Narrator / Reporter (5:21)

A raid on future budget surpluses and public service pay rises will fund the

Katie Page (5:25)

$6.36 billion Beatty government plan to fix

Narrator / Reporter (5:29)

Queensland's ailing health system and revive its own political fortunes.

Hedley Thomas (5:35)

Months of political turmoil that began with

Narrator / Reporter (5:37)

the Bundaberg Hospital scandal earlier this year culminated with the delivery of Queensland's first state mini budget. Premier Peter Beattie said while the massive funding and reform package had been forced by the extraordinary failures in Bundaberg, the

Katie Page (5:52)

changes would flow through to every facet

Narrator / Reporter (5:54)

of the state's health system. Queenslanders will pay for the changes through higher taxes and lower budget surpluses over the next 44 years.

Hedley Thomas (6:03)

Well mate, you've cost this state 6.4 billion. How do you feel? My colleague Craig Johnston joked on returning from the mini budget announcement. Another colleague, Tess Livingstone, added, when all

Katie Page (6:17)

our power bills go up, Headley, we can send you the bill.

Hedley Thomas (6:22)

My mother, Diana was in the Gold Coast Hospital and watching the TV news about the health crisis. Her condition was poor. The specialists were divided on how she would fare with the tumour in her adrenal gland. We feared the tumor was malignant and possibly inoperable. She was losing weight and had little energy. Her high cheekbones were now prominent because of the weight loss. She had lost her hair and replaced it with an expensive wig. My mother was a beautiful woman and had always striven to look her best. Her appearance worried her more than the probability that she had a terminal condition. My mother was a wonderful storyteller. She could tell classics, family squabbles, workplace triumphs, meetings with the rich and famous, although the facts were usually in dispute. She was also a natural stirrer. Perhaps that's why she took credit for her son. Choosing journalism was the craft, not a combination of stirring and storytelling. I drove back to Brisbane after each visit, feeling guilty that I was not doing more to understand her condition or find the best specialists to help her. The nurses told me she watched the TV news on the night of the 25th of October. All the bulletins led with the massive boost in funding for the health system. I left my desk earlier than usual. I had been asked to talk about the Jayant Patel story to the Sunnybank Private Hospital's annual Medical Council dinner. My talk at the Tattersalls Club in the city started with Elise Neville. She was more than a link in the chain. The death of this little girl, the campaign by her parents, Gerard and Lorraine, and the hideous failure of the health and regulatory system to repair itself even while prosecuting an inexperienced and exhausted doctor who had erred in treating a head injury, had a profound impact on me, Tony Hoffman, and many others. In the end, Elisa's death was not pointless. Like the deaths of the children at Bundaberg Hospital in 1928, it led to positive change. That night I dreamt that my mother had died. When I woke in the early morning, I felt uneasy and decided I would spend the day at her bedside. Where's Mummy? Where's Mummy? My daughter Sarah yelled as she clambered across the sheets. My wife Ruth, was not in our bed. She had gone down to Alexander, our son, when he cried out during the night. It was a little after 6am on the 26th of October 2005 when my sister Peter called. She was distraught.

Katie Page (9:17)

Head Mum has just died.

Hedley Thomas (9:20)

The staff in the ward just called me.

Katie Page (9:23)

They're so sorry.

Hedley Thomas (9:24)

They don't know what happened. Chapter 73 the findings Brisbane, 30 November 2005. One of the lawyers for the Jeff Davies led inquiry, Jared Cowley Grimmond, stood outside the Brisbane Magistrates Court. He he didn't miss anyone, jared said. Other lawyers who had fought since May to put the best possible light on the poor conduct of their clients were walking away grim, faced with a 538 page maroon coloured document titled Queensland Public Hospital's Commission of Inquiry Report. Jared Cowley Grimmond was right. Inquiry Commissioner Jeff Davies, who, who at that time was presenting the poisoned chalice of a document to Premier Peter Beattie as the TV cameras filmed their forced smiles, had not played favourites. He was as tough on the political leader who asked him to conduct the inquiry as he was on the minions whose incompetence cost lives. Apart from the tragedy at Bundaberg, the retired judge reported on crises in hospitals in Harvey Bay, Townsville, Rockhampton, Charters Towers and Brisbane. Jeff Davies did more than pinpoint the guilty parties. He urged national leadership, an overhaul of funding strategies and major reforms to the health bureaucracies and regulatory bodies. On the Beatty government and the former Coalition government, Jeff Davies found that a culture of secrecy fostered by successive governments had been a major cause of the Jayant Patel scandal and unsafe care in the health system.

Narrator / Reporter (11:32)

It involved a blatant exercise of secreting information from public gaze for no reason other than that the disclosure of the information might be embarrassing to government.

Hedley Thomas (11:44)

Davies ruled campaigns of concealment at the highest levels of the government were contrary to the public interest, misleading and deadly. That culture, encouraged by politicians, filtered down

Narrator / Reporter (11:59)

to Queensland health staff and through them to administrators in public hospitals, resulting in

Hedley Thomas (12:06)

a failure to act decisively on safety. In his report, Jeff Davies wrote, this

Narrator / Reporter (12:12)

culture started at the top with successive governments misusing the Freedom of Information act to enable potentially embarrassing information to be concealed from the public. All this reflects poorly on the politicians involved in the stewardship of Queensland Health. Unsurprisingly, Queensland Health adopted a similar approach. And because inadequate budgets meant that there would be inadequate health care, there was quite a lot to conceal. Again, unsurprisingly, the same approach was adopted by administrators in public hospitals and this in turn led to threats of retribution to those who saw it as their duty to complain about inadequate health care.

Hedley Thomas (13:00)

He criticised the former Coalition government, the Beatty government and former labor health ministers Gordon Nuttall and Wendy Edmond. Jeff Davies said that the lives and care of patients in the public health system in Queensland had been compromised for years because of chronic underfunding. He advocated national leadership on health funding to prevent the collapse of the public system, which he found was unsustainable unless more patients paid for their care.

Narrator / Reporter (13:31)

And it is also wrong, in my opinion, to assume that the other states are providing an adequate and safe system. Even more concerning is that the lower cost in Queensland in delivering healthcare services has come at the cost of lowering the standard of healthcare to one which is grossly inadequate and dangerous.

Hedley Thomas (13:55)

By relying on unqualified doctors to perform complex surgery beyond their competence, and by dumping inadequately trained doctors into hospitals, patients were put at risk.

Narrator / Reporter (14:07)

In my view, it is an irresistible conclusion that there is a history of a culture of concealment within and pertaining to Queensland health.

Hedley Thomas (14:19)

When it came to the Medical Board of Queensland. Jeff Davies ruled that the Board's incompetence

Narrator / Reporter (14:25)

had led to large numbers of overseas trained doctors practising in this state without meeting the standards required of Australian trained doctors.

Hedley Thomas (14:37)

This was particularly disturbing as the Board and its major stakeholders had been aware for several years that the registration system for overseas trained doctors was in crisis.

Narrator / Reporter (14:50)

Any reasonable inquiry would have revealed that Dr. Patel had lied in the application about his disciplinary history. If that had been revealed, the dishonesty alone should have persuaded the board that Dr. Patel was not a suitable person for registration. The Board effectively made no independent inquiry.

Hedley Thomas (15:14)

Jeff Davies blamed the SAC director general, Dr. Steve Buckland, for fostering a culture of concealment and suppression and for compromising the safety of patients by attempting to deny or or ignore serious clinical issues linked to dangerous doctors. He found that Dr. Buckland failed to

Narrator / Reporter (15:34)

take any appropriate action to suspend Dr. Patel from duty or providing surgical services or further restrict his scope of practice or cause any further investigation of Dr. Patel's conduct until April 9, 2005, after Dr. Patel had left the country. Each failure in the circumstances was deliberate or careless and incompetent and unreasonable.

Hedley Thomas (16:03)

And he ruled that Dr. Buckland was

Narrator / Reporter (16:06)

inclined to criticise the critics and to conceal the criticism rather than to deal with the problem.

Hedley Thomas (16:14)

Jeff Davies found that Dr. Jerry Fitzgerald's approach to the audit that he led into Dr. Patel in early 2005 and his interpretation of its alarming findings of a significantly higher complication rate were quite inexplicable. And Jeff Davies added that Dr. Fitzgerald had acted deliberately or carelessly and incompetently.

Narrator / Reporter (16:39)

Permitting Dr. Patel to continue to practice and then leaving it to the Medical Board of Queensland to take whatever steps they thought necessary was a course designed to minimise publicity and in effect, conceal the truth. The interests of the patients were ignored. Dr. Fitzgerald failed to take any step to restrict Dr. Patel's surgical practices through suspension, limitation of practice or restriction of duties at the hospital, whether temporarily or otherwise, when such advice was reasonably appropriate and and warranted. In my view, Dr. Fitzgerald had it in his mind from the outset that it was likely that Dr. Patel would not remain in practice in Australia beyond 31 March 2005. This was likely to put an end to the issue. He did this against the background of knowing that from 22nd March 2005 the issue had become a political one, it being raised in parliament by Mr. Messenger MP.

Hedley Thomas (17:50)

Jeff Davies recommended a police probe into evidence that Dr. Darren Keating, Bundaberg Hospital's director of medical services, had deliberately misled state and federal agencies in relation to Patel's status and abilities. He said that Dr. Keating had persistently ignored or downplayed the seriousness of complaints

Narrator / Reporter (18:13)

and had performed his duties carelessly or incompetently. When the matters are considered together, they lead to the view that there was a strong element of orchestrated incompetence or wilful blindness in Dr. Keating's response to complaints about his director of surgery. I find that Dr. Keating deliberately diminished or downplayed complaints about Dr. Patel. He declined to initiate enquiries into Dr. Patel where at the very least, serious concerns had been raised and he promoted or acquiesced in a perception amongst staff that Dr. Patel was protected by management because he was valuable for performing his

Hedley Thomas (19:01)

duties carelessly or incompetently. Peter Leck, the hospital's district manager, should face disciplinary action. Jeff Davies found. Peter Leck permitted Dr. Patel's promotion to director of surgery before anyone had checked his skills. Leck had not set up a system to vet the credentials of doctors at

Narrator / Reporter (19:23)

the hospital, and accordingly, the formal qualifications, training, experience and clinical competence of Dr. Patel, amongst others, was not assessed. And the opportunity was lost for such a committee to discover Dr. Patel's disciplinary history and take appropriate action. Upon learning of complaints and concerns about Dr. Patel's competence, Mr. Leck failed to ensure that they were investigated properly. Like Dr. Keating, Mr. Leck's conduct, in my view, evinces, if not a policy of calculated concealment, an attitude that discouraged any frank discussion of clinical issues within the hospital.

Hedley Thomas (20:09)

Jeff Davies singled out Tony Hoffman, the nurse manager of the intensive care unit at the hospital, when paying tribute to people whose care, passion or courage was instrumental in bringing to light the matters covered in his report.

Narrator / Reporter (20:24)

She might easily have doubted herself or succumbed to certain pressures to work within a system that was not responsive. She might have chosen to quarantine herself from Dr. Patel's influence by leaving the hospital, or at least the intensive care unit instead, and under the threat of significant detriment to herself. Ms. Hoffman persistently and carefully documented the transgressions of Dr. Patel. It was her courage and persistence which, in the face of inaction and even resistance, brought the scandalous conduct of Dr. Patel to light.

Hedley Thomas (21:07)

Finally, the missing surgeon Dr. Jayant Patel was found to have been a pathological liar who performed operations beyond his competence and beyond the capacity of the hospital and its staff.

Narrator / Reporter (21:22)

As a result of negligence on the part of Dr. Patel, 13 patients at the hospital died and many others suffered adverse outcomes. Dr. Patel unreasonably failed to transfer patients to a tertiary referral hospital within an appropriate time frame, causing adverse outcomes for many of those patients. On many occasions, Dr. Patel failed to adequately record in patient files the true details concerning material facts, including the surgical procedures undertaken, complications arising from surgery, wound dehiscence, infections, the course of post operative care, and reasons for post operative return to surgery. Dr. Patel failed to refer 13 reportable deaths to the coroner.

Hedley Thomas (22:17)

Davies recommended police consider charges of manslaughter, negligent acts causing harm, grievous bodily harm, assault occasioning bodily harm, and fraud. He found that Patel had virtues.

Narrator / Reporter (22:34)

He was not without skill, intelligence and an aptitude for learning, and might well have thrived in a larger hospital where he was closely supervised. Staff attested to the fact that Dr. Patel worked tirelessly.

Hedley Thomas (23:02)

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 74 Dear Dr. Patel Portland, Oregon July 2006 for most of the long flight to the United States, my imagination ran riot in my mind's eye. I was driving a hire car to an address I had memorized and knocking confidently on the heavy front door of Jayant Patel's impressive mansion. Like the reporter Paul Barry from 60 Minutes the previous year, I would stride across the manicured Lawn and declare, Dr. Patel, we know you are there. And as a photographer steadied for the gotcha shot, an unsmiling Patel would unbolt the door and invite me in for an exhaustive interview. It was a long shot, but stranger things had happened since this bizarre scandal first erupted. Stephanie Balogh, the Courier Mail's chief of staff, and Tony Hoffman were positive. Tony told me, just remember this, his

Katie Page (25:07)

Ego is so huge that he would love to talk about what happened and blame everyone else. I think he wants to, to talk. It's only his lawyers who have stopped him.

Hedley Thomas (25:17)

The patients and the families, the doctors and nurses, the politicians and the bureaucrats. They would be morbidly engrossed in even the most self serving explanation from Patel so far. His story remained untold. It was the final chapter. He might as well lay it out with the reporter who had made a statement study of his career. Having decided days earlier to resign from the newspaper after seven years there, I had another motive. An exclusive Patel interview would be an appropriate way to finish. He had been in legal limbo since a Queensland police brief of evidence comprising more than 35,000 pages had gone to the Director of Public Prosecutions, leanne Clare in February 2006. Dr. Patel's Brisbane solicitor, Damian Scattini, said the entire saga had been horrendous for his client. How do you imagine he feels about it all? He takes it all very seriously and

Narrator / Reporter (26:22)

it's been a nightmare for him.

Hedley Thomas (26:24)

Terry O', Gorman, the civil liberties lawyer, said he's been dubbed Dr. Death. For a period of 12 months or more, he's been the centre focus of a royal commission in which a whole lot of evidence not admissible in a court of law has been led. It is my view that he cannot get a fair trial. Hoffman and the patients, however, remained confident that he would be extradited for a trial in the Supreme Court in Brisbane. The detectives from the homicide squad were adamant that Tony would be a key witness for the prosecution. While Police Commissioner Bob Atkinson had visited Bundaberg to reassure grieving families that the case was a high priority. The 13 deaths attributed to Dr. Patel from evidence in the inquiry run by Jeff Davies had risen to 17 in the ensuing months. Prosecuting over so many deaths would increase the workload for the police and the lawyers. So the Police Commissioner agreed to whittle the number to a handful of manslaughter and grievous bodily harm cases where the evidence was strongest. As Patel pondered his future, waiting for a knock on the door from a US marshal with extradition papers or an opportunistic reporter with a digital recorder, Tony Hoffman suffered a breakdown. The stress had finally caught up with her. Ordered to take a long break from work, she watched a TV news clip. On 6 June, Premier Peter Beattie had upped the injection of funds into the health system to almost 10 billion after polls tipped. Electoral disaster, Beattie said this means more

Narrator / Reporter (28:16)

elective surgery, more responsive and Better resourced emergency departments, expanded public and community health activities, and ultimately a healthier Queensland.

Hedley Thomas (28:30)

Jim Cronenberg, the Oregon Medical Association's effusive manager, asked me for an update within moments of our meeting at Portland's Hotel Deluxe.

Narrator / Reporter (28:41)

Tell me what is happening. When are they going to bring him to Australia?

Hedley Thomas (28:46)

In a long career working with physicians, he had never encountered anything as strange as the Patel scandal.

Narrator / Reporter (28:54)

What happened to the unfortunate folks in Australia was a real shock to us here. This guy would have worked in every Kaiser Permanente clinic in Portland. He's worked with scrub nurses and anesthetists. He's assisted surgeons and supervised surgeons.

Hedley Thomas (29:08)

Doesn't that make it worse? I asked that he worked for a long time with many qualified people and yet it took years for him to be stopped.

Narrator / Reporter (29:19)

Well, I have a theory. I'm left to conclude that with all the surgeons with whom he worked, none of them saw enough. They saw a mistake here and there, Cronenberg answered. And they often say things like, well, I wouldn't have done it that way. But that's the thing. There is not always a precise and scientific way. Every time the human anatomy is different. I used to think that we were all set up the same way. But no, take a woman's uterus. There are big ones, small ones, long ones, wide ones. So after saying I wouldn't have done it that way, a reviewing surgeon will next say, but I can understand why it was done that way.

Hedley Thomas (29:59)

The Oregon Board of Medical Examiners in downtown Portland has an impressive sign above its reception desk.

Katie Page (30:07)

It says, to protect the health, safety and well being of Oregonians by regulating the practice of medicine in a manner that promotes quality health care.

Hedley Thomas (30:19)

One of the board's investigators, Don Short, had been asked to greet me and decline my requests for information about their most infamous registrant. The chairman, David Groom, would that day invoke an order which was signed by Patel, to prevent his reinstatement as a surgeon until he proves to the satisfaction

Katie Page (30:42)

of the board that that the criminal and administrative process against him in Australia is complete and that all penalties or conditions imposed by that jurisdiction have been satisfied.

Hedley Thomas (30:54)

Don Short was tight lipped. He had been told to say nothing about recent contact with either Patel or his criminal lawyer, Stephen Howes, who had already flagged a long battle with Australian authorities if extradition proceeded. Meetings were started. I went to a home in a heavily wooded suburb south of Portland. It belonged to John Dully. He was sitting in his favourite room filled with sports memorabilia and celebrated covers of Time and Life magazine. He pointed to an X ray in a frame on the wall.

Narrator / Reporter (31:32)

There's the clamp that Patel left inside me.

Hedley Thomas (31:36)

John asked me, do you think he will be extradited back to Australia? I couldn't say.

Katie Page (31:43)

Can you imagine that being left inside?

Hedley Thomas (31:45)

Someone asked his wife, Tracey, looking at the stainless steel clamp that measured 20 centimetres from tip to handle.

Katie Page (31:55)

They did such a good job hiding all this. There's a gag order on his lawsuit and they tried to sell it as a mistake. A terrible accident that happened in a

Hedley Thomas (32:05)

learning situation in 1992. John Dully, then a 27 year old restaurant cook, suffered from ulcerative colitis. He underwent a procedure to have his colon removed after being reassured by the confidence and apparent ability of his surgeon, Patel. When Dali left the best Kaiser medical centre to go home 10 days after the surgery, he was doubled up with pain.

Narrator / Reporter (32:36)

They told me in the hospital that they had nicked my urethra and had to repair it. I went home and I was having trouble urinating. I was urinating through my rectum. I told one of the interns what was going on and then they discovered the clamp. The intern told me, this is a surgeon's worst nightmare. He said I should get an attorney.

Hedley Thomas (32:58)

Patel had left the sexually active man permanently impotent. He required five major operations by other surgeons to repair some of the damage from the first procedure by Patel. The settlement of Daly's legal case in 1994 should have been reported to the Oregon Board of Medical Examiners by the Kaiser Group, but it withheld that information. John has wondered how many patients might have been better off if the board had begun investigations back then. He hoped Patel would be severely disciplined after his Bundaberg scandals.

Narrator / Reporter (33:39)

What I think would really hurt him most is having to explain what he did to people he thinks are beneath him.

Hedley Thomas (33:45)

He would hate that. I just know it. Susan Goldsmith swung her Chevrolet Tracker onto the freeway and headed north, peeling off for the last five minutes of the journey to Patel's house in the Bronson Creek estate, where the homes are larger and more expensive.

Katie Page (34:07)

I know he's around. I don't know if he's around this second, but I'm told he hangs out at the Starbucks in Washington Square.

Hedley Thomas (34:14)

The heavily pregnant investigative journalist for the Oregonian newspaper told me, you know, I

Katie Page (34:21)

had so much trouble finding doctors willing to talk to me, even those doctors who worked with him and knew about his problems. I don't know what it's like in Australia, but here there's like this culture of secrecy with the doctors. I went to one of the local doctors association meetings and they broke into a jog to get away from me. It was unbelievable. I was like, what is wrong with these people? If you're a sicko in this profession, you will be protected. Patel found the right profession and then he found the right specialty where there are a lot of complications.

Hedley Thomas (34:56)

What is our strategy? I asked Susan. Do you want to pull over and talk about it?

Katie Page (35:01)

Let's just bowl up and knock on

Hedley Thomas (35:02)

the door, she replied. So we did. She knocked. I called out. There were many questions. Why did he keep operating in Bundaberg when it must have been obvious that his patients were suffering? How did he cope, knowing of the suffering, the deaths and the maiming and the psychological trauma? What, if anything, would he like to say to those affected? I went back to the house five times and telephoned repeatedly, but nobody answered. Epilogue late 2006, Beryl Crosby looked shattered. Wired with devices to monitor her heart, she was still rushing around helping others when she should have been resting. In the weeks before Premier Peter Beatty called a circuit breaking state election for 9 September 2006, the doctors at Bundaberg Hospital were worried about her high blood pressure as well as her confidence conflict with Rob Messenger. The unflagging advocate for the patients and the fearless politician were no longer allies. Rob messenger believed that many of the several hundred patients, and perhaps Crosby herself, were being unjustly treated in Australia's largest compensation program for medical negligence. It included free legal and medical advice and relatively generous payouts for the physical injuries and psychiatric stress arising from Jayant Patel's surgery. I'm devastated, rob messenger told me when I visited Bundaberg for a late July meeting of the patient support group. Beryl's line is that I'm just being political. She believes I'm using this to advance my political career and that's a big kick in the guts for me. Beryl and I no longer have a relationship. She believes the compensation system is operating fine. Crosby, who had been sped to hospital by ambulance the previous week after collapsing from stress, could no longer cope with Rob Messenger's interference.

Katie Page (37:25)

Patients are walking out of meetings. We've had five now who say they won't come back because of him. People are angry with him. He's grandstanding. I think he's doing it because he believes he's winning votes, but little does he know he's losing them. I don't care if he burns up all the goodwill he had, but I care that he's upsetting the patients. Sad. It's Bedlam. We were great friends, she explained.

Hedley Thomas (37:48)

I had a hunch that the evening meeting of the Patient Support Group would herald news about the efforts to extradite Jayant Patel from Oregon to Australia. The patients hoped the appearance of the Attorney General for Queensland, Linda Lavarge, meant a breakthrough. Others were sceptical. Karen Oriel, the mother of teenager Shannon Mobs, who lost his leg and almost lost his life, said, I don't believe

Katie Page (38:16)

that Patel will ever be brought back to Australia because I think he would implicate too many other people.

Hedley Thomas (38:22)

When I spoke to Gerry Kemps widow, Judy, at her retirement villa at seaside Bagara, she was determined to see the surgeon stand trial.

Katie Page (38:32)

I think Gerry was meant to go the way he did to put a stop to all the carnage. But even now, I'm having anxiety attacks. They're scary. I'm taking antidepressants. The police reckon they are going to have news soon. I'm glad they've made Gerry one of the manslaughter cases. I feel as if he's contributing. I get so angry when people say, oh, they won't ever get Patel back here. I feel like slapping them. Of course they'll get him back. When the trial starts, I want to be in the front row. I will go every day, Judy said.

Hedley Thomas (39:05)

A little after 7pm, in a conference room at the Brothers Club, Lavarch and a small entourage took their seats. Her media advisor, Paul Childs, quipped about new quality controls. We don't appoint anyone now without first Googling them, he said. Lavarche pledged that her door would remain open for anyone with complaints about the compensation. She was adamant that the ongoing efforts of the Director of Public Prosecutions, Leanne Claire and the police to bring Patel back for a criminal trial were completely independent from her office. This is how Linda Lavarch put it.

Katie Page (39:48)

I can't go down and say, hurry up. They need to be independent. They need to be given all the time they require to investigate all the matters. You can categorically trust the office of the DPP to ensure that every matter is progressing well. You have all been courageous and the fact that you care about each other sends a very loud message to all of Queensland about what a great community this is.

Hedley Thomas (40:10)

The patients stayed for tea and biscuits. Nelson Cox looked as fit as a fiddle. Shannon Mobbs, the youngest victim, beamed as he walked on his new prosthetic leg. But Marilyn Daisy, down the back in her wheelchair, was unwell, although she did not let on. After an election campaign that went disastrously for the opposition, Premier Peter Beattie Romped to victory at the polls in September. A few months earlier, he was worried.

Narrator / Reporter (40:43)

In the end, health could be the death of me. We've got a fight on our hands, but it's a fight we can win.

Hedley Thomas (40:52)

But Beattie had faced up to a disaster that I suspected he knew was partly of his own making. He started an unprecedented process of reform. He was braver than any other Australian politician confronted with with a health crisis. The political pundits who had predicted serious pain for his labor government attributed Beattie's fourth term triumph to the voting public's disgust at the strife torn opposition, which had failed dismally in its attempts to capitalise on the health scandal. One of Labor's few losses was in the retiring Nita Cunningham's once safe seat of the Bundaberg. As I settled into my new role at the Australian newspaper, reliable sources hinted at something that seemed incredible. Through his lawyers, Patel had secretly offered to return voluntarily to Brisbane before the state election. Weeks of highly confidential talks between his legal defence team and the DPP had culminated in in Leanne Clair recommending to Linda Lavaats that the Patel deal be approved. It was an extraordinary opportunity. It would have saved years of costly and uncertain extradition proceedings. As part of the package, Patel's lawyers, Damien Scattini in Brisbane and Stephen Howes in the United States, had sought undertakings from DPP Leanne Clare and Attorney General Linda Lavarch that bail would not be opposed. At an initial court appearance in Brisbane, if a magistrate agreed to grant bail, Jayant Patel would fly back to Oregon and remain at his home until the start of his criminal trial in Brisbane Supreme Court. He had also offered to give up his passport and to report to Portland police. Queensland's best legal minds told me on and off the record that Linda Lavarch should have snatched the deal, particularly as Claire and her top prosecutors, David Meredith and Ross Martin, had urged acceptance. After exploring the fine details, Richard Douglas, the Davies Inquiry's former senior lawyer, told me, how is the public going to

Narrator / Reporter (43:19)

be served by getting Dr. Patel back in two or three years? People die. People forget who operated on whom. Time defeats proper outcomes. And once people's recollections are taxed, people who should be convicted are not convicted.

Hedley Thomas (43:36)

I thought of the elderly Judi Kemps. The evening after Marilyn Daisy's death at Bundaberg Hospital in October, I called Linda Lavarch's mobile phone. I already knew that the proposed deal to get Patel back had failed. Failed. I knew that Linda Lavarch had stubbornly refused to support it despite the DPP's lobbying. Her surprise decision after consulting the Premier, Peter Beatty, behind closed doors, was final. The office of the DPP was unimpressed. Patel was dumbfounded when Damian Scattini told him of the Queensland Government's veto. For more than a year, politicians had been demanding Patel's scalp. Some proposed hiring bounty hunters. Now he was being told, stay away. I was in no doubt that the decision had been influenced by political rather than legal reasons. The return of Patel at that time could have been disastrous for Beattie. So close to the state election, labor had directed its small target campaign away from Health. The politicians had concealed the deal's existence even as they spoke in public about the need for a trial and closure for patients. But the subterfuge was almost over when Linda Lavarch answered her mobile phone and nervously defended her decision. The front page of the Australian was already being drawn under the headline beatty scuttled Dr. Death Deal. The news stunned and appalled the patients, particularly Beryl Crosby, who recalled Linda Lavarche's visit in late July when she insisted her office had nothing to do with the independent dpp. When she had addressed the patients that July evening at the Brothers Club, Lavarch had already secretly rejected the Patel proposal some four weeks earlier. The story in the Australian developed momentum and provoked widespread anger. Peter Beatty and Linda Lavarch were accused of misleading state Parliament. They denied it. Damien Scattini broke his silence and forced Beattie to retract false claims. Beryl Crosby demanded the release of all relevant documents. In the same week, Marilyn Daisy was laid to rest after apologising for covering up information and misleading the public. Lavarch quit as attorney general on 18 October, citing depression. A warrant seeking Jayant Patel's arrest was taken by Queensland police to a Brisbane Magistrate on 22 November 2006. The warrant, a formal tribute to start an extradition process, listed numerous proposed charges, including manslaughter, grievous bodily harm and fraud. The news of the development overwhelmed many of the patients and their relatives. Beryl Crosby was kept busy briefing her members and doing interviews. Judy Kemps broke down. Her husband was named in the warrant as one of the three manslaughter cases. Cases mostly. My sources believe that Patel would not be coming back, or at least not for a long time. The Director of Public Prosecutions, Leanne Claire, warned that the extradition proceedings would be complicated and time consuming. But as Beryl Crosby told the patients, it was a start. Jayant Patel's favourite restaurant in Bundaberg, the Indian Curry Bazaar, has been busier Than ever, tourists ask Pam Samra to sell the placemats. She has retailed dozens of souvenirs. Former Health Minister Gordon Nuttall was forced to quit politics in disgrace after the Crime and Misconduct Commission found that he had lied to State Parliament about his knowledge of problems with overseas trained doctors. Having rescued the health inquiry, Jeff Davies became a key advisor on health to the Beattie government and the Royal Australasian College of Surgeons. Queensland Health now boasts an independent Health Quality and Complaints Commission with more powers, more resources and more responsibility. The government created hundreds of hundreds of extra places for doctors and there is new transparency on surgery performance and waiting times and 1,000 extra nurses. Tony Hoffman has another award, Whistleblower of the Year. The citation says that she put herself on the line to save lives. She has been to lunch with the Governor General, to dinner with the Queen and had cocktails with the Prime Minister. Dr. Gerard Neville and his wife Lorraine have been looking ahead. When told of their daughter Elise's special role in the Jayant Patel scandal, they wept. For my book Sick to Death. Two decades ago, Jeff Davies, the former Supreme Court of Appeal judge and the former Health Inquiry Commissioner, kindly wrote these words.

Narrator / Reporter (49:31)

As Headley Thomas accurately describes it, this is the story of the once in a lifetime scandal of Jayant Patel and the wider story of how political interference and bureaucratic incompetence conspired against a health system. It is an absorbing account. Even though I knew many, though by no means most, of the facts Mr. Thomas relates, I found this book hard to put down. For those who find some of it hard to believe, I can say to the extent that it covers the evidence in my inquiry, it is an accurate account. Moreover, whilst I may not agree with all of Mr. Thomas opinions, I believe that this book is a salutary warning to present and future governments to the bureaucracy and to the public as to what can happen when problems are concealed. I hope that warning is heeded. There is one glaring omission in the book. Whilst Mr. Thomas praises the roles of Ms. Hoffman and Mr. Messenger in bringing the scandal to light, he is unduly modest about his own contribution. This is part of what I said about him in my report. His investigative skill, persistence and undoubted authority as a respected journalist ensured that public notice and government action was taken, notwithstanding the apparent reluctance of hospital administrators and officers of Queensland Health to take appropriate action to permit the matter to be exposed. I went on later in the report to detail his important contribution to this the revelations of Mr. Thomas and others leading to my inquiry and report have already resulted in a huge increase in the health budget and substantial worthwhile reforms. Beneficial consequences of those reforms may not emerge for some time. More importantly, these benefits will ultimately be lost unless government and the bureaucracy maintain the will to put patient care and openness ahead of economic rationalism. This compelling account will focus attention on that need. The Honourable Geoffrey Davies, ao, Commissioner of the Queensland Public Hospital's Commission of Inquiry

Hedley Thomas (52:10)

in the next and final stage of this podcast series, you are going to hear about dramatic and surprising developments after the release of my book in early 2007 the police pursuit of Dr. Patel, his eventual extradition from the United States to Queensland, the criminal trials of the disgraced surgeon, and of course, his appeals to higher courts until finally it was all over. There were some remarkable outcomes, and you'll hear about those in the finale. Sick to Death is written and presented by me, Hedley 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 Kristin Amyot, Production management by Stephanie Coombs Artwork by Sean Callanan. Thanks to Ryan Osland, Matthew Condon, Corinna Berger, Ellie Dudley, David Murray, Dominique McDermott, Zach Skulander 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. 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.