Transcript: AMA Vice President, Dr Steve Hambleton, with Ross Greenwood, Radio 2GB

Now the issue, of course, relates to his time as director of surgery at the Bundaberg Base Hospital.  The whole point about this is how could it have happened and could it, potentially, happen again?

Have procedures been tightened to prevent another Jayant Patel slipping through the system and injuring, and in this case even killing patients, in the future?

Steve Hambleton is the Federal Vice President of the Australian Medical Association and also, I should point out, is a Queenslander.  So as a medical practitioner from that part of world would feel this very keenly.

Good evening to you Steve.

STEVE HAMBLETON: Good evening.

ROSS GREENWOOD: From the medical profession's point of view this is not, shall I say, the glowing testimony of much of the work that is done by many of your members.

STEVE HAMBLETON: No.  Look, this is a very sad day for the medical profession.  I mean it's an awful situation we find ourselves in and, as you pointed out, we never want this to happen again.

ROSS GREENWOOD: What has been done to try and prevent a recurrence if there were, shall I say, a wild card in the pack such as Jayant Patel?

STEVE HAMBLETON: Look, a number of changes have been triggered right across the country.  I guess it would be fair to say that Queensland probably had one of the lowest thresholds to get over in Australia and I think soon afterwards probably had the highest.

But we're all ready for national registration to occur, as of 1 July.  There are very good thresholds that will support our overseas colleagues come to this country, but will also double-check on everything.

We now have an English language standard to make sure that doctors coming into the country can actually converse with their patients.

So we now have qualification checking, so that we actually go to the university where their degree was actually offered and double-check that the person actually graduated.

We need certificates of good standing from everywhere where doctors have come from in the past.  There is no gap in their history.

So we will get those certificates and you know that will ensure that we have - can be confident - the people who are registered in this country are capable of looking after their patients properly.

ROSS GREENWOOD: Being fairly naive, I ask in a day, an age of shall I say incredible internet access is surely the registration of any medical practitioner anywhere in world not a fairly standard thing these days?

It is capable of being checked very, very quickly via the internet.

STEVE HAMBLETON: Well, disappointingly, it's not as quick as it should be.  I think that their electronic systems should allow us to very rapidly credential people and accredit them and I think that that's something we have to work on internationally.

There is a university in the United States that actually has done this for everyone.  Actually goes and finds the university, finds the student list to make sure you actually graduated, and you are who you say you are, and you did what you say you did.  So we rely on them.  Even Australia relies on them. 

But you're right. We should have better systems that more rapidly check.  But you've got to keep the bar high.  You've got to maintain confidence of the public.

ROSS GREENWOOD: What did all of this case of Jayant Patel say about those who were around him?  Those who were alarmed but, perhaps, those who also were fearful of either speaking out, or when they did were in fact affected by the attitude of the medical staff inside - the senior medical staff - inside the hospital?

STEVE HAMBLETON: Look, I think it's an example of things that go wrong.  What happens?  Why doesn't the system actually catch things out?

I think people described it like the Swiss cheese theory.  There are many layers where these things should be stopped.  You know bad outcomes should not happen but there should be multiple checks.

Now if the Swiss cheese holes all line up you might be able to shoot the arrow through.  It's up to us to make sure that there are enough layers to make sure that the system protects people, that protects the doctors.

We must not put people in situations where they're working outside of their level of expertise. 

Even if people withhold information, the system should still be able to say well, hold on a second, let's double check on this.  Let's just make sure that you know we're safe, we're doing the right thing by our patients.

ROSS GREENWOOD: Because the level of confidence that the community can have surely is only provided by the amount of confidence that we have that the people who are working on us are properly qualified and, in fact, properly experienced to do that job.

STEVE HAMBLETON: Well, you are absolutely right.  Step one is to make sure we train our doctors well and step two is that they are able to work in teams that can support that training and actually tap you on the shoulder if things are going wrong or notice when things go off track.

We have a different, I guess, attitude towards adverse events that is beginning to develop.  You know, to say well if we've had near misses let's learn from them.  Let's actually say well we didn't have an adverse outcome, let's make sure that doesn't happen again.

You'll find that there are meetings in every hospital around this country that look at near misses and adverse events, trying to learn from them and trying to do it in an open way.

Because we must learn from them, we must get better and better, we must have a self-healing health system and I think it shouldn't take major events like this to actually make us do that.

ROSS GREENWOOD: If the Government and Julia Gillard have introduced a My School system to basically allow parents to see the performance of their schools, is there also a call in the community for some sort of My Medical system whereby I can see the performance of my doctor or my specialist?

STEVE HAMBLETON: Well, those sorts of things certainly have been discussed and that's where … some of those things though do need some filtering.  You know, for example, if we get the best surgeon in Australia and we give them all the hardest cases they are still going to have adverse outcomes that could be quite well explained.

But, in general, we need to be open and accountable about what we do and how we do it.

ROSS GREENWOOD: Brilliant. Can I say, Steve Hamilton, the Federal Vice President of the Australian Medical Association we thank you very much for your time.

ROSS GREENWOOD: As I say that is a significant case of course tonight - Jayant Patel found guilty of killing three patients and permanently injuring another.

30 June 2010

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