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- [00:05]
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 33 nagging doubts good Friday 25 march 2005. I sat at my desk on Friday afternoon and contemplated the imminent start of a week's holiday, a visit to my parents in law in Mackay and a family camping expedition at Hook island farther north. As the Friday afternoon wound down and my colleagues headed to the Jubilee Hotel for a few drinks in the Journalists Bar in Brisbane, I remained troubled by Rob Messenger's revelations in state parliament three days earlier. A yellow A4 sized envelope from Tony Hoffman, who had followed through on my request of months earlier to send documentary evidence supporting her concerns, was still gathering dust on my desk. It contained copies of the statements that Rob messenger had tabled on 22nd and 23rd March on a petition erected at my desk to give colleague Craig Johnston and myself some privacy as we cajoled and flattered our contacts. I had months earlier pinned a list of stories I wanted to write. My most recent scrawl was Overseas trained doctors. The ticking time bomb I wanted to launch again into an issue that had alarmed me when I wrote about it in November 2003. At the time it went nowhere, but the time bomb had been ticking for some time now. Had messenger spedded up? I was also troubled on Friday afternoon because I had not found time to investigate the statements in the yellow envelope sent by Hoffman in late February. The clues to Jayant Patel's negligence fell between the cracks in my determination to prove myself. After two costly legal actions brought separately in 2004 by men who believed they had been unfairly injured by my reporting, I aggressively pursued a couple of big stories in early 2005. The major one explored the circumstances surrounding a Crime and Misconduct Commission investigation into an alleged bribery attempt by Peter Beattie, the premier of Queensland of an impoverished aboriginal community on Palm island near Townsville. Beattie, who faced a prison term if found guilty, was severely rattled by the scandal. He was livid with me for reporting that he had been tape recorded while making the bribery pitch, which was the waiver of an $800,000 debt in return for a public truce with the community's indigenous leaders. Peter Beattie had sought their smiles, handshakes and a cessation of all hostilities. If they agreed, he would gain political kudos in front of a media throng which had arrived on the island. The bait was the cash. When the scandal broke, it threatened not just his career, but also his freedom. After the revelation about the tape recorder was published with Beattie's comments, which a reliable source had provided to me, the Premier faced immense pressure in in State Parliament. Under relentless questioning by the opposition, he admitted that he had made the comments attributed to him. Subsequent investigations by the Crime and Misconduct Commission showed, however, that the tape was blank. The tape recording machine had malfunctioned. The comments which had been provided to me and reported were based on a detailed written file note made by the lawyers who heard Beatty. The Premier, who had adopted the potentially incriminating comments as entirely accurate on the basis that there was a tape recording, was furious. He felt that he had been tricked by my sources into admitting the truthfulness of a conversation which could amount to a bribe. My contacts and my personal loathing of the government's hideous addiction to secrecy delivered another scoop as the dust settled on Beattie's problem. It came in the form of Kathy Taylor, a bureaucrat from Beattie's inner circle who was appointed as the Freedom of Information Commissioner. Taylor lacked qualifications for the job and she had failed to even make the shortlist until the intervention of Beattie's top public servant, Leo Kelleher, on the selection panel. Happily for Kathy Taylor, one of her referees was also Leo Kelleher. One of Taylor's first decisions as the Commissioner was to sack Greg Sorensen, the deputy and one of the most experienced FOI officers in Australia. Greg Sorensen had angered the Beatty government for being too open with public information. Kathy Taylor's elevation and Greg Sorensen's ousting appalled even some of Beattie's backers. The Premier had sent a message that the secrecy would become worse. As I developed this story of ugly opportunism. The yellow envelope lay dormant. In early March, before Rob Messenger's outpouring, I had fired up my reporting colleague and friend Michael McKenna, to join me in investigating the contents of Hoffman's envelope. Mickey, are you up for a trip to Bundaberg? I. I asked Michael, who was back from leave after reporting on the death and destruction in Sri Lanka following the Asian tsunami. McKenna, whose father was a prominent and highly respected pathologist before retiring, had also written about concerns over the screening of overseas trained doctors. He understood the issues, but until Rob messenger stood up, the other big stories had devoured our attention now. On the afternoon of Good Friday, my plan was to take Hoffman's Bundaberg Hospital material to Mackay to show my father in law, Dr. Ian Mathewson, a retired GP. If Ian reckoned that the statements indicated potential wrongdoing, I would return to work ready to take the story further. My last task for the day involved emailing Tony Hoffman. I wanted to buy some time by assuring her that I remained keenly interested. I wrote Dear Tony, I've been following with interest the revelations in State Parliament through your local member, Mr. Messenger. I've got your statements and I'm aware that the whole story is yet to be told. I'm hoping to be able to come up to investigate a lot of the issues and speak to you confidentially and some of the other nurses, doctors, patients and their families in April. Would you be able to assist? I'll be away next week. Regards, Hedley Thomas Hoffman, worried sick and feeling increasingly isolated at her home in Bundaberg, replied a few days later.
- [08:09]
Tony Hoffman
I would very much like to meet with you and tell you the whole story, which is huge. As you can imagine, I'm in heaps of trouble. Although I have denied all to this point, I have not breached the code of conduct by going to the media. I have been threatened with the cmc. I have read your excellent journalism with interest and the issues surrounding John Tong scares me. In spite of this I will meet with you as long as I can remain anonymous. I don't know if anyone will want to speak out now because of the threats. What can you get with foi? Can you get access to the Fact Finding Mission by Jerry Fitzgerald? Queensland government employees desperately need some sort of agency we can go to when we have real concerns. At the moment the issue has been taken off the real issue, the patient's deaths, et cetera, and is focused on who leaked the information. We really tried to go through the right channels and nothing happened. I will wait to hear from you. I will help you with what I can. Thanks Tony.
- [09:17]
Hedley Thomas
Chapter 34 renewed interest 26 March 2005. The kitchen bench at Ian and Mary Mathewson's modest house in Slade Point is often strewn with paper magazines and torn out articles about medicine, science, the environment, inventions and current affairs vie for precious space, occasionally prompting Mary to take matters into her own hands and file them in the bin under the sink. Most of the time my mother in law tolerated the eccentricities of her gentle husband Ian. Like many extraordinarily intelligent people, Ian, who went to medical school in Aberdeen, north of his birthplace of Edinburgh in Scotland could make a hash of basic everyday tasks. It took Mary an eternity to teach him how to double click with a computer mouse. He would leave the house for hours at a time with the oven turned on. Operating the microwave was a major challenge. Occasionally there would be an explosion of flood food or cutlery. Once he managed to set a baked potato alight. Yet when it came to issues like the impact of genetics on the brain, advanced hydraulics and the history of space, Ian understood the detail and often developed new theories. As a GP and senior partner for many years in the Central Medical Group, a private practice in Mackay, he was loved by his patients and colleagues alike. There were many tears over his retirement due to ill health. His patients felt they had lost a doctor who cared passionately about their health. He was one of the few GPs left who regularly did house calls for elderly or ill patients. In retirement, he gave up his time to check on former patients. Whenever our children were unwell, Ian was consulted first for an opinion. He listened carefully before offering a prognosis. It always turned out correct. Years after leaving the job, he remained intensely interested in his profession, its development and policies, as he knew all the senior medical practitioners in Mackay and he was aware of the culture of bullying and the fears Queensland health staff had about speaking out about problems. He had been surprised at the reluctance of some of his friends to speak frankly to me, off the record about serious mismanagement issues they had witnessed in the hospitals and emergency departments in which they worked. They had confided to Ian and initially wanted to talk, but they backed off, fearing retribution. Ian disdained the culture of concealment in the state government. Peter Beattie's hypocrisy over freedom of information stuck in Ian's craw. He was still cranky that the Medical Board of Queensland wanted to take away from retired practitioners the time honoured right to call themselves doctors. In his Scottish brogue, he said to me, politicians like Beattie get honorary doctorates. We went to university for ours. Why do they think they can take ours away? After a few single malt whiskies from a favourite Highlands distillery, we sometimes convened a meeting of our own peculiar political organisation. The two member don't vote for any one party. With its platform of reversing the law that made voting compulsory, our motto was taken from Charles de Gaulle, who said, politics is too dangerous a subject to be left to politicians. On Saturday 26th March, Ian sat at the cluttered kitchen bench, absorbed in the statements Tony Hoffman had sent to me. My mother in Law Mary prepared dinner, a particularly spicy Indian chicken curry. Having grown up in a hospital environment in Kuching, on the island of Sarawak in Malaysia, Mary slipped easily into nursing after leaving school. Her father, Antoni Maramutu, whose family came from Madras in India, was a manager and operating theatre superintendent at the hospital where his daughter won her first job. She quickly fell in love with the tall, gift, gangly, bagpipe playing Scot who had left the bitter winters of Scotland to practice in the little hospital in exotic Kuching. Their courtship had the blessing of Mary's mother, Claire Guan, a Chinese woman whose marriage to an Indian man had caused a scandal three decades earlier. After eight years together in Malaysia and then Brunei, where Ian anesthetised the world's richest man. When the Sultan of Brunei fell from his polo pon, the family moved to Mackay. Mary was for years a formidable force in the central Queensland town facing the Coral Sea, running the Red Cross blood bank and surpassing plasma donation targets. Donors and friends nicknamed her Bloody Mary. It was a favourite drink. Ian was stroking his chin as he leaned into the kitchen counter and read the documents I showed him about the avoidable deaths and injuries. This does not look good, he said to me. It is very serious. The nurse in charge of the intensive care unit has a very responsible position. Her opinions should be taken seriously. I really think you should examine the matters more thoroughly when you go back to work. Ian's obvious concern surprised me. A fierce critic of lawyers who made money running legal actions against doctors, he had always been conservative and protective of fellow medical practitioners. Mistakes were inevitable. Doctors were not infallible. Ian, I knew, would almost always give a doctor the benefit of the doubt. I suspected he adhered to an unwritten code that discouraged doctors from speaking out about other doctors. One explained that simply. There but for the grace of God, go Ian set out in layperson's language the unusual circumstances surrounding several of the procedures and deaths listed in Tony Hoffman's statements. Ian said to me, some of the things described do not make sense. I don't doubt the documentation. I think this doctor has some serious competence issues. As it was a Saturday, I telephoned a friend, David Murray, a journalist on the Sunday Mail who was dating my wife Ruth's sister, Katrina. Are you guys doing anything about this doctor who was named in Parliament? I asked Dave. He was busy with something else and facing an early deadline and not aware of any interest in the Jayant Patel story. Ian has read some statements about the operations, I told him. You know how conservative he is about doctors. He reckons there's a lot more to this and I think he's right. He was shocked at some of the things this doctor did. He wants me to follow it up when I go back to work, but that won't be for another week. What do you reckon? Dave considered my unsubtle suggestion that he start investigating it, but he was bogged down. He said, sorry mate, I can't do it. I hope you can pick it up.
- [17:24]
Rob Messenger
When you're in next.
- [17:31]
Hedley Thomas
Chapter 35 Time to go 26 March to 1 April 2005, Jayan Patel began organising his escape. Although he had told Peter Lek that he might stay on in Bundaberg, Patel prepared a contingency plan. Lech could keep his health system. Patel just wanted out of Bundaberg. He wanted to put as much distance as possible between himself and the bad news. He went to see Peter Cronin, the operator of the local Jetset Sun State Travel Agency. Patel said he wanted a one way ticket to Portland, Oregon business class. Cronin looked at the schedule. It was a handy commission walk in. Purchases of an International Business class fare worth $3,500 were rare in Bundaberg. Patel had been a good customer, spending a small fortune in the past on international travel for himself and his wife and daughter who came to visit. Most of the locals who travelled abroad spent weeks planning their itinerary and poring over various options. Often they wasted the travel agency's time before buying a cheaper fare on the Internet. But Patel made the arrangements on the spot and said he would pay with cash. Cronin booked a flight leaving Bundaberg for Brisbane on 2 April with an overnight stay stay at the Comfort Inn and Suites at Northgate, close to the airport. The onward flight from Brisbane to the United States would depart on 3 April, a week before Patel's 55th birthday. After two years at Bundaberg Base Hospital, Patel had seen more than 1,450 patients. He had performed more than 1,000 operations. The damage he had wreaked was incalculable. Now he was going to flee scot free. On the 1st of April, April Fool's Day. Jayant Patel was about to have the last laugh. He was booked to return to the United States. But even at this late stage, Queensland Health Management and the Medical Board of Queensland expected he might stay on as Director of Surgery. Patel packed his bags. He would miss the apartment at Borgara, with its views east over the beach and the water. At 8:30am one of the hospital's administrative staff called Duncan Hill, an officer at the medical board, to find out if Patel's registration had been renewed since lapsing on March 31. Duncan Hill asked to be transferred to Peter Lek, who said he still did not know whether the surgeon was staying or leaving. For the next few hours, Patel went back and forth from Leck's office, claiming to be unable to make up his mind on whether to accept the offer of a new four month contract. Peter Leck massaged Patel's considerable ego. He bent over backwards trying to accommodate him. When Patel saw Dr. Keys Nydem, he his original sponsor from 2003, in the corridor at the hospital three days before the departure date, Patel explained that he had already paid $3,500 for a flight back to the United States. Am I able to claim this? He asked Dr. Nydam. Yes, absolutely, came the reply. Emboldened, Patel told Peter Leck that he wanted full reimbursement for the business class, airfare and the overnight accommod in Brisbane. It was duly authorised. In the previous three days, Patel had enjoyed stress related sick leave. He used it well, hosting a farewell party at the Indian Curry Bazaar restaurant. All his Bundaberg friends came. There were the nurses whom he had favoured, the doctors and a handful of the administrative staff. They championed Patel and condemned those responsible for smearing his good name. Rob messenger was steaming over the Australian Medical Association's latest attack on him for naming Patel in Parliament. He was watching ducks on a pond in Harvey Bay during an Indigenous Youth Leadership Forum. The ducks appeared to move effortlessly, yet he knew they were frantically kicking beneath the water. Messenger was feeling like a sitting duck himself, maybe even a political dead duck. Nobody, apart from the anonymous hospital staff and a handful of patients, had backed him since he outed Patel. Dr. David Molloy, the head of the Australian Medical association, had gone out of his way to blast Messenger. It's an absolute disgrace that Dr. Patel has been forced to leave his job based on a gross misjudgment on the opposition's part. Mr. Messenger should realise that having no one to care for his constituents when they are injured and there is no emergency care for Bundaberg is a terrible problem. Using his mobile phone outside the forum, messenger called Malloy to ask whether the AMA Queensland president had even read the letters tabled in state parliament. Dr. Malloy was conciliatory. No, he replied.
- [23:23]
Rob Messenger
Isn't it about time that you got.
- [23:25]
Hedley Thomas
Your facts straight before you started making public comments? He heard David Malloy say that he had it on good authority that Patel was an innocent victim who had been merely trying to whip some lazy nurses into shape. Once again, it seemed that the medical community was sticking together. In Brisbane, Kerry Gallagher, chief executive of the AMA in Queensland, put the finishing touches to a counterattack on Rob Messenger. Gallagher enjoyed writing for Dr. Q, the organisation's glossy magazine, and he particularly enjoyed writing the article headlined Plumbing New Depths.
- [24:09]
Rob Messenger
He wrote, in Queensland, you would expect certainly at my age, nothing that came from Queensland Parliament, Queensland politics, and most definitely from Queensland politicians would surprise. This week, however, Queensland Parliament and one politician in particular did surprise, sadly. Indeed, it is more correct to say disappoint and disgust rather than surprise. Accusing messenger of plumbing depths, of politics that would normally be too low even for the average bathysphere to reach.
- [24:48]
Hedley Thomas
Gallagher scoffed at the notion that the local parliamentarian's cause might have been noble. The CEO borrowed a quote from a British priest who had been dead for half a century and he applied it to messenger, saying, the parliamentarian made a.
- [25:05]
Rob Messenger
Loud noise at one end and no sense of responsibility at the other. Finally, I note that the member for Burnet is the Shadow Minister for Education and the Arts. Oh dear, oh dear, oh dear.
- [25:22]
Hedley Thomas
Tony Hoffman had heard the AMA's reactions and its smug repudiation of Rob Messenger. The senior nurse feared the worst. She and the other nurses trusted only one Queensland Health Executive, the Chief Health Officer, Dr. Jerry Fitzgerald. But they were bitterly disappointed at the time time he was taking to do something. Tony had kept Dr. Fitzgerald's card since the visit in February and she called him. Fitzgerald listened carefully as the experienced nurse broke down. Hoffman spoke to him through her tears.
- [26:00]
Tony Hoffman
We feel we're being made the scapegoats in this.
- [26:04]
Hedley Thomas
Dr. Fitzgerald was surprised. My reporter's not going to say that it's going to validate what you have said. Chapter 36 calm before the storm early April 2005. The few nights camping on Hook island after staying with the Mathewsons in Mackay made for our best family holiday. Framed pictures of the kids in their snorkeling gear would soon adorn a shelf in the office. Back at my desk, I had a new project. This shadowy fellow, Jayant Patel, and the nurse, Tony Hoffman. She was going to extraordinary lengths to out him. John Doyle walked over to talk about the status of a few of our Freedom of Information applications. In his last job, Doyle had been a senior officer in charge of the Queensland Police Services Freedom of Information Unit at Roma street headquarters. Until his retirement, he was one of the umpires who made decisions on the release of thousands of documents. He had dealt previously with Paul Whittaker, a relentless reporter and an experienced user of freedom of information, who had suggested to Doyle that in his spare time he should work for the Courier mail. In early 2004, after Whittaker, my brother in law, resigned to go to the Australian in Sydney, I followed up with Doyle and negotiated his contract. He began coming in one day a week to develop applications and reply to FOI officers when they used spurious reason to justify concealment. Doyle was kept busy battling a culture of secrecy fostered at the top by Peter Beattie and his ministers and their political advisors. As a public servant, he had been a part of the system, but he was never a political hostage. Doyle released documents during his time as FOI chief if the applications were appropriately targeted and there were no legitimate reasons to prevent disclosure. Now working for us, he witnessed his former counterparts in other departments clutching at straws and relying on nonsense arguments to stymie a request. We were awaiting a response from Queensland Health to one of our targeted requests unrelated to Patel. A source had explained how all FOI applications to Queensland Health, and particularly those made by journalists and the State opposition or by patients where the information sought was sensitive, were vetted at every stage in the department and in the Minister's office. This was highly inappropriate. It put further pressure on the officers tasked with deciding whether documentation could be released. Before the FOI officers could release a single page, the political hacks in the Minister's office were consulted and afforded every opportunity to sabotage the exercise. Principles of transparency and openness had been discarded. The game sanctioned at the leadership level of government involved concealing as much as possible for purely political reasons. The COVID up had been perfected. Democracy could rotate. John Doyle grinned mischievously. Our latest application to Queensland Health aimed to catch them out at their own game. It sought all the documents created by policy advisors, media advisors, the FOI officers themselves, the Minister and any other bureaucrats which related to the handling of previous FOI applications. It was a nightmare for a secretive department full of control freaks because it could potentially show up the brazen efforts to hide material. After Doyle walked away, I renewed contact with the nurse from Bundaberg. I wrote an email to her. Hi Tony, I'm back after Easter holes. Thanks for replying last week. You can be assured of a couple of things. Nobody will know about our contact and if asked, I will refuse to disclose your identity or anything that could identify you. When would be convenient to meet or talk? What is happening now? I saw the AMA president David Malloy went on the offensive in attacking your local mp which I guess he had to do in defence of one of his members Patel. But it seemed to deflect attention away from the doctor's conduct while on leave I showed the statements to my father in law, a very experienced doctor who was appalled at the many botch ups and he decoded the medical language for me. I gather that the report by Fitzgerald is close to completion. Do you know about that and what it is likely to find? Regards, Headley. Tony Hoffman's reply came just a couple of hours later.
- [31:37]
Tony Hoffman
Hi Headley, thanks for your reply. I've never been in this situation before and I am appalled at what has happened to the nurses in this situation. Everyone has the right of reply but us. At least eight ICU nurses had made the initial and related complaints. The report is with the DG now. I do know a little of what is in it but I'm so scared about being whistleblown that I don't want to say much. Jerry Fitzgerald is a really nice man and I would rather someone else say what is in it. Our concerns were valid. Rob messenger has really gone out on a limb with this but I feel he's a loose cannon and even more naive than me in some ways. There is so much going on here and so many lies and so much politics that it really bothers me about the veracity of people who are who want to work in this field. I'm sure your father in law would be really horrified at what was in the letter. Imagine living through it on a daily basis. I'm coming to Brisbane on Thursday for a conference at Royal Brisbane Hospital. It is finished at 3:30. If you think we could meet at the airport or elsewhere. We are catching the last plane back to Bundaberg. I think it leaves about 6:40. If this is not a good idea and you want to come up here I will make myself available. At the moment this is the only thing I haven't done to break the code of conduct which is supposed to protect whistleblowers. So I'm quite worried about it. All this is not politically motivated. I've always voted labor. I say this because my only concern is for the patients and the staff. I'm disappointed, disgusted with the AMA and executive though they all called Patel Dr. Death and Dr. E. Coli etc incredibly two faced.
- [33:32]
Hedley Thomas
She ended it with her mobile and home phone numbers. I responded hi Tony. Tomorrow afternoon would be fine. I think the airport being such a busy place with people whom you and I may know coming and going would not be a good location. Would you be able to come by the Courier Mail's offices in Campbell Street, Bowen Hills. It is near the city. En route to the airport, we can have a quiet and discreet chat in the staff restaurant where nobody will know you or your friend. Please bring all relevant documents with you. Regards, Hedley Hi Headley.
- [34:12]
Tony Hoffman
Hopefully we'll be there around 4 o' clock depending depending on when the conference ends. I don't have much with me as I've only just got home now, but I can always send what you want after we discuss Tony.
- [34:39]
Hedley Thomas
Chapter 37 what the 4 to 6 April 2005 Darren Keating returned from his Easter vacation to a shambles. He had missed all the action the furore over Rob Messenger's disclosures to State Parliament on 22nd of 23rd March, the fallout at the hospital and the sudden resignation and departure of of Jayant Patel to the United States. Keating was angry. Everything had spiraled out of control as he took a fortnight's break with his family. He knew that the Queensland Health chiefs in Charlotte street would be decidedly unimpressed with the negative feedback and media interest. Thankfully, it appeared to have died down after a burst of relief reporting by A Current Affair Today Tonight the Bundaberg News Mail and the Courier Mail. The official line for public consumption was being scripted out of Queensland Health's headquarters in Brisbane. Dr. Keating would leave the PR to the PR flags. He had his hands full in dealing with the ramifications of losing Jayant Patel. The elective surgery targets would be even harder, if not impossible to meet. All the work the throughput of hundreds of patients had blown up in management's face. It was humiliating. Keating had made an educated guess about the probable source of the information that had fallen into Rob Messenger's hands. Tony Hoffman. He would deal with her and any other other collaborators later. The paperwork came first. Keating wrote to the Department of immigration on 5 April formally withdrawing the hospital sponsorship of Patel's visa. Peter Lech was also busy writing. He drafted a note to Patel. Lech wanted it signed by the hospital's community representative, Viv Chase, and sent to Patel in Oregon.
- [36:53]
Rob Messenger
Dear Dr. Patel, I am writing on behalf of the District Health Council to offer our support and to advise that we are deeply saddened and appalled by the disclosure in State Parliament of confidential information which has subsequently led to your decision to leave Bundaberg. I'd like to express my thanks for all your hard work while you were here and for the care you provided to the residents of our community. All the best wishes for your Future. Yours sincerely, Viv Chase, Chairperson, Bundaberg District Health Council, 5th of April 2005 After.
- [37:27]
Hedley Thomas
Peter Leck's secretary, Joan Dooley had typed the draft and told Chase that it was ready, he came in to sign and post it.
- [37:36]
Rob Messenger
It's probably not exactly what I would.
- [37:38]
Hedley Thomas
Have said, but that'll do, chase commented as he perused the letter. The next morning. Darren Keating, after reflecting overnight on the damage caused by the disclosures and the embarrassment being suffered by Queensland Health and the Health Minister, prepared a memorandum for distribution to all medical and nursing staff. Nobody, least of all management in Charlotte Street, Brisbane, which took a dim view of uncontrolled leaks, would misunderstand Keating's position.
- [38:12]
Rob Messenger
Dear all, since my return from leave I have become very aware that all medical staff at Bundaberg Base Hospital are unhappy with the recent events leading up to Dr. Patel's resignation. The lack of natural justice afforded to Dr. Patel so as to respond to the allegations due to the leaking of an internal letter to a local MP who tabled this letter in Parliament to his political advantage is scurrilous. The potential damage to the working relationship between medical and nursing staff at Bundaberg Base Hospital is very worrying. Nevertheless, patient care must continue and I ask you to continue to perform your jobs to your normal high standard while continuing to build upon the professional links that exist in all departments. Locums have been arranged from 11 April to while interviews are occurring shortly for the Director of Surgery position and I hope it is filled as soon as possible. This incident provides an opportunity to ensure that nothing similar occurs in the future. I would welcome your feedback in whatever form about what strategies should be used to prevent a similar occurrence.
- [39:28]
Hedley Thomas
The mimo flattened the nurses. They were copying the blame in the wards. Hoffman noticed that some of the staff were avoiding her. A few of the doctors who had been extremely concerned about Patel's surgery now changed their tune, siding with management as it worked to shut the issue down. Dr. Key's Nidum was still stroppy. Some of the doctors believed they had to stick together who might be targeted next. They asked if the nurses thought they could get away with scandalous public leaks such as this. Keating realized that several of the senior medical staff worried they could be in the firing line in future. Some of the overseas trained doctors told him so. The culture of concealment kicked right back in. Hoffman doubted she had any future at the hospital. A few of the nurses who were Patel's supporters whispered behind her back as word went around that she was the one who went to Messenger. After stating management's position in the memo, Keating left his office in the early evening with a nagging worry. Having received so many complaints from different people about the bombastic surgeon, Keating knew Patel was troubled. Where there is smoke, there is potentially fire, Keating thought. Does he have any history in the United States? For the first time, he decided to do some independent homework. Maybe Patel had baggage elsewhere. On 6 April, Keating did an Internet search on his home computer. He went to the Google search engine and typed in Jayan Patel. But there were too many hits. It would take forever to read them. Keating then remembered that Patel's middle initial was M for Mucondray. He tried it and noticed a reference to a Jayant Patel in Oregon. Something twigged. Keating recalled Patel saying that was where he had come from. Patel had also boasted about his work in New York State. Keating went first to the Oregon Board of Medical Examiners, the equivalent of the Medical Board of Queensland. The result that he found online immediately stunned him. Under the heading Board actions taken between April 1, 2000 and December 1, 2000, the following entry appeared. Patel Giant M MD15991 Portland, Oregon. A stipulated order was entered on September 12, 2000. The order restricted licensee from performing surgeries involving the pancreas, liver resections and ilioanal pouch constructions. Keating found the definition of stipulated order. It was an agreement between the Board and a licensee which concludes a disciplinary investigation. The licensee admits to a violation of the Medical Practice act and the order imposes actions the Board and licensee agree are appropriate. Stipulated orders are disciplinary actions. It was more than a dilemma. Keating had stumbled on a potential catastrophe. Patel, the man Keating was publicly defending, had been severely censured in the US and banned from performing the same complicated surgical procedures which had led to deaths, injuries and a litany of complaints. Keating delved deeper. He double clicked on the links to the Board for Professional Medical Conduct in New York State. The revelations there were worse. The Board on the other side of the United States had ordered Patel be stricken from the roster of physicians in the State of New York on 5 August 2001 for his gross negligence and negligence on more than one occasion in complicated surgical cases. There was more detail on the New York site, including a PDF file containing correspondence between Patel and the Board. It was all there. A public portrait of incompetence. The ease with which Keating had discovered Patel's background and fraudulent conduct meant others would surely also discover it. Keating's career, his family the hospital's future and everything else he held dear could turn on this unexpected discovery of Patel's shocking past. Everything sped up. He knew that the next day Minister Gordon Nuttall, The Director General, Dr. Steve Buckland and their entourage, usually at least one media advisor and a policy advisor, would be visiting the hospital. Keating confided his discovery to his wife, Janine. He told one other person, a close friend whom he knew he could trust, Jennifer Kirby, who headed the District Quality and Decision Support Unit at the hospital. He talked it over with Kirby. She could scarcely believe the turn of events. Was it all true? Did the complaints that she was supposed to take seriously really have substance after all? Keating went to bed in a quandary. In the end, he decided to share the pain. He decided to pass it to to a manager with as much to lose as he did Steve Buckland. Keating, an administrator who routinely made file notes about innocuous conversations with staff or actions taken, printed nothing from his home computer. He made no physical record of the most remarkable discovery in his career. He withheld the information from Pisa Leck, the hospital hospital boss, and no paperwork would be handed to Steve Buckland during his visit. This would be an oral briefing, face to face. Less chance of it leaking. Chapter 38 grind them down 3pm 7th of April 2005. Margaret Mears entered the large staff dining room. The atmosphere was charged. Doctors, nurses, administrators, clerical staff. More than 100 people across every department of the hospital had temporarily left their workstations for the visit of the Health Minister Gordon Nuttall and Director General, Dr. Steve Buckland. Mears, a highly experienced nurse whose job involved interviewing and preparing patients before their operations, booking the procedures and coordinating staff to deal with the admissions, was prepared to give Nuttall the benefit of the doubt. As a politician, his previous two official visits to Bundaberg as Health Minister had been conciliatory and productive. She recalled him urging cooperation and trying to build a team spirit. On one of those visits, Nuttall had told Meares and her colleagues, we are.
- [46:59]
Rob Messenger
Sitting in a boat rowing, and everyone should be rowing the same way. Those who don't want to row with us can get out of the boat now.
- [47:08]
Hedley Thomas
She liked his style. He was, she believed, working towards a better health system. Meares, like most of those in the staff dining room, strongly suspected Nuttall's third visit was tied to the events two weeks earlier in State Parliament. Although she did not support the leaking to rob Messinger of the documentation about patient outcomes, she was glad that it meant the Patel debacle would finally be addressed. Meares, too, had long standing concerns about Patel's conduct. On two occasions, after he had been aggressive and shouted at her, she talked to Carolyn Kennedy, the assistant Director of nursing, but decided to take no further action. On many other occasions, the junior doctors with whom Meares regularly came in contact would confide examples of Patel's bullying and his reckless care of patients. She had seen Patel speaking over the top of Dr. Martin Carter and rudely interrupting other people in meetings involving issues of wound dehiscence, infection rates, mortality and morbidity registers, investigation registers and risk registers. The meetings became so heated, the animosity so obvious and the interjections from Patel so constant, that little of substance was ever resolved since the Robb messenger outpouring. Meares had also heard rumours that Dr. Jerry Fitzgerald's preliminary findings backed up the nurses. Nuttall, shirt sleeves rolled up, strode to the front of the room. He could act tough, too, and in talks beforehand with Buckland, they had decided to fight fire with fire. They were acutely embarrassed at being caught unawares by Rob messenger and his National Party colleague, Stuart Copeland. But the problem was now much worse. Patel had left. The rate of surgery was almost at a standstill, and some of those in the room were to blame. Earlier that day, before the detour of the State Government King Eyre to Bundaberg, Nuttall's visit to the nearby little town of Springshaw had shown him what could happen. When everyone in the same boat rowed together, Queensland Health went forward. Nothing leaked. Nobody was lost overboard.
- [49:34]
Rob Messenger
I have been to Springshaw today. Wonderful town. 900 people. And I've opened a community health centre which cost $250,000. And the town raised that money. What a wonderful town.
- [49:47]
Hedley Thomas
Nuttall paused for dramatic effect before ploughing on.
- [49:51]
Rob Messenger
And now I'm in Bundaberg.
- [49:53]
Hedley Thomas
Meares heard Nuttall say that the only way to stop the nonsense involving Bundaberg Base Hospital was to vote messenger out. The Minister called on all patients affected.
- [50:05]
Rob Messenger
By Patel's resignation to write to Mr. Messenger personally. Can we put an official report out relating to the allegations? The answer is no. There's no point in it continuing. There cannot be a report based on the lack of natural justice.
- [50:21]
Hedley Thomas
When Nuttall stepped aside and Buckland took the floor, the Director General went further, forcefully lecturing the staff about the damage they had done to the hospital and to the reputation of Queensland Health and Dr. Patel. As a result of the leak, Buckland fulminated. The staff had completely screwed everything up. Buckland said that no Decent doctor would want to come to Bundaberg to work in these circumstances? The tone of the meeting was condescending and belittling. Instead of receiving feedback about Patel, the nursing staff were hit by recriminations for speaking out misleadingly. The doctors and nurses were told that not even the investigation by Jerry Fitzgerald would be completed. As for any findings, Buckland said the staff could forget it. Nothing would be released. Because Patel had been denied natural justice, he was now far away and unable to give his side. Mears, by now infuriated, could not follow the logic. Surely, just because a doctor goes missing does not mean an investigation cannot continue. If police reverted to such a policy, nothing would ever be solved. Did Buckland somehow imagine that if Patel had stayed, notwithstanding his arrogance and self belief, he would have confessed? Yes, it's all true. I'm completely incompetent and those deaths and injuries are all down to my ineptitude. Mears asked Buckland, what could be done about Patel. He replied, how are we going to.
- [52:05]
Rob Messenger
Get him back from America?
- [52:07]
Hedley Thomas
In other words, nothing would be done. Karen Jenner listened to in amazement. The intensive care unit nurse walked into the staff dining room, confident that Nuttall and Buckland were going to start a full inquiry into Patel's conduct. When she heard Nuttall and Buckland dismissing the deaths, the injuries, the incompetence and everything else she and the other nurses had striven to document. After witnessing carnage on a dramatic scale, she became enraged. From the back of the dining room, she shouted out, Dr. Patel can reply.
- [52:44]
Tony Hoffman
To the allegations from the United States.
- [52:47]
Hedley Thomas
But Buckland responded with a rallying call, saying he supported his staff 100% and would not tolerate anyone being tried by the media and denied natural justice. Karen Jenner was disgusted. Jenner reported, if you Support your staff 100%, then where is the support for the nurses who made the multiple formal complaints about Dr. Patel? Just because one letter was leaked does not mean that the nurses are not entitled to your support. Buckland slapped the question and the plea for support away. His patronising rejoinder stung Jenna.
- [53:25]
Rob Messenger
What part of there is going to be no inquiry don't you understand?
- [53:32]
Hedley Thomas
Even Dr. Keyes Neidem believed Buckland and Nuttall were overly harsh and severe. Gail Alma, whose job as the nurse consultant in charge of infection control had put her in regular conflict with Patel, became angry. She called out, are you trying to.
- [53:50]
Tony Hoffman
Say that we're not going to find out the outcome of that report?
- [53:54]
Hedley Thomas
Buckland answered, the report can't be released. She wanted Buckland or Nuttall to publicly acknowledge the dire problems, not bury them with such a ludicrous justification. Even if they had said, look, there are some issues with Dr. Patel and we will investigate them, but we can't Release them because Dr. Patel has left, Aylmer would have felt vindicated for the stands she and other nurses had taken. Instead, she felt that the nurses who had done the hard work were now being held up as the villains at the very top. Despite everything that had happened, the chiefs still weren't listening. Aylmer feared it had all been a massive waste of time. All the emotional energy and tears, the late nights preparing documentation and checking for charts, the battle to produce the evidence, were trashed. Their careers might be next. Meares also feared the repercussions as she left the meeting. Still furious, a senior staff member said to her, don't you like your job? Is that why you spoke up? But Dr. Steve Buckland was rattled. Across town, Rob messenger was angry.
- [55:12]
Rob Messenger
The minister can't get away with covering.
- [55:14]
Hedley Thomas
This up, he told the reporter from the Bundaberg News Mail. This is an issue I will continue to pursue and keep fighting for. Staff Darren Keating could hold onto the explosive information no longer, but he was not going to tell Peter Leck. After Gordon Nuttall and Steve Buckland finished their official duties, alienating most of the nurses and several doctors with stern lectures and a shutdown of the Patel issue, Keating approached the director general. Nuttall had left to visit a relative in a nearby private hospital. In the hour before the party was due to return to Brisbane. Buckland stepped away from the staff cafeteria.
- [55:58]
Rob Messenger
Can I talk to you?
- [56:00]
Hedley Thomas
Said Keating. The director of medical services, related his stunning Internet finding of the previous evening. Repeating the words negligence, gross negligence, and surgery bans in Oregon and New York State, Buckland sighed.
- [56:18]
Rob Messenger
This guy, he's got problems with his registration, keating said.
- [56:24]
Hedley Thomas
A truly awful day was turning into a disaster, and it was still early. Buckland had backed the wrong horse. Now it had bolted, and he was the biggest loser. Keating, nervous and uncertain about what would come next, studied the stocky bureaucrat's face for emotion. Buckland was a hard man to read, Keating continued with the hurried, harrowing briefing. He told Buckland that after doing the Internet search at home, he had checked Patel's personnel file, including the documentation related to his registration by the Medical Board of Queensland, and he had made a further discovery. The surgeon had also lied about his past when he sought the job in Bundaberg.
- [57:11]
Rob Messenger
There was a copy of his application for registration as a medical practitioner and in that application, the individual has to, yeah, declare whether they've got any restrictions. And he said no, he had no restrictions.
- [57:26]
Hedley Thomas
By the time Keating stopped talking, he could read Buckland like a book. The powerful bureaucrat's eyebrows were raised high on his forehead. The briefing over, Buckland headed for the airport, his head swimming. Damn, could it get any worse? On the flight back to Brisbane, Buckland decided to hold back almost everything Keating had told him about Patel. He wanted to do his own research first. He covered his bases by telling Nuttall.
- [57:57]
Rob Messenger
There is more to this guy than we know. I will have a look at it. We need to continue to have a look at this guy. He's not what we think he is. I will go and have a look at him and I will come back to you.
- [58:07]
Hedley Thomas
Above the drone of the engines powering the state government's King Air, Nuttall and his principal media advisor, David Potter, talked about the negative feedback from the staff meeting. In a town the size of Bundaberg, a high powered ministerial visit to the local hospital to read the riot act to dissatisfied staff was news, local news. They hoped it would not play out too badly in the local newspaper. Rob messenger was nothing if not persistent. After writing to the Medical Board of Queensland on 23 March about Battelle, he wrote again on 7 April to urge action. Michael Demi Garou, the board's deputy registrar, reviewed the latest correspondence in the file. It was up to him to respond to the politician's muck raking. It would not do much good now that Patel had left. For Demigor, the surgeon's sudden departure was a blessing. It would save the board the expense and trouble of investigating. Demi Garou prepared his reply, messenger writing that it had been contemplated that conditions may be imposed upon Dr. Patel's registration. His timely resignation, however, meant that issues.
- [59:26]
Rob Messenger
Of ongoing public protection and assurance of.
- [59:29]
Hedley Thomas
Professional, safe and competent practice were no longer relevant. Messenger interpreted the letter as a brush off. If you were a doctor, all you needed to do to avoid serious scrutiny was quit and try your luck elsewhere. 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 Leek 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 Osland, Matthew Condon, Corinna Berger, Ellie Dudley, David Murray, Dominique McDermott, Zach Schooland 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 free photographs, videos, timelines and more at the website.