Dr Death clean-up chief warns patients still in the dark over hospital errors

The health economist charged with fixing Queensland Health’s rotten culture in the wake of the Dr Death scandal says patients are still being kept in the dark about the performance of their doctors and hospitals.

Jayant Patel near his home in Portland, Oregon, recently. Picture: Clint Brewer Photography

The health economist charged with fixing Queensland Health’s rotten culture in the wake of the Dr Death scandal says patients are still being kept in the dark about the performance of their doctors and hospitals, with only the “grossest” level of medical errors exposed publicly.

Respected health policy expert and manager Stephen Duckett was headhunted by the Queensland government in early 2006 to run the “clean-up crew” in the aftermath of Jayant Patel’s controversial two-year tenure as director of surgery at Bundaberg Base Hospital to 2005.

The Australian’s latest podcast series Sick to Death – based on investigative journalist Hedley Thomas’s book about the Patel case – is exploring how the Indian-trained American surgeon was allowed to practise in regional Queensland despite a terrible disciplinary history in the US.

It took only eight weeks after Patel started operating in Bundaberg for the hospital to receive the first of 22 serious complaints from patients and fellow staff about the surgeon’s performance. He only stopped working after whistleblower nurse Toni Hoffman went public and journalist Thomas uncovered Patel’s past.

An inquiry found 13 patients died because of his negligence and many more were injured. He was convicted of manslaughter and grievous bodily harm in 2010, but those verdicts were quashed by the High Court in 2012 and he eventually pleaded guilty to fraud.

University of Melbourne health economist Stephen Duckett says patients deserve more transparency about doctor and hospital performance. Picture: Gary Ramage

Dr Duckett, chief executive of Queensland’s Centre for Health Improvement until 2009 and now an honorary enterprise professor at the University of Melbourne, said the complaints to the Bundaberg hospital were not acted on because of Patel’s work ethic and ability to generate extra funding by churning through patients and doing complex surgeries.

“The Patel issue was (he was) a doctor who was essential for the financial performance of the hospital, so the hospital condoned performance that should not have been condoned, and I think that sort of attitude is way less prevalent these days,” Dr Duckett said.

He described the Patel saga as a tragic and important “wake-up call” which had lasting effects on the Queensland and Australian healthcare systems.

But he said there was still a disturbing lack of transparency about the performance of doctors and hospitals.

Dr Duckett said detailed data about complication rates and other measures of public hospital and private doctor quality needed to be released.

Currently, only the “grossest level” of sanction or complaint was recorded on a doctor’s registration, he said.

“That’s if they’ve been so bad they’ve been reported to the registration authority and they’ve made a determination,” he said.

“It doesn’t tell you if they’re within the normal range (of patient complications) or if they’re at the top of that normal range or the bottom.

“It’s absolutely legitimate for the performance of (individual) private doctors to be in the public domain. Private patients have a contract with the private doctor, and they’re paying them.

“In the public system, you’re not choosing an individual doctor, you’re choosing a hospital, so information about the hospital should be in the public domain.”

Research conducted by Dr Duckett for the Grattan Institute in 2018 found that one in every nine patients who go to hospital in Australia suffers a complication, or about 900,000 patients a year. Of those who stay in overnight, one in four suffer a complication, or about 725,000 a year.

The study described a “veil of secrecy (that) hangs over which hospitals and clinicians have higher rates of complications and which are safety leaders”.

“A patient’s risk of developing a complication varies dramatically depending on which hospital they go to: in some cases, the additional risk of complication at the worst-performing hospitals can be four times higher than at the best performers,” Dr Duckett’s 2018 study says.

“Hospital safety statistics are collected but they are kept secret, not just from patients but from doctors and hospitals. This has to change.”

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Patients kept in dark over hospital safety data

The health economist charged with fixing Queensland Health’s rotten culture in the wake of the Dr Death scandal says patients are still being kept in the dark about the performance of their doctors and hospitals.

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Why I’m revisiting the chilling tale of Jayant Patel after 20 years

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The latest national data from the Australian Health Practitioner Regulation Agency reveals that in 2024-25 there were 12,744 complaints made about 9087 doctors, or about 6.1 per cent of the profession nationwide, up from 11,207 complaints about 8418 doctors the previous year, or 5.9 per cent.

In both years, more than 80 per cent of the complaints were lodged by patients, their relatives or other members of the public.

The most common type of complaint – nearly 40 per cent – was about clinical care.

In 2024-25, the regulator closed 7039 complaints: 3.2 per cent involved conditions being imposed on doctors’ registrations or an undertaking accepted; 1.4 per cent had doctors reprimanded, cautioned or fined; and 0.7 per cent had their registration suspended or cancelled.

One-third of the closed complaints were referred to another body or retained by a health complaints organisation, and the majority – 61 per cent – had no regulatory action taken, a cohort of which included where a doctor had taken steps to address the complaint.

The Australian understands that a public disclosure on an individual doctor’s registration only happens if they are reprimanded, cautioned or fined, or if their registration is suspended or cancelled, or if they have conditions or an undertaking imposed.

Do you know more? Contact Hedley Thomas and the team at [e-mail]

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