MORE ON HOW A BUREAUCRATIC HEALTH SYSTEM WORKS

Queensland Health "drove out" two highly qualified, Australian-trained surgeons from Bundaberg, leaving the door wide open for the lethal Dr Jayant Patel to walk in, the health inquiry was told last night. Australian Medical Association Queensland president Dr David Molloy said the story of their departure was "typical" of Queensland Health's preference for malleable junior doctors over experienced but "difficult" specialists. Dr Molloy said the two previous senior surgeons at Bundaberg Hospital, prior to Dr Patel, were highly qualified Australian men who wanted to work in the Burnett region but left in disgust because of their treatment by the bureaucracy.

He said one of those doctors, Dr Sam Baker, who served in Bundaberg from 2001-2003, had frequent run-ins with hospital management over his need for a second back-up surgeon to provide relief. "He is now working in Townsville because he was driven out of Bundaberg," Dr Molloy said. "The story of how Dr Patel ended up in Bundaberg is typical of employment practices in Queensland Health . . . and I think quite frankly it is a disgrace."

Commissioner Tony Morris, QC, asked for the second doctor's name – which was not disclosed publicly by the witness – to be provided to the inquiry later so they could contact him privately about his experience. The inquiry heard that doctor was now working in the public sector in Logan, south of Brisbane.

In other damning allegations, Dr Molloy, a private obstetrician/gynaecologist, told the inquiry:

* Overseas-trained doctors employed in Queensland were often promoted to positions above their competence and sometimes did not have an understanding of Australian systems such as Medicare and WorkCover.
* Waiting lists to get an appointment in the outpatient section of public hospitals – the process to allow patients to eventually see a specialist – were as long as eight years for some sub-specialties.
* Queensland Health services were being shut down for longer periods than before because of the costs required to run them.
* The quality divide between private and public hospitals is greater than ever.
* Visiting Medical Officers – experienced private specialists who visit a public hospital several times a week to see patients – were being "phased out" by Queensland Health because they were considered "troublesome".
* Doctors working for Queensland Health were bullied and feared to speak out about their concerns for fear of reprisals.

Dr Molloy said Queensland Health was moving away from using VMOs in their hospitals because they preferred staff who were technically their employees. "The VMOs are considered a troublesome lot . . . they are not easily pushed around by management," he said. "There is no doubt this (not using them) is causing problems in regional Queensland."

He said doctors were frustrated by the increasing levels of bureaucracy in Queensland Health which hampered delivery of care to patients. He claimed staff routinely had to go through five to six levels of managements before a decision on clinical care was given by the director-general. "Queensland Health has 64 staff and has large layers of management. Within these layers there's sub-management, there's a lack of accountability in these layers of management," Dr Molloy said.

Dr Molloy said at the beginning of his career there was only one floor of management at the Royal Brisbane Hospital but now that had ballooned to one whole building "up to floor N" which resulted in the closure of many hospital wards.

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Massachusetts: Foreign STD sets off worry: "A sexually transmitted disease rarely seen in recent decades in the United States has reemerged in Boston and other American cities in the past six months, fostering fears that it could herald a new wave of infections of an even more dangerous disease, AIDS. The return of lymphogranuloma venereum, known as LGV, to North America also illustrates the increasing globalization of infectious diseases in an era of rapid air transit and frequent travel for work and pleasure, disease specialists said. At the Fenway Community Health clinic in Boston, for example, one patient told a physician he probably caught the germ while visiting Brazil; the disease is endemic to Latin America, Africa, and Southeast Asia. Disease trackers who investigated a cluster of cases in the Netherlands in 2003 found that infected patients had multiple sex partners across Europe and the United States."

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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