See: http://www.abc.net.au/lateline/content/2015/s4306663.htm
Transcript
EMMA ALBERICI, PRESENTER: Last night, we revealed the story of French spinal surgeon Richard Emery, who closed his practice and left Australia after he was the subject of repeated anonymous complaints and medical audits.
The story has touched a nerve inside and outside the medical profession.
One of the country’s most renowned neurosurgeons, Dr Charlie Teo, has backed Senator Nick Xenophon’s call made on this program last night for a Senate inquiry into the medical complaints process.
Charlie Teo has told Lateline that there is evidence of bullying in his profession that goes right to the top and that it’s destroying the lives of doctors and their families.
Today, Senator Xenophon added to the debate, describing the medical complaints process as being, “all about protecting a closed shop rather than the best standards of patient care.”
Steve Cannane reports.
STEVE CANNANE, REPORTER: He may have moved back to France, but the plight of Dr Richard Emery has now sparked calls for a Senate inquiry into the medical complaints process in Australia.
NICK XENOPHON, INDEPENDENT SENATOR: I’ll be working on a Senate inquiry in relation to this. I’ve already had calls from some very senior surgeons around the country who say that what Dr Emery experienced is not unique and it raises some very disturbing questions about our health system.
STEVE CANNANE: Last night, Lateline revealed how Dr Emery was the subject of a series of complaints and audits that ultimately led him to close his practice and leave Australia. Those complaints came from surgeons who in some cases were his competitors.
Outspoken Sydney neurosurgeon Charlie Teo believes the complaints process is open to abuse and has backed calls for an inquiry.
CHARLIE TEO, NEUROSURGEON: I can tell you stories where it’s gone that one step further than Richard Emery, stories where good neurosurgeons – and I know this for – from first-hand experience – good neurosurgeons, good people, doing exceptional things, pushing the envelope and making the established neurosurgeons look bad. The established neurosurgeons then have bullied this particular person I’m talking about for more than seven years resulting in his death by suicide eventually. So, Richard Emery, as you heard, was on the verge of suicide. There’s another chap in Melbourne who’s on the verge of suicide. Others have had their families completely destroyed and their lives destroyed.
STEVE CANNANE: Charlie Teo says there is a culture of bullying in surgery that goes right to the top.
CHARLIE TEO: There are, unfortunately, people that I know who are very guilty of bullying and discrimination who are currently holding positions of authority in those bodies like the College of Surgeons and like hospital medical advisory boards and expert advisory boards and associations, and unfortunately, while they’re there, the culture’s never gonna change. So what I’d like to see, is I’d like to see a system whereby complaints have to be legitimate, they have to be for the greater good. Like Nick Xenophon said, they have to made in good faith.
STEVE CANNANE: Dr Mukesh Haikerwal is a former president of the AMA and the chair of Beyond Blue’s doctors’ mental health program. He believes the AHPRA complaints process is harming the mental health of doctors.
MUKESH HAIKERWAL, BEYOND BLUE: It’s part of the problem in the way it does its work, it’s part of the problem because of the way which it does mandatory reporting and it’s part of the problem because of the way it just jumps on people’s potentially vexatious claims and takes them all seriously without first investigating them. And that’s really got to be moderated and changed to give people more confidence in the system.
STEVE CANNANE: Dr Mukesh Haikerwal told a Senate Inquiry four years ago that he was concerned AHPRA’s notification system would lead to doctors losing their jobs due to claims made in bad faith. He says it’s time the process was reviewed.
MUKESH HAIKERWAL: So if we do have someone who has a problem, we need to be able to identify them, we need to be able to know that they’ll be dealt with in a way that is – the same way as we would like to be dealt with; in other words, some respect, with some thoughtfulness, and obviously, if somebody’s doing something that’s wrong, that needs to be rectified
STEVE CANNANE: No-one from AHPRA was available for interview. In a statement, a spokesperson said, “If a notification is not made in good faith, and assessment finds no risk to the public, the matter will be closed with no adverse outcome for the practitioner. If the Board has evidence that a registered health practitioner has made a notification not in good faith, it will investigate and take appropriate action.”
Dr Charlie Teo believes a simple change to the system could protect doctors from vexatious complaints.
CHARLIE TEO: I have thought about it and there are – I think there are ways we can get around it. Things like benchmarking. Now benchmarking simply says that, “If you’re gonna complain that my complication rate is high, can you please give me a jury of similar surgeons who do similar operations and show me what their benchmark is? Show me what my complication rate is compared to theirs and if it’s way, way higher, then I – I would concede. But if it’s the same as or lower than, then please, back off.”
EMMA ALBERICI: The Federal Health Minister Sussan Ley was in her electorate today and wasn’t able to speak with us. Her department did, however, respond to questions raised by last night’s story…
A spokesperson for the Australian Government Department of Health did answer some questions via email:
Does the Minister have any concerns about the self regulation system within the medical profession?
Under the National Registration and Accreditation Scheme (NRAS), established under the Health Practitioners Regulation National Law Act 2009 (the National Law), as enacted in each state and territory, the Medical Board of Australia (MBA) is responsible for the regulation of doctors in Australia. The MBA is supported in its role by the Australian Health Practitioner Agency (AHPRA). Both are statutory authorities and under the National Law both operate independently of governments, but have expert members who are appointed by all Health Ministers following robust merit selection processes. Under the National Law, Health Minsters are not able to intervene in individual registration matters.
AHPRA has a complaints (also known as a notification) process by which a member of the public can inform them about the practice of a particular doctor. Once received, the MBA will commence an investigation of the complaint and make a decision on whether it is appropriate to take any action, in the interest of public safety, in relation to the doctor’s practice. Many of the decisions of the MBA can be appealed.
The NRAS is designed to protect public health and safety, reduce administrative red tape and to ensure national consistency of professional standards. The National Law sets outs the requirements for handling notifications, and includes appeal rights and other protections for affected doctors.
Are there any further plans to investigate the regulation system?
NRAS was introduced in 2010 following an intergovernmental agreement (IGA) in 2008. The NRAS was designed to protect public health and safety, reduce red tape, and to provide mobility for professions across state and territory borders and to ensure that only practitioners who are safe and competent are registered to practise.
The IGA made a commitment to establish an independent review following three years of its operation and in April 2014, Health Ministers announced an independent review of the NRAS.
The review was extensive covering many aspects of its functions, including the role and function of the National Boards (including AHPRA) and how the Scheme is meeting its legislative objectives.
On 7 August 2015, Health Ministers agreed to the public release of the Final Report of the Independent Review of the NRAS for health professions (the Report). The release of the Report was accompanied with a Communique outlining Health Ministers’ responses to the 33 recommendations in the Report. The Final Report and Communique.
Is it fair that if a Doctor has no record of malpractice against them that they be told to leave a workplace because they don’t have the ‘support of their peers’?
It is the responsibility of employers to provide a safe workplace for employees that is free from bullying and harassment. Questions relating to the employment of Dr Emery and the Townsville Hospital should be directed to the Office of the Health Ombudsman in Queensland and/or the Townsville Hospital.