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Barry Lane
10 June, 2008  
Physicians not healing themselves

Some rather dangerous doctors have been let loose on the community. Recently we’ve had Reeves and Patel and in Britain there’s the notious Shipman case. The damage might have been averted earlier if there’d been an open national register of complaints and findings against medicos. Over to you Lillian

imageThe notorious activities of a Victorian medico named Ian McGoldrick got a good work out in one of my 2005 columns.

The Medical Practitioners Board had appealed to the Court of Appeal after the Victorian Civil and Administrative Tribunal had allowed McGoldrick’s appeal from the board’s decision to refuse him a ticket to practise.

It was McGoldrick’s bad character – he handled the truth rather carelessly – rather than professional incompetence which was the basis of the board’s refusal to register him.

In the course of reversing VCAT, Justice Peter Buchanan of the Court of Appeal said:

“The purpose of the decision reviewed by the tribunal (VCAT) was not punitive, but protective. In Clyne v NSW Bar Association (when dealing with a lawyer rather than a doctor but the principle is the same) the High Court said:

‘Although it is sometimes referred to as “the penalty of disbarment”, it must be emphasized that a disbarring order is in no sense punitive in character. When such an order is made, it is made, from the public point of view, for the protection of those who require protection, and from the professional point of view, in order that abuse of privilege may not lead to loss of privilege’.”

imageThose words came flooding back when I read the recent Butcher of Bega story in The Sydney Morning Herald.

Natasha Wallace’s chilling report on Dr Graeme Reeves (pic) details more than a decade of utterly inappropriate responses by the relevant regulatory authorities to the case of a doctor who, due to illness, should have been prevented from practising years ago.

Pretty obviously it is in no one’s interest to allow those who are physically or emotionally impaired by demons to be permitted to begin, or to continue to, ply their trade.

In addition to Dr Reeves we’ve had the “Dr Death” (aka Dr Jayant Patel) debacle in Queensland and the Shipman inquiry in the UK.

imageAfter a six month inquiry in 2005, the Queensland Health Commissioner, Geoff Davies QC, reported to parliament that Patel (pic) was incompetent, a liar and that his poor judgment was linked to the deaths of 13 patients.

If Patel’s history had been known before he came to this country it is difficult to imagine that he would ever have been registered.

Patel is in the process of being extradited from the US to stand trial on charges arising out of those deaths.

The Shipman inquiry, conducted by High Court judge Dame Janet Smith, found that over 23 years of medical practice Shipman murdered 284 people.

Six months after qualifying as a doctor and at the tender age of 25, Shipman killed his first patient. He went on to attain the grisly honour of being the most prolific serial killer in British history.

imageIn her report, Dame Janet (pic) took the lash to the General Medical Council for what she described as a “culture of self-interest”, which had to be swept away.

To overcome inadequacies in its administration, the High Court judge made various recommendations to reform the council, including that it keep a publicly accessible national register of doctors and log all complaints by patients and fellow practitioners.

So what’s happened in response to the grotesque revelations in the Reeves case?

A hapless medical bureaucrat has been stood down on full pay for letting the doctor slip under his guard.

Where’s the leadership from the Commonwealth on the issue?

Surely, as was proposed in the UK, keeping tabs on medicos should be a national function, even if state and territory registration and disciplinary structures are retained.

Before there’s a mad Shipman or another Reeves or Patel let loose here, you’d hope for some sort of national register of medical practitioner infractions, with at least a tiered arrangement for access to that information.

Over to you Nicola (Lillian) Roxon.