THE CHRONIC CRISIS IN AUSTRALIAN PUBLIC MEDICINE

Three articles below from just one day!

Doctor numbers nosedive in Australia

When there are heaps of people wanting to get into medical schools this is just plain government negligence. Why is money being spent on useless "postmodern" courses when funds for medical education are so limited?

AUSTRALIA'S doctor shortage is becoming critical, with new figures revealing a plunge in the number of GPs. A report to be released today shows the number of practising GPs fell 9 per cent between 1997 and 2005.

The release of Australia's Health 2008 will reignite tensions between doctors and the Rudd Government. Health Minister Nicola Roxon said GPs should rethink their roles as medical "gatekeepers" in light of the finding. "Why, when families struggle to see their GP, when people often end up in their local hospital because they can't get frontline care from their local doctor, do we need gatekeepers?" she said.

The Australian Medical Association argues that doctors must be the gatekeepers of the health system to ensure patient safety

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Dud medical regulator to be sued

RAPE victims of a deviant doctor are planning to sue Victoria's peak medical watchdog for failing to act on sex assault complaints. The women have engaged Slater & Gordon to investigate suing the Medical Practitioners Board for failing to suspend dermatologist David Wee Kin Tong after two patients said he molested them. Dr Tong was jailed in March for at least 5 1/2 years for sexually assaulting 14 patients. His last victims were assaulted three years after the first complaints were made.

The women claim inaction by the profession's watchdog left Dr Tong free to abuse up to 12 more unsuspecting victims. It is believed the board, a statutory body charged with investigating complaints and protecting the public, did not hold a formal hearing into the allegations after an investigation into Dr Tong. A second complaint to the board in 2005 led to Dr Tong being reprimanded. The board is not required to pass complaints on to police.

After a victim went to police in 2007, investigators were initially refused access to the board's records on Dr Tong and were forced to serve a warrant for the material to be released. Victoria Police's sexual crimes squad raided the board's headquarters, but had to fight a legal challenge in court to use the files. The board has since apologised publicly for its handling of the complaints, but a police source says that the board's actions were tantamount to a "cover-up".

The Herald Sun has learned the wealthy doctor tried to divest himself of his Toorak mansion before it could be confiscated to pay his victims' compensation. Victoria Police restrained Dr Tong's Toorak property, which he had sold for $2.35 million, only days before settlement. The proceeds of the sale were later confiscated. Already gone were antiques and paintings, many of which Dr Tong bought at Sotheby's and Christie's auctions.

Dr Tong, 40, pleaded guilty to seven counts of rape and seven counts of indecent assault involving 14 patients at clinics at Clifton Hill, Malvern, and Preston. The offences occurred between October 2001 and 2007 during examinations. He also lost his right to practise medicine. Another two women have since come forward with allegations against Dr Tong.

During a search of Dr Tong's home, police found 120 pictures of naked women -- some of them patients -- placed in small photo albums. Dr Tong told many of the women, aged between 22 and 34, they could get moles on their genitals and required a full-body examination.

Kay, who was the first victim to come forward, said although compensation was an issue, she wanted the board to change its investigation procedures to ensure the safety of others. "I was the first, but they just didn't follow up," she said. "I felt really violated and they (the board) hadn't listened to anything I said to them and took his word for it."

The MPB has since reviewed cases involving potential sex offences and apologised to victims. "Why the hell didn't they stop it back in 2004 when we complained," Kay said.

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Public hospital and its head surgeon facing negligence lawsuit

MELBOURNE'S The Alfred Hospital and its former head of trauma, Thomas Kossmann, are facing legal action alleging medical negligence. Law firm Slater & Gordon has told The Australian it is preparing several cases against the hospital, and possibly Professor Kossmann, for allegedly negligent surgery performed on trauma patients.

The cases come in the wake of a damning peer review into Professor Kossmann's surgical and billing practices, which were first revealed in The Australian in April. The review alleged he had exaggerated his experience on his CV, conducted risky and unnecessary surgery, and rorted government insurance agencies, including the Transport Accident Commission. It also alleged he had put lives at risk with bungled surgery that involved grave errors in more than half of the 24 cases that were examined.

Professor Kossmann has denied any wrongdoing and attributed complaints from doctors about his surgery to competitive jealousy. He condemned the peer review, led by orthopedic surgeon Bob Dickens, as a "witch-hunt", and several of his former patients have come forward to praise his surgical performance.

When the review was released last month, Jennifer Williams, the head of Bayside Health, which operates The Alfred, absolved the hospital of any legal responsibility. But Slater & Gordon medical negligence specialist Paula Shelton said her firm was preparing several cases involving allegedly unsuccessful or unnecessary surgery performed by Professor Kossmann at The Alfred. "They are all people who have got significant problems," she said. "There are certainly a couple of them that I think are serious. It's fair to say they relate to poor (surgical) outcomes." For the cases to succeed, the victim must prove at least 5 per cent physical impairment and that the surgery done was poorer than could be reasonably expected at the time. Slater & Gordon is still investigating the cases and expects to obtain the medical records from the hospital and launch action within a few months if independent advice confirms the alleged negligence.

A spokeswoman for Professor Kossmann said the surgeon was not aware of any claims against him and therefore could not comment. Ms Shelton said she was unable to give details of the cases, but The Australian has spoken with one of Professor Kossmann's patients who is not among the existing cases, but is considering joining any action against the hospital.

The patient, who declined to be named, claimed he had complications after Professor Kossmann operated on him in 2004 following a car accident. He claimed he suffered a post-operative infection following the original surgery. "At the time I found him to be very professional and thought the complications which arose both in the short term and long term just came with the territory; however, reading the reports coming out now makes me wonder about that," he said. "About a year or so later, my leg played up again so I went to a doctor to have a look at it and they found deep-vein thrombosis, which he attributed to the original injury ... X-rays showed that a titanium screw placed in my knee ... had snapped during that surgery and had been left there."

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