Doctor Kiran Phadke says cancer patients will lose their right to make choices about their treatment under a “culture of fear” being imposed on experienced clinicians by health bureaucrats.
Dr Phadke’s concerns that individualised treatment will become more difficult were echoed by other leading cancer specialists, who spoke out in his support following his suspension from St George Hospital and Sutherland Hospital.
Dr Phadke, who is both an oncologist and haematologist, pioneered cancer care services in the region.
He was director of medical oncology at St George Hospital from 1990 to 2015 and Sutherland Hospital from 2005 to 2015.
Health Minister Jillian Skinner announced his suspension, which occurred in June, before Dr Phadke had a chance to answer concerns, initiated by a nurse, about the treatment of six patients between 2003 and 2014.
Mrs Skinner used the term “under-dosing”, suggesting the cases were similar to complaints against Dr John Grygiel at St Vincent’s Hospital.
In fact, the matters are very different and Dr Phadke’s matters relate to treatment guidelines and their interpretation.
Health officers have reviewed all of Dr Phadke’s new oncology patients for more than five years from January 2011 to June 2016 and found treatment was appropriate.
They are continuing to review the files of haematology patients.
Dr Phadke told the Leader, of the six cases cited by Mrs Skinner, three of them dated from 2003, well before official treatment guidelines started, to 2010, a few months after their introduction.
He said the other three cases, from 2009-2014, involved patients with “unique personal circumstances”, who had been provided with all options and information to make an informed decision on treatment.
Dr Phadke said patient care was very complex, and every case involved “a very human element for the patient, their family and friends”.
He said, in more than 35 years of treating cancer patients in NSW, his priorities had been to ensure patients understood their options, what was involved in treatment, to respect their wishes and keep their welfare paramount.
Dr Phadke said the culture being imposed by the bureaucracy was “increasingly depriving patients of choices about their individualised treatment and their own quality of life”.
Dr Phadke, a refugee from Uganda in 1972, said he once inserted a drip into the arm of a wife of dictator Idi Amin while a soldier pointed a gun at his head.
“I felt less of a target at that time,” he said. “If someone in the health system has a set against a doctor for any reason, be it professional rivalry or personal prejudice, the doctor can be vilified, humiliated and their career ruined without them having the chance to adequately defend themselves”.
STRONG SUPPORT FOR DOCTOR
Dr Phadke said “overwhelming support” from patients, including a flood of letters and emails to the Leader, had given him strength.
Typical of supporters was Kim McGuire, of Heathcote, who wrote, “I feel obliged to support Dr Phadke during this traumatic time as he provided lifesaving care and treatment to me during a critical stage in my battle against cancer”.
“He showed me kindness and compassion and acted swiftly to provide me immediate treatment and a professional holistic on-going care plan.”
Themis Theo, of Rockdale, wrote, “I consider myself extremely fortunate to have met and to have received treatment from such a brilliant and caring doctor”.
Other patients and doctors said the handling of the situation had created panic.
Chair of the St George Hospital Medical Staff Council, Associate Professor Theresa Jacques, said she did not know the details, but Dr Phadke “has been a major contributor to oncology services in the district and fought passionately for the community”.
“It is important there is procedural fairness in any investigation and I am deeply distressed to see acknowledgement of his contribution swept away through media focus on events that have yet to be finalised, as I understand it,” she said.
A local cancer care provider said, “We are in shock, not just the doctors but the entire cancer sector feeling like they have lost their leader”.
“I think it is probably professional jealousy...there are some who have perhaps been disappointed with the work Kiran was getting that was impacting on them. There was a feeling for the past couple of years they wanted him gone.”
A private cancer care centre Dr Phadke established at Miranda last year had created tensions, sources said.
Professor Paul de Souza, formerly of St George Hospital and now foundation professor of medical oncology at Western Sydney University, said Dr Phadke was “a fine doctor”.
“Presumably they are concerned about people not following protocols, but everyone understands protocols are not a substitute for medical judgment,” he said.
“Examining compliance to protocols is like Googling for health information, rather than talking to doctors, who are the experts.”
Senior surgeon Kevin Hanel, who resigned from St George Hospital in protest at Dr Phadke’s treatment, called it “the greatest act of bastardry I have seen in my career”.
Professor Philip Clingan, director of the department of medical oncology in the Illawarra Shoalhaven Local Health District, said Dr Phadke had “an incredibly good reputation” and “the whole emphasis for a clinician is to make sure you individualise patient care”.
Jillian Skinner said she revealed details once Dr Phadke’s patients had been informed “to reassure the public the system was safe”.
Health district chief executive Gerry Marr said cases notified or recommended by patients and families were under review and the results would go to the Health Care Complaints Commission.