Don’t scare whistleblowers into silence

The story of Toni Hoffman, who exposed Dr Jayant Patel, shows how secrecy is dangerous.

A very special nurse telephoned me a few days ago for an overdue catch-up.

We talked about our families and health. And we spoke about her remarkable whistleblowing.

Toni Hoffman isn’t a household name. She hasn’t forged a second career in politics or become a media celebrity. But by following her conscience and instincts Toni is a heroine and a lifesaver many times over. She is a revered leadership figure and confidante for numerous nurses who witness wrongdoing.

We will never know how many Australians are still breathing because of the direct and indirect consequences of Toni’s actions as a whistleblower to me 14 years ago. It must be an incredible number. Her story and its lessons should be regularly revisited by politicians and bureaucrats. Whenever they are cynical or cavalier about a connection between concealment and harm, they can examine this case.

Because now more than ever Australian politicians misuse power to exploit the structural weakness of sections of this country’s media. By tacitly encouraging police to rely on search warrants and other tools of suppression and investigation such as mobile telephone call charge records, they chip away at a fundamental pillar in our democracy.

Exposing whistleblowers and intimidating potential sources into silence means that vital disclosures to the public will not happen. And this is what our politicians and their minions see as success.

In most cases in my experience the motive of governments is to minimise the risk of embarrassment. The oft-cited concerns over privacy or national security are usually a ridiculous hoax.

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These people arrogantly decide behind closed doors that the information funded by Australian taxpayers and brought to them by journalists doesn’t belong to the public. This creeping culture can only be reversed with a suite of fundamental reforms to a raft of secrecy-promoting laws and policies. It in this context that Toni’s story is more relevant now than at any time since she first came to me with it in April, 2005. It is a powerful illustration of how a culture of secrecy is dangerous and deadly.

It underlines why bureaucrats and their political masters with a default response to conceal are a public menace in a democracy.

Toni’s story also underlines the crucial role of journalism. It is no secret that our craft is challenged by shrinking revenues, smaller newsrooms, distracted consumers, and theft by tech titans Google and Facebook. It is unforgivable of politicians to leverage this with heavy-handed police raids, searches by stealth and other Orwellian responses.

Toni met me for the first time in Brisbane one afternoon — against the advice of her friend and chaperone, Karen. They signed the visitors’ book with false names (Jane English and Sue James). Toni became a whistleblower to me that afternoon. She nervously painted a picture of a sick public hospital with a director of surgery who had been feted by the public servants and politicians because he was fast and hard-working. The system’s ruthlessly efficient business model rewarded zealotry.

Dr Jayant Patel was lauded by his bosses because he was particularly keen to operate. In his zeal he cut the all-important surgical waiting lists — and any improvement in this public measure of progress gave the bureaucrats and politicians cause to pat themselves on the back.

They would conjure up a “good news” media release, write self- serving commendations and seek to reward the hospital with more funds. The outcomes for patients were far less important.

Toni told me back then: “To meet the budget and surgical targets, hospitals have to do a certain amount of surgery. Hospitals make money from surgical procedures. Because he was churning through the surgery, he was making them money.”

As this deadly cycle gathered momentum the bureaucrats did not want to know about the grave worries of experienced nurses in the Intensive Care Unit about the ensuing complications, infections and deaths. They didn’t want to know because their political masters had conditioned them to turn a blind eye and actively conceal bad news. When Toni tried to report her concerns through official channels at the hospital she was stymied and bullied.

After she came to me with this disturbing story I spoke confidentially to other nurses who expressed similar concerns. Then I tried checking Dr Patel’s credentials. Was he regarded as competent by his peers? He was trained initially in India, but he’d lived and worked mostly in the US. We needed to know if he had any history of negligence. It led to me discovering with an online search that the nurses’ instincts were right. Patel was indeed a dangerous surgeon — the Board for Professional Medical Conduct in New York State had ordered he be “stricken from the roster of physicians” for his “gross negligence and negligence on more than one occasion” in complicated surgical cases. Patel’s repeated acts of negligence had harmed many patients in the US and these were a matter of public record, yet he became Director of Surgery at Bundaberg’s public hospital for two years after having lied to the Medical Board of Queensland and health bosses to land the job.

The board and the government were failing to properly check the professional records of overseas-trained doctors streaming into our health systems. In the ensuing royal commission-style inquiry more shocking examples came to light — but only after attempts by the politicians and bureaucrats to cover them up.

A child molester from Russia, for example, had been approved and employed as a psychiatrist in Queensland’s public hospital system — despite having no qualifications in psychiatry or even medicine. Anxious and vulnerable people were treated by a complete fraud who took them off their anti-psychotic medication. When this was discovered by the bureaucrats and minister, it was covered up at the highest levels.

Internal documents and former public servants revealed how refrigerator trolleys were used to wheel cartons of documents in and out of Cabinet, thus ensuring they would be withheld from the public for 30 years. These documents told the truth about public health, not national secrets such as the identities of Australia’s spies abroad, but the politicians in successive governments played god with safety.

By the end of the public inquiry which began with Tony Morris, QC, and ended with a hefty and scathing final report from retired Supreme Court judge Geoff Davies, QC, there were many sweeping reforms to enhance patient safety, improve transparency, and deliver billions of dollars in additional funding to the system to improve outcomes.

The findings by Davies were strong. One in particular carried a lot of force and is particularly prescient today: A “culture of secrecy” fostered by successive governments had been a major cause of the scandal and ensuing unsafe care in the health system.

Davies wrote: “It involved a blatant exercise of secreting information from public gaze for no reason other than that the disclosure of the information might be embarrassing to the government. Campaigns of concealment at the highest level were contrary to the public interest, misleading and deadly. As a result of negligence on the part of Dr Patel, 13 patients at the hospital died and many others suffered adverse outcomes.”

In acknowledging people “whose care, passion or courage was instrumental in bringing to light the matters covered here”, Davies singled out Toni Hoffman as a heroine, adding: “It was her courage and persistence which, in the face of inaction and even resistance, brought the scandalous conduct of Dr Patel to light.”

Davies made this finding about my role: “His investigative skill, persistence and undoubted authority as a respected journalist ensured that public notice and government action was taken, notwithstanding the apparent reluctance of hospital administrators and officers of Queensland Health to take appropriate action to permit the matter to be exposed.”

And this is the major point. Whistleblowers bring their knowledge of scandalous conduct to light when they go to journalists, who then strive to bring it to public notice. We are all on a slippery slope when governments get away with scaring our sources into silence.

Hedley Thomas won a Walkley Award in 2005 for breaking the Jayant Patel story. He wrote a book, Sick To Death, about the case.