Australia: More on another dangerous public hospital doctor

Hundreds of patient files are being reviewed after a damning report into a foreign-trained doctor found he performed surgery beyond his capabilities. The Health Quality and Complaints Commission report found Egyptian-trained doctor Abdalla Khalafalla was allowed to operate on patients at the Mackay Base Hospital without supervision despite "red flags" over many years about his competence.

Dr Khalafalla worked in Mackay from April 2004 to August 2006. An audit of 1000 unsupervised surgical procedures he performed between 2001 and 2006 has been launched in the wake of the HQCC probe. Queensland Health said the audit would include operations he performed in Townsville, Mount Isa, Proserpine and Mackay.

Dr Khalafalla's contract was terminated in August 2006 after the Medical Board of Queensland deregistered him, but the board acted only after former Nationals MP De-Anne Kelly raised the matter in Federal Parliament.

Health Minister Stephen Robertson said Dr Khalafalla, believed to be living in Victoria, was unlikely to face criminal charges. But he admitted the case raised similar questions about clinical practices to that of Indian-trained surgeon Jayant Patel. "There have been incidents where clinicians have not reported where they have witnessed harm to a patient as a result of another surgeon conducting his or her work," Mr Robertson said.

Cabinet meanwhile endorsed a plan yesterday to introduce mandatory reporting by doctors if they saw patients being harmed by colleagues. "We cannot allow these circumstances to keep going on where doctors witness harm, serious harm on some occasions, and not have it reported," he said. The two-year HQCC investigation found the Royal Australasian College of Surgeons supported Dr Khalafalla's appointment in Mackay despite receiving notifications about his competence dating back to 2002.

It said a review of his surgical performance at the Mackay hospital in September 2005 found six out of 26 cases involved a "potentially dangerous technique". The review found two of the patients could have died if action had not been taken and recommended a national reporting system for tracking the performance of registered health professionals.

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Incompetent doctor report 'like reliving nightmare'

THE former head of an inquiry into former surgeon Jayant Patel says a report handed down yesterday into another Queensland surgeon was like "reliving a bad nightmare". Barrister Tony Morris, QC, headed the initial 2005 inquiry into Dr Patel, the former director of surgery at Bundaberg Base Hospital now on manslaughter charges, before stepping down five months later over claims of bias.

Queensland's Health Quality and Complaints Commission (HQCC) yesterday released the results of a two-year investigation into surgeon Abdalla Khalafalla, who allegedly performed at least 27 major operations beyond his credentialled level of skill. Egyptian-trained Dr Khalafalla, who has previously worked in Townsville and Victoria, worked at Mackay Base Hospital from 2004 to 2006. In August 2006, former Nationals MP De-Anne Kelly outlined to Federal Parliament four cases where Queenslanders allegedly were injured in operations conducted by the unsupervised doctor and the HQCC began its investigation.

Mr Morris said today he had read the report and found it "absolutely terrifying". "It's like reliving a bad nightmare," Mr Morris told ABC radio. "You read the report and it's almost a complete replication of what happened in Bundaberg. "And the really terrifying part is it's still the same attempt by the bureaucracy to say 'It's not our fault - let's blame the doctors'. "But Queensland Health are to blame and the only change I've seen is that the bureaucrats are now smarter about how they get back at whistleblowers." He said the health department needed to be rebuilt from scratch.

Health Minister Stephen Robertson said the commission's report dealt with issues that occurred two to three years ago and improvements had been made. "They (the commission) do make the observation that the changes made would have gone a long way to stop this thing that happened in Mackay from occurring again," Mr Robertson said. He said it was unfair to blame health bureaucrats. "What occurred in Mackay was a doctor not being properly supervised by who? Not a bureaucrat, a senior doctor," Mr Robertson said. "That senior doctor was reporting to another senior doctor."

An audit is under way into all cases of major surgery performed by Dr Khalafalla at Mackay Base Hospital without direct supervision. The Government is also proposing new laws to force doctors to report cases of patient harm by colleagues. Dr Khalafalla is living in Victoria but is no longer registered to practise. The commission report has been passed on to Victorian and other authorities around Australia.

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Comment from a political reporter:

QUEENSLAND Health Minister Stephen Robertson has put in a woeful performance in the wake of the damning Health Quality and Complaints Commission report into how the department handled allegations of incompetence against surgeon Abdalla Khalafalla. Yesterday I wondered how the Government was going to spin its way out of trouble on this one. Robertson has provided the answer _ blame the doctors. Surely with an 69-strong army of PR flacks at Queensland Health, he could have come up with a better line.