Queensland considers how to improve checks on foreign doctors
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《英国医生杂志》
The Queensland government will hold a royal commission into the issues arising from the appointment of a surgeon to a senior hospital post who had a history of "gross negligence" in the United States.
In 2003 Dr Jayant Patel, who was trained in India, was appointed to the post of director of surgery at Bundaberg Base Hospital, Bundaberg, in central Queensland, at a salary of $A200 000 (?2 000; $160 000). Queensland抯 chief health officer, Dr Gerry FitzGerald, has confirmed that over the next two years at least 14 of Patel抯 several hundred patients experienced major complications. Although Dr FitzGerald confirmed that three of the patients had died, nursing staff estimated that Dr Patel could have been involved in as many as 20 deaths during his two year contract.
In early 2003 the Queensland Medical Board approved Patel抯 application to practise on the basis of a certificate of good standing from Oregon. However, Queensland officials overlooked an annotation mentioning that other details were attached, but which Dr Patel had not submitted. The attachment listed findings against Dr Patel in the United States. Nor did the Queensland officials check Dr Patel抯 US records, even though some are available on the internet.
In September 1983 New York medical authorities had found Dr Patel guilty of "gross negligence" over his performance at Rochester General Hospital, Rochester, New York, and Patel was placed on probation for three years.
In September 2000 the Oregon Board of Medical Examiners found Dr Patel guilty of gross negligence, but rather than revoke his licence it restricted the surgery he could perform. As a result the New York Board for Professional Medical Conduct notified Dr Patel in May 2001 of their intention to cancel his licence. However, Dr Patel asked for, and received, permission to surrender his licence.
Soon after Dr Patel started at Bundaberg Base Hospital in early 2003 nursing staff raised concerns about his performance. However, it wasn抰 until February 2005, under pressure from the Queensland Nurses Union, that Queensland Health, the state department, launched an audit of his surgery record.
However, before the audit was completed an extract from a letter from nursing staff to the hospital抯 management revealing the extent of the problem was tabled in the Queensland parliament. In the ensuing public controversy Dr Patel fled to Oregon and is subsequently believed to have returned to India.
Although the Queensland division of the Australian Medical Association at first defended Dr Patel, the president of the national association, Dr Bill Glasson, has subsequently argued that the case highlights the need for more rigorous and nationally consistent standards for checking the credentials of overseas trained doctors.
For its part, the nurses?union argues that the initial screening error was compounded by a culture of bullying in Health Queensland that resulted in the early internal complaints by nursing staff being ignored. Last week Queensland抯 health minister, Gordon Nuttall, acknowledged the problem. "I am doing all that I can to try to change the culture in Queensland Health so that that does not occur," Mr Nuttall said.
The terms of reference of the royal commission of inquiry, its duration, and who will head it have yet to be announced.(Canberra Bob Burton)
In 2003 Dr Jayant Patel, who was trained in India, was appointed to the post of director of surgery at Bundaberg Base Hospital, Bundaberg, in central Queensland, at a salary of $A200 000 (?2 000; $160 000). Queensland抯 chief health officer, Dr Gerry FitzGerald, has confirmed that over the next two years at least 14 of Patel抯 several hundred patients experienced major complications. Although Dr FitzGerald confirmed that three of the patients had died, nursing staff estimated that Dr Patel could have been involved in as many as 20 deaths during his two year contract.
In early 2003 the Queensland Medical Board approved Patel抯 application to practise on the basis of a certificate of good standing from Oregon. However, Queensland officials overlooked an annotation mentioning that other details were attached, but which Dr Patel had not submitted. The attachment listed findings against Dr Patel in the United States. Nor did the Queensland officials check Dr Patel抯 US records, even though some are available on the internet.
In September 1983 New York medical authorities had found Dr Patel guilty of "gross negligence" over his performance at Rochester General Hospital, Rochester, New York, and Patel was placed on probation for three years.
In September 2000 the Oregon Board of Medical Examiners found Dr Patel guilty of gross negligence, but rather than revoke his licence it restricted the surgery he could perform. As a result the New York Board for Professional Medical Conduct notified Dr Patel in May 2001 of their intention to cancel his licence. However, Dr Patel asked for, and received, permission to surrender his licence.
Soon after Dr Patel started at Bundaberg Base Hospital in early 2003 nursing staff raised concerns about his performance. However, it wasn抰 until February 2005, under pressure from the Queensland Nurses Union, that Queensland Health, the state department, launched an audit of his surgery record.
However, before the audit was completed an extract from a letter from nursing staff to the hospital抯 management revealing the extent of the problem was tabled in the Queensland parliament. In the ensuing public controversy Dr Patel fled to Oregon and is subsequently believed to have returned to India.
Although the Queensland division of the Australian Medical Association at first defended Dr Patel, the president of the national association, Dr Bill Glasson, has subsequently argued that the case highlights the need for more rigorous and nationally consistent standards for checking the credentials of overseas trained doctors.
For its part, the nurses?union argues that the initial screening error was compounded by a culture of bullying in Health Queensland that resulted in the early internal complaints by nursing staff being ignored. Last week Queensland抯 health minister, Gordon Nuttall, acknowledged the problem. "I am doing all that I can to try to change the culture in Queensland Health so that that does not occur," Mr Nuttall said.
The terms of reference of the royal commission of inquiry, its duration, and who will head it have yet to be announced.(Canberra Bob Burton)