Sunday, September 18, 2005

ANOTHER HORROR HOSPITAL

The official inquiry into Queensland public hospitals started with Bundaberg hospital but Hervey Bay hospital also has now been revealed as having been run with great negligence. And once again it's the bureaucrats who are most at fault

Two Hervey Bay doctors whose orthopaedic surgery abilities were criticised in a Queensland Health report were victims of grossly inadequate supervision, two former colleagues said yesterday. Senior operating theatre nurse Dale Erwin-Jones told the health inquiry that Damodaran Krishna and Dinesh Sharma, Fijian-trained doctors employed as senior medical officers, were regularly rostered for duty when there was no one in the district available to supervise them. They were at one stage on call every second night, creating a potentially unsafe situation for both them and their patients.

Ms Erwin-Jones said the doctors' direct superior Morgan Naidoo was on leave two to three months every year and frequently uncontactable, while orthopaedic visiting medical officer Sean Mullen was only rostered on for a limited amount of time. She said Dr Krishna in particular tried to operate within his abilities and always attempted to get help if he ran into difficulties mid-surgery but she claimed assistance from Dr Naidoo was rare. On at least two occasions when Dr Naidoo could be contacted by phone from the operating theatre for advice, Dr Krishna "was clearly being advised 'You'll have to get on with it"', she said.

A review into problems in the hospital's orthopaedic department, commissioned by Queensland Health and conducted by the Australian Orthopaedic Association in 2004/05 found the treatment orthopaedic patients received in the region was unsafe. It led to a shutdown of orthopaedic services at the Hervey Bay hospital in May. Dr Naidoo's inadequate supervision of doctors Sharma and Krishna and his long periods of leave were singled out for criticism. One of the report's authors John North told the health inquiry on Tuesday that he did not observe doctors Sharma and Krishna operate but based his findings on staff interviews and patient files.....

Medical Board of Queensland barrister Ralph Devlin said delaying the cross-examination was only fair to doctors Krishna and Sharma "who in other material appear to be described as very good at what they did".

When he took the witness stand yesterday Dr Mullen stressed that the two doctors were not the ones to blame for problems as they were the victims of "administration failure". He said in the case of Dr Sharma he was confident he would become a good orthopaedic surgeon. He said he had for years been trying to raise the issue of the lack of supervision for the junior doctors and eventually took his complaints to the AOA because of the inadequate response from hospital management. He said on one occasion he volunteered to take a greater role in supervising the doctors, free of charge, but the offer was rejected.

More here

And here's more that does not seem to be online but which was reported on p. 2 of the Brisbane "Courier Mail" on Sept 16, 2005. This patient was lucky. She only had her arm amputated. Others have lost their lives

"An elderly woman had to have her arm amputated in 2000 because her doctor was unavailable for six days, it was alleged yesterday.

Another surgeon, Sean Mullen, who worked occasional shifts at Hervey Bay Hospital told the health inquiry that he was contacted by a concerned nurse who was distressed about the large wound on the woman's arm and asked him to intervene. He said junior medical staff had been trying to contact the woman's doctor - the hospital's orthopaedic director Morgan Naidoo - over six days but he was unable to check on the woman.

Dr Mullen said when he saw the patient it was obvious she needed urgent surgery. He rang Dr Naidoo who asked him to take over the woman's care. Dr Mullen immediately operated and had to remove a large amount of the arm muscle because it was "dead and infected". He said the arm must have been in such a state for several days. It was subsequently amputated. "The delay ... would have led to the outcome which was amputation." Dr Mullen said.

The inquiry has heard Dr Naidoo was notoriously difficult to contact and lived in Brisbane on weekends. Because he frequently cancelled procedures, theatre staff allegedly referred to his surgical speciality as cancelectomy".

An internal Queensland Health report savaged Dr Naidoo's management of the orthopaedic department and said his absences were "of concern to both theatre and ward staff". It was reported that he was extraordinarily difficult to contact, being either out of range or out of town and that he simply did not respond to messages left by staff," the report said. "It was suggested ... when difficult issues arose, Dr Naidoo would take recreation or study leave."

Dr Naidoo has not been called to give evidence.

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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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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