nieces and nephews are all doctors and Jayant is the best of them all.
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Hedley Thomas
Tony Hoffman lightheartedly told me.
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Tony Hoffman
Quick, find those other 13.
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Hedley Thomas
For Hoffman and most of the other intensive care unit nurses, the work at Bundaberg Base Hospital would not wait. She was also under enormous stress, but received little help from Queensland Health. Although a disaster counselling team had moved into the hospital to look after the staff, the ICU nurses who had borne the brunt of Patel's conduct were overlooked.
- [07:53]
Tony Hoffman
Now everyone at the hospital is saying, we need help, we need counselling, Hoffman told me. Where were they when we needed help?
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Hedley Thomas
Her father, Warwick, had advised her not to take any leave while you're still working. You can see some of the knives coming, he said. At the same time, Hoffman was under pressure from Rob Messenger. They had not seen each other since that fateful 18 March meeting at his electorate office. She feared that the parliamentarian had been pressed by his masters to wring more political mileage from the tragedy.
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Tony Hoffman
He wants me to tell him it's OK to release my name as the person who gave him the material. And he's trying to make me say things about people on the inquiry who's a crony and who isn't and I don't know who is who, saying no way.
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Hedley Thomas
Hoffman had only a few regrets about going to Messenger. The material she had handed to him included a special identifying characteristic, a unique number which was tagged with the name of a patient. Upon admission to hospital due to a misunderstanding, Rob messenger had not removed the number when he tabled the documents in state Parliament. The breach of patient confidentiality upset Hoffman and unnecessarily exposed her to potential punishment.
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Tony Hoffman
I only gave those so he would have some documentary backup. I didn't think or imagine that he would release them with the UR numbers, but it was a matter of life and death. We were desperate. There were still procedures taking place. There were more than 16 complications after our written complaint. What else could we do?
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Hedley Thomas
In the streets around Bundaberg, strangers stopped to shake her hand or kiss her cheek. Good on you, Tony became a familiar cry. But she could only shake her head after meeting Nita Cunningham, the Labor Party's member for Bundaberg, when She mentioned to Cunningham the name of Queensland Health's chief. There was a blank stare from the politician. Hoffman told me she didn't even know
- [10:07]
Tony Hoffman
who Steve Buckland is. She said, who's he?
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Hedley Thomas
The local parliamentarian was happy to condemn messenger for his disclosures, but she had no idea who ran the massive government department in her time of need. Hoffman drew comfort from the support of the other nurses. Even those critical of her in the beginning realised how she had been prepared to sacrifice her job for the patients. At a meeting of the nurses, Hoffman
- [10:36]
Tony Hoffman
told them, look, I've never been in this situation before. Tell me what to do. If you think we should be doing this or that, please just tell me.
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Hedley Thomas
But they didn't know either. Everyone was in uncharted waters. Patel's surviving patients and their loved ones remained gravely worried. In a number of cases where wound sites were angry or infected, they feared the worst blame for ongoing pain. After a Patel procedure was directed to the missing surgeon and Queensland Health, the patient advocate, Beryl Crosby, worked around the clock, reassuring people who clung to the mushrooming support group and pushing Queensland Health to organise rapid appointments with specialists to assess the need for corrective surgery. A team of nurses with experience in trauma counselling went to Bundaberg to soothe patients suffering physically and psychologically. These patients shared the anxiety of Mary Lee, whose stomach swelled with bile after a Patel procedure.
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Tony Hoffman
Before I could enjoy things a little bit, but now when I try later, I feel sad and down. There's no day or night that I feel good about myself, she said.
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Hedley Thomas
A quick fix was impossible. The hospital in Bourbong street had been under intolerable strain before the Patel crisis. It would not cope with a sudden influx of former patients seeking urgent help. Almost 900 Patel patients received a Dear Patient letter from Queensland Health to explain the work of a team of liaison officers who had converged on Bundaberg. Surgeons from the private sector were contracted to see patients referred by a senior hospital doctor. The plan involved corrective surgery in private hospitals. The option for care outside the public hospital system was welcomed by Beryl Crosby, who knew that the trust of many of the patients and much of the community had been shattered.
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Tony Hoffman
I hope the people who have been involved in employing this so called surgeon and the hierarchy who have swept these misconduct allegations under the carpet, never sleep
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Hedley Thomas
peacefully, wrote Sharon Egmaless in a letter published by the Bundaberg News Mail.
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Tony Hoffman
My father in law and my husband's uncle were victims of this incompetence and you have deprived our family of so much, not to mention all the families you have ripped to pieces.
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Hedley Thomas
I had been wondering how Gerard and Lorraine Neville felt about the revelations. Nothing would bring their daughter Elise back, but it might comfort them to know her death was a catalyst for change. The stories that I had written about Elise back in July 2004 had motivated Tony Hoffman to contact me. For the first time in my talks with Hoffman since the Google search, we considered disclosing to Gerard and Lorraine Neville the little known but critical role Elise had played. I wanted to tell them how she had been vital to the case and the reforms that were sure to follow. Hoffman wanted to disclose the truth too, but she decided it was too soon. She remained fearful of retribution from Queensland Health. Although Gerard and Lorraine had no knowledge of the chain of events, the still grieving couple dashed off a letter. Lorraine wrote.
- [14:12]
Tony Hoffman
If our concerns about Queensland Health's internal investigation of our complaint had been taken seriously when first raised in 2002, and if those concerns had been investigated and reported publicly, we think it is quite possible that the culture of health complaints handling might well have changed for the better. If so, the tragic events at Bundaberg Hospital might not have occurred, or at least been so widespread.
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Hedley Thomas
Susan Goldsmith, the senior investigative reporter for the Oregonian newspaper, was determined to localise the Patel story. She began making calls and received a tip off that Dr. Sally Ehlers, a surgeon in the township of Centralia in Washington state, about 140 kilometres north of Portland, had blown the whistle on Patel a decade earlier when they worked together for the Kaiser Permanente Group. Sally had heard nothing of the scandal in Queensland. The reporter Susan Goldsmith told her.
- [15:19]
Tony Hoffman
Just put Jayant Patel into Google. You'll see what I mean. He's Australia's doctor. Death.
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Hedley Thomas
Chapter 56 maintain the rage May 2005. An informant urged me to investigate the United States background of one of Queensland health psychiatrists. I went to the same website that had revealed Jayant Patel's past. It took a few seconds for my computer to display the results from the State of New York's Department of Health. Dr. Keith Muir, a prominent Queensland psychiatrist, was struck off in the United States in 1995 for having sexual relations with two vulnerable patients. The State Board of Medical Examiners in neighbouring New Jersey had earlier cited Dr. Muir for engaging in what it described as gross and repeated malpractice, which clearly placed two patients at emotional risk and indeed caused them harm. The New Jersey Board revealed that he had preyed on the vulnerabilities of the patients and corrupted the therapeutic relationship by engaging in sexual relations for his own gratification while continuing to treat and prescribe antidepressants to the women. The board found that he had utterly failed to maintain an appropriate patient record and he clearly knew or should have known of the patient's vulnerabilities and the likelihood that transference of the patient's feelings onto the therapist could occur in Australia. Dr. Muir had headed the Meeting mental health unit at Cairns Base Hospital for a decade, and he was acting deputy director at Nambour General Hospital. When I called him, he told me he was the innocent victim of a gross injustice. When the proceedings against him were underway in the United States, he had left to work in Queensland. He said to me that he was shocked, but not entirely surprised. And he added, it's like a bad dream that doesn't end, but comes back to haunt you. Dr. Muir accused the two women complainants of being in cahoots with each other and best friends, despite them having been accepted by US health investigators as highly credible. Unsurprisingly, the Medical Board of Queensland had been unaware of Dr. Muir's background until the Patel case erupted. Had the Board known of the proceedings, Dr. Muir might not have been registered in Queensland. My interviews with staff in Cairns disclosed that Dr. Muir's conduct had troubled psychiatric nurses and patients for years. Another psychiatrist, Annette Johansson, had formally complained to the Queensland Health rights commission about Dr. Muir in 1995, the same year New York State authorities revoked his licence to practice after an investigation which somehow took four years to complete. The Health Rights Commission had decided that Dr. Muir was unfairly accused of sexual harassment. Its investigators did not bother checking his United States background. My articles about Dr. Muir drew a hostile letter from the commission's head, David Kerslake.
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Peter Beattie
For the record, it is not, nor
- [18:51]
Tony Morris
has it ever been, the Health Rights
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Hedley Thomas
Commission's role or responsibility to check the validity of a health practitioner's registration or whether a practitioner has been subject to disciplinary action in any other jurisdiction. It struck me as classic bureaucratic buck passing. Whatever happened to initiative to thinking outside the square. Here was a case in which an investigative agency conducted an unbelievably prolonged inquiry into the goings on in a public hospital mental health unit headed by a psychiatrist who was also accused of sexual harassment of a colleague, Annette Johansson. Just a cursory check to see if Dr. Muir had a clean slate in his previous job would have been easy and conclusive.
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Peter Beattie
That is the sole preserve of registration
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Hedley Thomas
boards, which is no doubt why they are so named. His absurd statement proved how utterly hopeless the various agencies were in uncovering basic facts, let alone fulfilling their statutory duties. The public responses to the Courier Mail after the revelations over the Dr. Muir bungle were mostly angry. One of Dr. Muir's patients, however, wrote about her life being positively transformed by the man. And a former colleague attacked what he called the public crucifixion of Dr. Muir at a media conference. Peter Beattie, who was still furious with the medical board for failing to check Patel's background, became angrier when asked about my reports on Dr. Muir.
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Peter Beattie
I've got to the stage where I'm sick to death of these allegations and let me tell you as Premier, I've got to the stage with this where I'm looking forward to this Royal Commission getting to the bottom of how all these systems operate and coming up with some very clear medicine to fix it. I hope Tony Morris takes a scalpel to the whole process.
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Hedley Thomas
The next day, Tony Morris drove his car to the Gold Coast Hospital, 80 kilometres south of his George street office, to deliver personally a summons for all documents related to the treatment by district management of doctors and specialists. He had been alerted to problems there in a letter received from the Premier, Peter Beattie. The top level attention was a coup for the Gold Coast Bulletin newspaper, which had been campaigning on local health problems. Morris held an urgent meeting with hospital hospital management and handed over the summons, which would have cost the public purse about $30 for a functionary to deliver. The story improved when, on the way out, he and the Bulletin's reporter, Ann Wasson Moore, were told by security staff to leave the premises. Morris had truly entered the arena with his unusual decision to drive from Brisbane to the Gold Coast Hall Hospital and once there, personally handled the issue. In all other public inquiries, the investigative team members were assigned to do jobs like these, while the inquiry commissioner stayed above it all. Like a judge overseeing the actions, he was going to extravagant lengths to promote the inquiry and demonstrate his zeal. His actions afforded an early glimpse of his willingness to step across a line. Morris had no intention of sticking to an orthodox and conservative script. Queensland Health staff, already severely rattled, were apoplectic. A few days later, Toni Morris ordered Dr. Steve Buckland, Queensland Health's Director General, to hand over a report arising from a clinical review by two orthopaedic surgeons, Dr. Peter Giblin and Dr. John North. They had investigated orthopaedic services at Harvey Bay hospital. After my November 2003 stories on the two Fiji trained doctors, Morris had received a tip off that Queensland Health was trying to smother the scathing findings. After perusing the document, Morris promptly released it to all media outlets and put it on the inquiry's website. In his accompanying 13 page ruling, he disclosed that although the inquiry was still at an investigative stage, it has received
- [23:26]
Tony Morris
a great deal of information suggesting that there is a culture of bullying within Queensland Health.
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Hedley Thomas
He referred to a practice of burying adverse reports and of making life difficult for anyone in the public health system who was seen to make complaints or criticisms of Queensland Health.
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Tony Morris
Tony Morris wrote, all other considerations aside, it seems to me that the public of Queensland, and especially people who live in the Fraser coast region, are entitled to know that in the opinion of two eminent orthopaedic surgeons specifically appointed by Queensland Health to review the situation, patient safety is at severe risk. Public inquiries like this one, which are conducted at the public expense in relation to issues of public interest and concern should, in the absence of the strongest reasons to the contrary, be conducted in the full blaze of public scrutiny. Proceedings conducted behind closed doors with secret exhibits and anonymous witnesses are characteristic of organisations like the Star Chamber, the Spanish Inquisition, the Gestapo and the KGB found in totalitarian dictatorships rather than the institutions of a democratic society.
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Hedley Thomas
Morris had initially planned to restrict television cameras from the inquiry's hearing room, but he began to reconsider after hearing from the nine Networks political editor Spencer Jolly. Morris consulted Jolly's competitor, the Seven Network's Patrick Condren, who added his enthusiastic assent.
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Tony Morris
Morris told Condren, as you know, this is virtually unprecedented in Australia, but I can't really see any objection in principle and there are some obvious advantages if people are given an opportunity to see and hear what goes on at the inquiry. I am optimistic that this will increase their confidence and in the commission's independence from the government, including Queensland Health.
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Hedley Thomas
It seemed that viewers were going to witness a televised real life hospital drama beamed into their living rooms. The TV network salivated. It would be great for ratings. Meanwhile, the Patel story was widening every day. Public and political outrage followed the revelations of Queensland Health spending more than $3,000 on a one way business class fare for Patel to leave the country in early April. The number of deaths being formally investigated topped 80 because vascular surgeon Dr. Peter Woodruff and the Queensland Health Review team had instructions to examine the circumstances of every deceased patient who had any contact with Battelle, no matter how limited. Chief Health Officer Dr. Jerry Fitzgerald, who remained in contact with the family, still believed that many of the seriously ill patients would have died anyway. He suspected that Patel's intervention had hastened their demise and worsened their quality of life before the end. And he told me this but until
- [26:39]
Tony Morris
somebody crawls through all these patients files
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Hedley Thomas
and determines if they would have died or not, it's pretty hard to say anything definitive about it. Well placed informants emerged from obscurity every day to provide news tips about outrages in the health system. Pressure was building. The Courier Mail's editor, David Fagan, ensured generous space for the ongoing story. He was calling in the newspaper's editorials for the resignations of Health Minister Gordon Nuttall and his director general, Dr. Steve Buckland. Astute observers of power and politics insiders such as the Beatty government's top media strategists knew it would only worsen when the inquiry's public hearing started. As one of those advisors told me,
- [27:30]
Tony Hoffman
three fundamental things hurt health, crime and education. Health moves votes. This has the potential to be incredibly destructive. The problem here is the direct connection between government inaction and dead people. One of Peter Beatty's great capacities is his ability to stand up and say, we fucked it, we fixed it, now move on. But in this there are all sorts of horror stories coming out.
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Hedley Thomas
Nuttall's bureaucrats saw Morris as an unstoppable wrecking ball who threatened everything. They seethed over his powerful mandate to discover the truth. They would have preferred to limit damage from his inquiry by severely restricting certain information, such as the Harvey Bay Review. The relentless lawyer, however, held all the cards. He had. Peter beat his ear and the authority to take a scalpel, as he called it, to the whole process. Morris underlined his resolve in a 19 May statement which foreshadowed possibly sweeping changes
- [28:34]
Tony Morris
in the administration of Queensland Health. He spoke of claims of concealment of bad news, obfuscation of the truth, use of creative or falsified statistics and use of spin to distract attention from adverse media reports.
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Hedley Thomas
The doctors, nurses and allied health staff who had known this for years cheered. Tony Hoffman wrote to my editor to thank his journalists and the public for their support.
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Tony Hoffman
She said, I had previously no contact with the media and prior to my dealings with the Courier Mail, I also was a sceptic. Please continue to help keep us honest by reporting the truth and exposing the falsehoods. In a democratic state, this is what we should expect and accept nothing less. There is some very important work to be done in the coming weeks to ensure that what happened at Bundaberg never happens again.
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Hedley Thomas
Hoffman and her colleagues saw in Morris a fearless lawyer wielding a new broom. He talked their language. He was rapidly winning public support. But old hands, like some of the retired Supreme Court judges, regarded Morgan Morris as a show pony. Obsessed with image and they tipped that the inquiry would fail. One judge told Nuttall there will be a few more body bags before it's over. This podcast is made possible by subscribers to the Australian and our principal sponsor, Harvey Norman. Since late 2017, when I started pursuing Chris Dawson for the 1982 murder of his wife, Lynn, Harvey Norman has been a loyal backer. It began with the Teacher's Pet and Harvey Norman and its CEO Katie Page's support has continued for over eight years. I'm proud to have had their backing on all of mine and the Australians investigative podcasts the Night Driver, Shandy's Story, Shandy's Legacy, the Teacher's Trial, the Teacher's Accuser, Bronwyn and most recently, the Sick to Death podcast. For more information on this podcast, go to theaustralian.com chapter 57 fasten seat belts 23 to 25 May 2005 a shrill whine in the elevator shaft of the Beatty government's newest monument to law and order, the Magistrates Court building on George street, echoed around court 34. A man marched in the lobby outside wearing a hand painted shirt that read I am a Medical Blunder Victim. In the minutes before the advertised starting time of the 10am Lawyers, journalists, onlookers and inquiry staff exchanged nervous glances. Folders of statements were passed across the wide tables reserved for the barristers and solicitors. Trolleys laden with legal documents were pushed back and forth. Ralph Devlin, looking jaunty in an expensive suit and trademark bow tie meant, met my gaze. A tenacious lawyer with much experience in commissions of inquiry, he was appearing for the Medical Board. I half joked that he had been handed a poisoned chalice. Not at all, he said confidently. We are only here to help. We awaited the entrance of Tony Morris and his deputies, Sir Lou Edwards and Margaret Vita for Day one of the Bundaberg Base Hospital Commission of Inquiry. After the inquiry's secretary, David Groth, had read aloud the terms of reference, a succession of lawyers sought from Morris his permission to appear on behalf of their respective clients. For the patients there were Jerry Mullins and Justin Harper for Queensland Health, David Badice SC Brad Farr and Chris Fitzpatrick for the Australian Medical association of Queensland, David Tate for the Queensland Nurses Union, John Allen for the Medical Board, Ralph Devlin for Dr. Darren Keating, Jeff Deam for Peter Leck, Ron Ashton for the Health Rights Commission, Ross Perrott for Senior clinicians, Raylene Kelly, Toni Morris made notes during the roll call of lawyers and
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Tony Morris
I don't know, I suppose, whether Dr. Patel wishes to be present or heard?
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Hedley Thomas
He asked. The room chuckled as the tension eased. David Andrews, the senior counsel who was appointed to assist Tony Morris, had a dry reply.
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Tony Morris
I haven't heard that Dr. Patel wishes to be heard.
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Hedley Thomas
Morris and his staff had been overwhelmed by letters and calls from Queenslanders who wanted the inquiry to investigate the allegedly negligent care they or loved ones had received in hospitals the length and breadth of the state. Maurice wanted to nip in the bud any notion that such investigations would be feasible.
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Tony Morris
It would be impossible for this inquiry to examine everyone who feels that they have a grudge or a complaint or a dissatisfaction with medical treatment received by themselves or by family members somewhere in Queensland. What we want to see is a short, sharp, lean investigation that gets to the facts, comes up with appropriate recommendations and puts in place systems and structures that ensure that the problems of the past don't happen again. Most importantly, we want to look to the future.
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Hedley Thomas
He summarised some of the areas he had begun to consider for reform. Areas such as protection for whistleblowers, the complaints handling systems in the public health sector, the recruitment and retention of medical staff, the burgeoning bureaucracy. He ended the opening speech with an anecdote related to him by a leading Queensland surgeon who had done his postgraduate training in Scotland.
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Tony Morris
He mentioned that he has a registrar who's of Asian origin and in fact a second or third generation Australian. And a patient recently said to this surgeon, well, I don't want that foreign trained doctor coming near me. And the surgeon said, well, I'm the foreign trained doctor, I was trained in Edinburgh, so if you don't want a foreign trained doctor operating on you, you'd better have the registrar who was trained exclusively in Australia.
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Hedley Thomas
Morris wanted to quell the community tensions and racism that had arisen since the Patel revelations. For a number of overseas trained doctors, the taunts had been too much to bear.
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Tony Morris
Some of them have different coloured skin, some of them come from what might be regarded as non traditional backgrounds for the medical practice in this state. But they are still extremely talented doctors.
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Hedley Thomas
A short time later, David Andrews, whose key role involved planning inquiry strategies and questioning the main witnesses, got down to business.
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Tony Morris
Commissioner, I call Tony Hoffman.
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Peter Beattie
Hoffman.
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Hedley Thomas
She walked tentatively to the table for witnesses below and to the right of the bench where Maurice and the deputies sat. The cameras clicked and flashed. Hoffman started nervously responding to questions about her experience and training over the years as an intensive care unit nurse in London, Saudi Arabia and Australia. She raised her master's degree in bioethics and her tertiary qualifications in managing for most of the day and the next one, Hoffman recalled two years of agony at the hospital. At times she was tearful, describing the dysfunction of hospital management, the injuries and deaths of patients, and the fears of reprisals against staff who complained.
- [37:07]
Tony Hoffman
All the nurses in intensive care were seeing all these patients die and we could not do anything. We just thought, what on earth can we do to stop this man? We took to hiding patients and telling them they should ask to be sent to Brisbane. We were telling them things we shouldn't be saying.
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Hedley Thomas
Hoffman painted an ugly picture of Patel's competence. Her sincerity and courage clearly made a strong impression on Morris. At 4:55pm on day two, after adjourning for the day and telling Hoffman that she would next be needed to give evidence at the Bundaberg sittings in June, the head of the inquiry, Toni Morris, stepped down from the bench to approach her. He extended an arm and he shook Hoffman's hand. She was chuffed. But the lawyers who witnessed it were agog. They apprehended a bias, a predetermined view. Nobody had heard of a judge or an inquiry commissioner approaching a witness during the actual proceedings in this way. Like the rest of the community, Morris regarded Hoffman as a heroine. Accordingly, had he already decided that those who opposed her were villains? Morris had just sown the first seed for his inquiry's failure. Chapter 58 Human Headlines 26 May to 3 June 2005. The drama unfolding in court 34 transfixed political junkies and everyday folk who saw a tragedy undergoing forensic scrutiny. Although Toni Morris QC was making few friends in the top layers of Queensland health, his robust style won plaudits in the community. Each morning, listeners to Steve Austin's ABC Radio 612 program in Queensland heard extended extracts from the proceedings. They heard clinicians such as Dr. Peter Miak, the hospital's renal specialist and director of medicine, who had stood up to Jayant Patel. He spoke of efforts to sideline the director of surgery.
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Dr. Peter Miak
The advice I provided to everyone around me, I sort of said, don't go anywhere near this chap. Absolutely not. I mean, I told everybody. I insulated patients, I did my own audit, I submitted to the appropriate channels. There were issues, there were problems there. They were identified. I stopped using him. I told everybody not to go near him.
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Hedley Thomas
He recalled a conversation with Dr. Darren Keating in the days after Patel's true past had been revealed.
- [39:54]
Dr. Peter Miak
It was interesting. It was a strange meeting. I was in the renal unit, which has stuck to the medical ward doing some procedures. Or talking or looking at patients. In fact, he came up one afternoon to that area up in the ward, which was somewhat unusual because, as I mentioned before, he was rarely seen on the ward. And he sought me out and we sat in my little office and we just started talking in general terms about the Patel issue. And I wasn't quite sure what was going on, what was the discussion about, where it was heading, all the rest of it. But anyway, I talked, you know, about how unfortunate it is that patients have been hurt and the rest of it. I'm not quite sure what he wanted, but part of it at the end, in fact, he made a comment which I regarded as a veiled threat. He sort of said, you have to understand what goes around comes around. I was a bit lost for words and I said, darren, you and I see things very, very differently. And that was it.
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Hedley Thomas
Dr. Miak spoke of another conversation in which Dr. Keating described the hospital as a business. They were indeed poles apart. Margaret Vida asked.
- [41:06]
Tony Hoffman
I would have thought it was the business of a hospital to be looking after the sick. What would your interpretation then be of what is the business of the Bundaberg Base Hospital?
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Hedley Thomas
Dr. Miak replied, to make money, to
- [41:19]
Dr. Peter Miak
come in on budget. That's my interpretation of it. Quite simply. Patients are a secondary consideration and most physicians, most nurses, most people who work, in fact, would see it 100% differently. You can't run a hospital as a business, irrespective of what anybody tells you. In fact, the hospital is there to serve a community. Patients don't come in with a sign on their forehead, you know, heart attack when they come in. In fact, they have hundreds of other things you have to tack. So that's my interpretation of it. It has to do with money, which I think is a pity. I think it's totally wrong.
- [41:55]
Hedley Thomas
Before Dr. Miack had given his powerful evidence about the gulf between clinicians and administrators and the abyss into which patients could fall in a sick and fractured health system. The inquiry staff had planned for Dr. Keating and Peter Lech to be called as witnesses in June. But immediately after Dr. Miak had finished, Tony Morris asked his senior lawyer, David Andrews, to join him and the two deputy commissioners for a brief meeting. Jared Cowley Grimmond, a Crown law officer seconded to the inquiry staff to conduct investigations and interview witnesses, was handed a notice from Morris with instructions to contact Peter Lech's solicitor and his barrister, Ron Ashton, and asked that they be present in the hearing room before the lunch break. When Ron Ashton arrived about 12.30pm, Tony Morris asked The whereabouts of Peter Lek. Ron Ashton, who had little experience as a barrister after a long career as a solicitor, sounded taken aback. He told the inquiry head, well, he is in the city. I mean, he is in the city of Brisbane.
- [43:09]
Tony Morris
Morris replied, well, will you convey to him that we will want him present after the lunch break to go into the witness box?
- [43:17]
Hedley Thomas
Lex solicitor Patricia Feeney, a long time professional acquaintance of Ashton's, was shocked at the lunch break. She asked David Andrews if he was able to explain why Leck was required to give evidence at such short notice. Andrew said that he could not. Feeney called Peter Lek on his mobile phone. He had been in the city walking and he did not have time to return home to change into a coat and tie. Although Ashton and Feeney could have strongly protested on the record that the position suddenly adopted by Morris was unfair, they remained silent. Leck was duly sworn and for most of the next 100 minutes sat hunched at the witness table. He endured a scathing examination conducted almost solely by Morris, who did not know that Leck was being treated for a psychiatric condition. Watching from behind a glass partition, I winced at the severity of the interrogation. Leck looked like a whipped dog who wanted to roll himself into a ball to make the smallest possible target. His lawyers, who raised scant objection at the time, would later speak of him being lacerated. At times, Morris seemed incensed.
- [44:39]
Tony Morris
It doesn't worry you that patients might be dying or that 15 year old boys might be losing their legs. It's not your role to see where there might be some truth in these allegations. It's the role of the Director of
- [44:51]
Hedley Thomas
Medical services in terms of clinical issues.
- [44:54]
Tony Morris
I'm not a clinician. Did you talk to anyone who actually works in the hospital seeing patients? Why doesn't someone get out of the office occasionally and go down and say, nurse Hoffman, we hear you have a bit of a problem with Dr. Patel and that you're not talking to one another. Can we sort it out instead of all this nonsense about mediation and fixing meetings and scheduling things and going on for months and months while patients are literally dying in the icu? What have you done since you were first told about this problem in October? To achieve anything to save the lives of the patients who have been killed by Dr. Patel?
- [45:32]
Hedley Thomas
With respect, Commissioner, can I say with the greatest respect, rhetorical questions of that kind are unfair to the witness. Morris was only warming up. He told Lech that historically, doctors ran hospitals and performed operations with a minimum of what Toni Morris called pen pushers or bureaucrats. Near the end, Ashton told Morris, May I hasten to say respectfully, we do not for a moment complain about. Certainly don't dissent for a moment about your authority and power to require him to give evidence today. And we don't complain about your decision to do so, but I simply respectfully ask that it be understood by all the disadvantage under which he labours in those circumstances. At 4:05pm, Darren Keating, who had taken a seat each day to follow the inquiry evidence, heard for the first time that he would be up next. Morris put to Dr. Keating that if he'd spent a bit more time in the operational parts of the hospital rather than in your office, he might have
- [46:44]
Tony Morris
discovered that nurses were hiding patients from Dr. Patel so he couldn't operate on them. Senior medical staff were recommending to patients that they seek transfer to Brisbane rather than go under the knife of Dr. Patel. What needs to be done to ensure this sort of tragedy doesn't happen again, relating to the people that died, the boy who had his leg amputated, the woman who had her breast cancer passed over by Dr. Patel, all of these tragic circumstances that we've heard over the last four days. Would it be a good start to have hospitals run by doctors who are real doctors, who see patients and know what goes on from day to day in the operating theatre and the wardrooms?
- [47:30]
Hedley Thomas
Keating did not buckle under the pressure. He gave a two word answer. He said, not necessarily. The replay of the evidence on the evening TV news further shredded the public reputations of the two men. Leck and Keating were humiliated. Their lawyers were livid. The previous day in State Parliament, Peter Beattie and his team were taunted by the National Party's hitman, Jeff Seney, who carried a sign. It read, labor killing Queenslanders 87. It was a reference to the number of patients who had died after contact with Patel.
- [48:14]
Tony Morris
I've had to deal with a number of their families.
- [48:17]
Peter Beattie
I've found that to be very distressing and I didn't want to let the spin doctors carry the issue forward.
- [48:24]
Hedley Thomas
Over the weekend, there were rumours that Morris had dangerously exposed the inquiry to a potential Supreme Court legal challenge by Leck and Keating for apprehended bias. Even some of the staff of the inquiry were concerned that if Morris overplayed his hand, the inquiry would be shut down. Damien Atkinson, one of the two junior counsel assisting Morris, had little sympathy for Leck or for Keating. But he was anxious for the inquiry to reach findings after a fair fight in the court of public opinion and amongst the patients and their loved Ones. Ones. However, Morris was cheered. People saw him illuminating matters of life and death in a system which relied on secrecy and distortion of the truth to hide mistakes and negligence. The pain and embarrassment of a couple of bureaucrats paled into insignificance compared with the carnage at the hospital and the grief and loss of relatives. As my friend and veteran newspaper reporter Peter Cameron told me on the way down George street, nobody ever made a great omelette without cracking a few eggs. But Morris had sown two further seeds for the inquiry's failure. By the end of the following week, Ron Ashton had adopted a new approach. He sought to reverse his acquiescence over the handling of his client, Peter Leck, by Morris on Day four. If Leck should decide at some point to attempt to share shut down the inquiry for apprehended bias, his lawyers would have a difficult time explaining to the Supreme Court why they had been happy to go along with Morris at first. Accordingly, Ron Ashton rode into Day Nine on a different boat and described the process of calling and questioning unfair, unnecessary, unexplained and in the context context of the treatment of witnesses in the Commission, so far, essentially unique to our client. It was a pointer to the potential for a future challenge. But the evidence of most interest to me on day nine came from Dr. Dennis Lennox, the author of the Queensland Health Report on overseas trained doctors. This report had been leaked to me in late 2003. Lennox had suffered because of the leak. He was not even the leaker. He told Morris of the bureaucracy's bullying secrecy practice of suppressing reports and shoot the messenger culture. He also rejected the spin peddled back in November 2003 by Health Minister Wendy Edmond and her new chief, Dr. Steve Buckland, about the report being a draft with no official status. He lamented a health system which lacked transparency and sold out its staff. After Dennis Lennox ended his testimony, it became apparent that my proposed evidence was being rejected by one of the key parties at risk of being punished by the inquiry. I was leaked a confidential letter written by Paul McCowan, a solicitor for the Medical Board, in which he had attacked my formal statement. He we're concerned that a draft proof of evidence has been produced and circulated which is directly or implicitly critical of our clients, in particular Mr. O' Dempsey and the Medical Board of Queensland. The Board's hide took my breath away when it became clear that my statement would not be formally tendered as evidence. I thought I knew how Dennis Lennox felt when his report was buried. Meanwhile, Peter Beatty's book called Making a Life Leadership and Politics flopped on its release. Written before the Patel story broke, he nominates one of his top 10 achievements
- [52:25]
Peter Beattie
as providing the systems and budget to enable doctors, nurses and health workers to cut waiting times for public hospital operations to the best on record in a health system which has been judged the most effective in Australia.
- [52:47]
Hedley Thomas
Chapter 59 bring him back 9 to 11 June 2005 Tony Hoffman felt like a supporting actor in a horror film that had received worldwide attention. The heroine's screams had finally been heard, but where, she asked, was the lead performer? Where was Jayant Patel?
- [53:10]
Tony Hoffman
Lisette, my friend from Sweden, reckons he's put on a turban and is riding the Jamu Express.
- [53:17]
Hedley Thomas
Hoffman's close friend, who lived in Gothenburg where the Patel story had just made the front page, recalled fond memories of their travels in India when both were young nurses. Except for some hair raising experiences on a train, the Jammu Express before public hearings moved from Brisbane to Bundaberg on 20 June, I wanted to visit Patel's hometown in Gujarat province in southwest India to talk to his friends and former colleagues. There was a new urgency. On 10 June, two days before photographer John Wilson and I boarded a Qantas flight to Mumbai, a New Delhi based friend called Rahul Bedi sent me one of many stories running prominently in India. This is what the story reported An
- [54:07]
Tony Hoffman
Indian trained surgeon linked by health officials to the deaths of at least 87 patients in Australia over two years should be charged with murder, a government inquiry recommended on Friday. The Commission of inquiry investigating Patel's practice at the Bundaberg Hospital recommended in an interim report on Friday that he be charged with murder in the death of James Edward Phillips, who died five days after Patel surgically removed part of his esophagus. In recommending the murder charge, the report said, there was no doubt that the surgical procedure undertaken by Patel was objectively likely to endanger human life.
- [54:47]
Hedley Thomas
There was also a recommendation that Dr. Patel be charged with negligence for causing bodily harm in relation to the Aboriginal patient Marilyn Daisy, who had developed gangrene in her leg after she was allegedly left without treatment for several weeks following an amputation performed by Patel. Patel was also accused of having made false representations and having committed fraud for allegedly falsifying his application to practice medicine in Australia by removing any mention of his disciplinary history. In the United States, a 1974 treaty between Australia and the United States permitted extradition and, as the report disclosed, Patel could face a maximum sentence of life in prison if tried and convicted under Australian law. But there was also speculation that Patel might have returned to India, which had no extradition treaty with Australia. Dr. Patel's Oregon based lawyer, Stephen Howes, had flatly refused to comment about his client's whereabouts. The lawyer said that he had only just received Tony Morris's interim report. He intended to give it very close scrutiny, he added, but until then he wouldn't be saying anything. The picture opportunity is usually a predictable setup in which the participants shamelessly exploit an artificial moment and each other for mutual benefit. Peter Beattie orchestrated picture opportunities every day. They were a lot cheaper than paid advertising. After nine days of public hearings involving evidence from from 13 witnesses, four of whom were from Bundaberg Base Hospital being Tony Hoffman, Dr. Peter Miak, Dr. Darren Keating and the hospital's head Peter Legg, Tony Morris believed that he had heard enough to give Beattie an interim report. Their meeting meant a picture opportunity. Meanwhile, both Beattie and I had penned separate letters to Jayant Patel. Mine went to his Hotmail email address. It said in part, perhaps you are following the evidence in the Commission of Inquiry as well as the media's reporting. If you would like to put any part of your side of the story or make any comment, feel free to email me. I assure you that anything you want to say will be reported. Beattie tabled his letter to Patel in the state Parliament, posted it on the Smart State's website and sent it to the media in Oregon. It was unsubtle.
- [57:33]
Peter Beattie
If you maintain, as members of your family have reportedly stated, that you are an excellent doctor who provided quality care to your patients, you also owe it to yourself to come forward and defend your actions. He urged Patel to return to Queensland as soon as possible to explain your actions in relation to the treatment received by patients of the Bundaberg Base hospital.
- [58:03]
Hedley Thomas
As part of the enticement, Beattie offered a one way economy class airfare to Brisbane. It was a far cry from Patel's last flight funded by the Beattie government in April when he had fled Queensland with a one way business class fare to Portland, Oregon. The letter was meant to be seen as deadly serious, but it looked like a childish stunt. Nobody should have been surprised when Patel did not hop on the next available flight to Australia, although Beattie became momentarily excited when the government's website manager noted that his letter had attracted a hit from someone in Portland, Oregon. Beattie publicly tipped that Patel was paying attention and considering the offer. His hopes were dashed by opposition leader Lawrence Springborg, who identified the real cyber visitor, an inquisitive Portland practitioner, Dr. Russ Faria.
- [58:59]
Tony Morris
The Premier and his spin doctors need to be more careful in the future when they go about wildly speculating in
- [59:05]
Hedley Thomas
the media as to how close they are to capturing Dr. Patel. Springborg gloated, My missive to Patel went unanswered, too. Morris had been doing his bit to encourage Patel's return to Australia. He approved a letter to the surgeon's Portland lawyer, Stephen Howes, to establish whether
- [59:27]
Tony Morris
Patel is prepared to return to Queensland to participate in the inquiry and if so, what conditions, such as payment of travelling and accommodation expenses or even an indemnity from prosecution might be required by Patel in order to secure his return.
- [59:45]
Hedley Thomas
Morris would acknowledge later that the communications had attracted no response whatsoever. The suggestion of an indemnity was surprising. The outcry from the people of Queensland, had one been granted, would have been deafening. Morris was approached before the start of the inquiry by Tom Percy qc, who offered to represent Patel. When Percy did not turn up at the public hearings in Brisbane, Morris decided that Patel, having chosen not to avail himself of the opportunity to participate in the inquiry, had waived an entitlement to challenge the evidence of his accusers or to introduce his own. Accordingly, Tony Morris recommended a multitude of criminal charges. In his interim report he went further than anyone expected by proposing felony murder charges as an alternative to manslaughter.
- [60:43]
Tony Morris
It has traditionally been applied where death results from an act of violence or negligence committed in the course of a violent offence, such as a rape or an armed robbery.
- [60:54]
Hedley Thomas
Morris said that so long as the act done unlawfully was likely to endanger human life, the charge could be justified. He provided a helpful example. If a pedestrian is knocked down and killed by the reckless driving of a getaway car used by bank robbers, a felony murder charge could be brought because the reckless driving of the car was likely to endanger human life.
- [61:21]
Tony Morris
Ordinarily, even the grossest negligence on the part of a medical practitioner would not attract a murder conviction of unless the jury could be satisfied beyond a reasonable doubt that the degree of negligence was inconsistent with any state of mind other than a positive intention to kill. But very different considerations apply where, for example, an impostor pretends to be a medical practitioner and kills a patient whilst attempting to perform a surgical procedure.
- [61:52]
Hedley Thomas
Although Patel had medical training and qualifications, his efforts in Bundaberg and the outcomes for the patients were the result of his deceptions. Put simply, as he was operating unlawfully, he had forfeited the usual protections afforded to doctors. Peter Beattie, who commended every word of the interim report from Morris, rammed through more legislative changes to tighten the registration system for doctors and increase the penalties for imposters.
- [62:25]
Peter Beattie
This is terrible. This happened on our watch. This will be a matter on our consciences until the day we die. What we have to do in those circumstances is to ensure that the perpetrator is brought to justice and the system is improved so it never happens again. And that's what we're doing with the legislation today.
- [62:49]
Hedley Thomas
The promotion by Toni Morris of the idea that a surgeon could be charged with murder caused grave concerns concern outside the political arena. Some lawyers believed he was grandstanding and had gone too far. The report gave Ron Ashton and Jeff Deem, the lawyers for Peter Leck and Dr. Darren Keating, respectively, another potential legal argument. In any Supreme Court challenge, they would be able to argue that Morris had made up his mind before witnesses were cross examined. Morris had made secondary recommendations for the provisional arrest of Patel and his extradition but extradition from where? Where do you hide or reside, never mind work, when thousands of Internet sites around the world have posted your photograph and name under the heading Dr. Death. For someone accustomed to living the high life life flying up the front of the aircraft, enjoying the financial spoils of surgery and the ego stroking, Patel's predicament was difficult to imagine. The news had traveled quickly to India and the United States, where reporters and TV crews began staking out Patel's home again. Bloggers and media conglomerates alike, from one person outfits to the New York Times and its worldwide subscribers, were zeroing in on him as surely as law enforcement officials. His name, image and home address were known to millions of people, thanks to evidence at the inquiry. We even had details of his US Passport issued shortly before he came to Australia. It bore the number 207-55-6040 and was due to expire on the 17th of December 2012. And if he used his American Express credit card, police would know about it. Sick to Death is written and presented by ME Headley Thomas, the Australian's national Chief Correspondent. Claire Harvey is the Australian's Editorial Director. Audio editing, production and music have been done by Jasper Leake with assistance from Leah Samaglou and Neil Sutherland. Our producer is Kristen Amias, Production management by Stephanie Coombs Artwork by Sean Callanan. Thanks to Ryan Oslin, Matthew Condon, Corinna Berger, Ellie Dudley, David Murray, Dominique McDermott, Zach Schoolander and all our family, friends and colleagues who helped in this series and contributed voice, acting and special thanks to Tony Hoffman and Rob Messenger. Subscribers to the Australian hear new episodes of Sick to death first@sicktodeathpodcast.com and on Apple Podcasts. You can get exclusive access to photographs, videos, timelines, and more at the website. Foreign. This podcast is made possible by subscribers to the Australian and our principal sponsor, Harvey Norman. Harvey Norman has provided unwavering support for my investigative podcast since 2018. For more information on this podcast and on our entire investigative catalogue, go to theaustralian.com au.