A Critical Analysis of Overseas-Trained Doctor ('OTD') Factors in the Bundaberg Base Hospital Surgical Inquiry
Regulating Health Practitioners, Law in Context Series, Vol. 23, No. 2, 2006
20 Pages Posted: 23 May 2009
Date Written: May 22, 2006
This article explores one of the most intriguing and hitherto largely unexplored aspects of healthcare quality and safety investigations in Australia: the role of a protagonist's status as an overseas-trained doctor ("OTD"). The topic is controversial, not the least because of the growing importance of OTDs in maintaining basic health services in some areas of Australia, but also due to the difficulty of teasing genuine quality and safety problems in this context from possible racial or xenophobic concerns. As a case study, we will explore the problems associated with Dr. Jayant Patel at the Bundaberg Base Hospital ("BBH") in Queensland.
It is now well known that Toni Hoffman, Nurse In Charge of the Intensive Care Unit at the Bundaberg Base Hospital ("BBH"), "blew the whistle" on Dr. Patel. Before this, Dr. Patel had practised as Director of Surgery at the BBH for two years, commencing in April 2003. Ms. Hoffman maintained that during Dr. Patel's time at the BBH, she raised concerns about his practice and competence with at least twelve parties, including hospital staff, administration and management, Queensland Health administrators, the coroner and police, without result. Ms. Hoffman has revealed that she and other BBH staff were so concerned about Dr. Patel's apparent incompetence that they hid patients from him.
The Patel case highlights that healthcare policy makers and regulators need to be aware of the distinct quality and safety problems raised by OTD status. Just as the major failure in paediatric cardiac surgery at the Bristol Royal Infirmary was "a powerful political lever for change" in the United Kingdom, the events at Bundaberg must be the catalyst for long-overdue reform to the way that OTDs are dealt with in the Australian healthcare system.
Keywords: Whistleblowing, healthcare quality and safety, Patel case, overseas-trained doctors, medical regulation, adverse incidents, errors
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