RAH stroke deaths scandal inquest hears Transforming Health created ‘bad blood’ among doctors as radiology specialists try to ‘protect their turf’
A PLAN to centralise radiology services at the new RAH has created “bad blood” between doctors, with accusations some conspired to “protect their turf” — which stopped others maintaining skills, an inquest has heard.
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A PLAN to centralise radiology services at the new Royal Adelaide Hospital has created “bad blood” between doctors amid accusations some have conspired to deskill others to “protect their turf”, an inquest has heard.
State Coroner Mark Johns is conducting an inquest into the deaths of RAH patients Michael John Russell, 60, and Leslie Robert Graham, 87.
The men died when the hospital’s only two Interventional Neuro-Radiology (INR) specialists — Dr James Taylor and Dr Rebecca Scroop — were on leave at the same time for four days in April.
The procedures were performed by the state’s only other registered INR specialist, Dr Steve Chryssidis, but were unsuccessful.
Both deaths have shed light on a wide range of staffing issues with radiology across Adelaide.
On Friday, Queen Elizabeth Hospital radiologist Dr Ruben Sebben laid bare the wider implications of staffing issues.
He said a plan to move radiology services to the RAH under the Transforming Health reforms had meant doctors at other hospitals could become de-skilled.
Dr Sebben said Interventional Radiology (IR) specialists needed to perform a certain number of procedures a year to maintain their skills but as cases were sent to the RAH, that was not taking place at other Adelaide hospitals.
“Skills are becoming so under-utilised, you have to question whether it’s appropriate to perform procedures that could result in serious risk or even the death of a patient,” he said.
He said two of the four IR specialists at the QEH also worked in private practice so their risk of de-skilling was lower.
“Two of us were at major risk of de-skilling,” he said.
Dr Sebben said the decision to centralise the service had not been discussed with the QEH radiology team and many doctors felt they had been “left high and dry”.
“It was pretty much the door got shut in our face and that was it — there is a reasonable amount of bad blood between the hospitals,” he said.
In an email to SA Medical Imaging (SAMI) management, Dr Sebben said it was clear some radiologists had been “actively excluded from maintaining our skills by working at the RAH”.
“What we glean from this correspondence is a group of doctors, who by virtue of their incumbency at the RAH, have exercised the right to exclude colleagues employed by the same area health network,” he wrote.
“This constitutes nothing more than the preservation of a fiefdom by individuals who believe it is within their power to control publicly owned and funded facilities to their own advantage.”
Dr Sebben told the inquest the response he got from SAMI was not well received.
“It showed very clear evidence a group of individuals skills had conspired to prevent another group of individuals from maintaining their skills — skills I had been training in for 25 years,” he said.
“(It showed) that they had closed ranks as a group and it was to protect their turf.
“I found the whole tone of that email communication very distasteful — there was inconsistencies in there, there were falsehoods in there.”
Dr Sebben said he did have some INR skills but was not fully comfortable completing all procedures and while accredited, was not registered with the Conjoint Committee Guidelines for Recognition of Training in Interventional Radiology (CCINR).
The inquest was previously told there are three INR specialists employed by SAMI in the state — Dr Scroop, Dr Taylor and Dr Chryssidis, who are required to be registered on the CCINR.
Dr Sebben said no one at SAMI or the Health Department told him doctors needed to be on the CCINR register to perform INR procedures.
On Thursday, RAH radiologist Dr Michael Wilks told the inquest he was not aware INR specialists need to be on the CCINR register — despite performing about 10 INR procedures over the past three years.
“I was never made aware of that,” Dr Wilks — who is accredited by the Central Adelaide Local Health Network to perform INR procedures — responded.
RAH acting head of radiology, Dr Jim Buckley, last week told the inquest the rostering blunder was an “error” while Mr Johns has questioned the hospital’s “casual” approach to health administration.
An internal SA Health review found there had been “longstanding, territorial” issues between the three stroke specialists employed by SA Medical Imaging — Dr Taylor, Dr Scroop and Dr Chryssidis.
The inquest has previously heard Dr Scroop and Dr Taylor receive more than $1.1 million a year each to cover the 24-hour INR service at the RAH.
Dr Taylor, Dr Scroop and Dr Chryssidis will give evidence later.
The inquest continues.
