A senior surgeon told a public meeting over the proposed sacking of cancer specialist Kiran Phadke from St George and Sutherland Hospitals the investigative process was probably the most incompetent he had seen.
More than 350 people defied oppressive heat – the temperature in the car park outside was 44C – to attend the meeting on Friday night at Southern Districts Rugby Club, Sylvania Waters.
Dozens of people stood for the entire 90-minute meeting, which was organised in just one week by a community-based group.
Businesswomam Madeline Tynan, one of the organisers who lost her father Michael to cancer a year ago, acknowledged that some at the gathering would “not be feeling well”.
Dr Kevin Hanel, a former chairman of St George Hospital’s surgery department, said he had assisted in dozens of reviews of doctors over 20 years, including “the Bundaberg situation” [the inquiry into surgeon Jayant Patel at Bundaberg Hospital in Queensland].
”I don’t think I have ever seen a more incompetent, malicious, vindictive process as I have seen here,” he said.
Another surgeon, Professor Denis King, who is chairman of the Illawarra Shoalhaven Local Health District Board but attended in a personal capacity, said there had been “a serious denial of natural justice”.
“The system, I believe, has failed Kiran,” he said.
“We have been going backwards and forwards for months trying to get some common sense.
“I think the only way this is going to be resolved now is if the community, through its representatives, encourages them to seek a fair solution.”
A resolution, that was carried unanimously, stated, because there had been no adverse findings in respect of Dr Phadke’s oncology practices, he should be reinstated unconditionally to practice oncology at both St George and Sutherland Hospitals.
The resolution, which was supported by a petition, also requested Dr Phadke be granted a three months extension to respond to findings in respect to his haematology practice.
Heathcote MP Lee Evans was present, along with former shire MPs Malcolm Kerr, Allan Andrews and Lorna Stone.
Sutherland Shire mayor Carmelo Pesce arrived late after having to attend another function, and stood with many at the back.
The meeting heard from cancer patients, who said Dr Phadke had saved their lives, while Phill Bates, public officer for the Cancer Care Foundation and Cancer Care Lodge (Bezzina House) praised Dr Phadke for his fund-raising and inspiration.
One cancer sufferer, who was treated by a doctor trained by Dr Phadke, said, “He has brought up a new generation in oncology and haematology”.
Another speaker, Barry, who “drove 250 km in the hot sun” to speak on behalf of country people who had benefited from Bezzina House, said, “I have been involved in politics, I have been involved in unions, and I have got to say I have never seen such a stitch-up in my life”.
“We are not going to let them get away with this are we?” he asked.
Councillor Carol Provan, another of the organisers, said, “All we want for Kiran and his family is due process”.
“He looked after my mother in the most amazing way, and all I can remember is his care, his empathy…When you are a doctor for a long time, a lot lose that, but he never did.”
A speaker named Paul said, “I’m not a doctor but I believe I have commonsense”.
“I look around this room tonight – there’s thin people, fat people, old people, young people...I can’t believe a bureaucrat says one ‘pill’ fixes everybody”.
Dr Hanel, who resigned from St George Hospital in protest at Dr Phadke’s suspension last year, said he was “not here because I’m a friend and colleague”.
“Kiran, you could be my brother and if I thought you were a shonk, I would be home watching TV,” he said.
Dr Hanel said the system for investigating complaints about a physician was governed by policy directives that the process be fair and impartial, provide the clinician with information about the issues, provide the opportunity to respond and be private and confidential.
He detailed multiple aspects of the inquiry, which he said did not meet the requirements for fairness and impartiality.
Dr Hanel said the first two investigators appointed to review Dr Phadke’s cases both knew him and worked at competing hospitals in the same area.
When external reviewers were later appointed, the system had already been violated.
“Medicine is a commercial field, there are always conflicts of interest,” Dr Hanel said.
“You know, if patients don’t go to you, they will come to me.
“Even though you don’t like to point fingers, and no one directly comes out and says these sort of things, I am sure if Woolworths went broke no one at Coles would be giving them any sympathy at all.
“It’s quite obvious, behind the scenes, this has a lot do with what’s happened here.”
Dr Hanel said unfairness included calling Dr Phadke to a meeting and not providing any support, judging cases dating back to 2003 before some guidelines were developed, not looking at all his case notes, taking three months to allow him access to the investigators’ reports, reporting him to the Medical Board of NSW and giving him five days to mount a defence and withholding positive findings from the board – “they said they forgot”.
“Was it fair for [district CEO] Mr Marr and his associates to allow the Minister for Health to get up in the media, lie about the facts and set herself up for a possible defamation action?” he said.
“Is it fair in any judicial area to allow an anonymous complaint to be made, to investigate it with access to only a limited part of the evidence, to not allow the evidence in defence to be heard, to not allow legal representation at the trial, to sentence someone to professional and financial ruin and then, nine months later, give the verdict?
“It might happen in Russia and China, but this is the NSW Health system.”
Dr Hanel said one of the external reviewers had concluded “Dr Phadke shows his concern for the wellbeing and quality of life of his patients and, throughout the documentation I have received, the concerns for patient quality of life is paramount”.
That had not been mentioned in Mr Marr’s final report, Dr Hanel said. “He has gone through and cherry picked every adverse finding, and put it in the final report”.
Dr Hanel said 20 oncology patients had been reviewed, without one problem being found.
“Despite that, they go to the Medical Board and Kiran loses his licence to practice in in oncology,” he said.
Dr Hanel said “the absurdity” of the inquiry was illustrated by one of the cases in which Dr Phadke had been found to have provided incorrect treatment.
Dr Phadke had been “criticised for not pushing this patient to having a stem cell transplant”.
“In Mr Marr’s report there is no mention of the fact the patient had been to three other hospitals, been offered stem cell transplant, and had refused,” Dr Hanel said.
“He had also been to Greece, where he was told he should have one, and refused treatment there.”
Professor King said he first met Dr Phadke when they worked together before the 1988 state election to get cancer services for southern Sydney.
At the time there had not been one service south of Cooks River, despite the area having 40 per cent of the population of NSW.
”One of the promises of the Greiner government was to establish cancer services in southern Sydney,” he said.
“The community owes Kiran a huge debt of gratitude.”
Professor King said, as a colorectal surgeon, he used cancer services often, and had worked out early there were two types of medical oncologists – “those who treat the cancer, and those who treat patients who have cancer”.
Dr Phadke was among the latter.
”The diagnosis of cancer brings so many other issues, so many personal issues, so much stress…
“There are so many treatments available and, while all acknowledge that protocols are the starting point, for the good oncologist that’s what they are, the starting point.
“You then determine what best suits the needs of the patient and Kiran is very much in that group and treats people who have a disease. He doesn’t treat them as a disease.”
Professor King said the investigation into Dr Phadke was started by an anonymous complainant [ Health Minister Jillian Skinner said it was a nurse] following claims of underdosing at St Vincent’s Hospital.
“It is interesting the medical oncologist from St Vincent’s hasn’t had a single manifestation of support from the community,” Professor King said.
“I really feel if that hadn’t happened, a lot of what’s happened to Kiran wouldn’t have happened.
“The press and, to be honest, some of the politicians just lost the sense of proportion around that time.”
Professor King said he agreed with the “whistleblower” legislation.
“We need to protect people if they want to come forward, but it brings with it a couple of other responsibilities for the system,” he said.
“Firstly, it removes the right of the accused to face their accuser.
“Kiran has never had that opportunity, so someone has to do that for him and that someone should be the [local health] district.
“The local health district has a clear responsibility to ensure the welfare of their staff. Kiran is on their staff.”
Professor King said, as he had stated in his submission to the parliamentary inquiry, the health system’s Code of Conduct placed defined and important obligations upon those dealings with allegations.
“I can’t remember anyone who has received less support that Kiran,” he said.
”In the handling of complaints, there needs to be ‘natural justice.
“The first stages are to establish the facts, where necessary have genuinely independent reviews of the matter, and offer the accused a reasonable opportunity to reply.
“I believe that none of these occurred in Kiran’s case.”
Professor King said he suggested to the parliamentary committee, among the issues they should look at, were clear conflicts of interest in people who were judging Dr Phadke, and the decision to contact patients and to publicly name and effectively shame him before he had a chance to respond.
“It really is a serious denial of natural justice,” he said.
Professor King said the question that should be asked of the local health district and new Health Minister Brad Hazzard was, ‘How can it be that Dr Phadke has been advised of his possible dismissal from his role as a medical oncologist when there have been no adverse findings made in relation to his oncology practice, no overdosing and no adverse patient effects?”
“It actually defies logic,” he said.
Professor King said the second point to be made was that Dr Phadke had not had sufficient time to review cases, and probably needed a further six months.
Dr Phadke told the gathering he couldn’t believe the number of people present.
“On a hot day like this for all of you to turn out it just blows me away,” he said.
”To me it is quite scary that somebody like me could have an experience like this and there is no one around for months and months, in government and various areas, to do something about it,” he said.
”It actually tells you what the bureaucracy has become like.
“I always thought we elect politicians to govern, and the bureaucrats follow their instructions. Now, it’s other way around.”
Dr Phadke said the worst day for him was August 2 last year when former health minister Jillian Skinner incorrectly linked him with claims of underdosing chemotherapy patients.
“This has since been proven wrong,” he said.
“It is amazing to me what some politicians – not all, because we have got a lot of others here tonight – will do to save themselves.
“Anyway, it hasn’t saved Jillian Skinner.”
Dr Phadke said he was amazed the state government had not learnt from the example of former police commissioner Peter Ryan, who was brought from England to head NSW police.
”Gerry Marr is another one,” he said.
“We import somebody, who has hardly spent time in this country, from Scotland, make them an executive of one of the largest area health services in the state and then we go along with whatever they want to do in terms of policies and protocols...”
Dr Phadke said he was “a doctor, who listens to public views and their wishes on quality of life”.
“I know what the guidelines are, but I think every person is different and I always believe in individualised treatment,” he said.
“We should give the patients treatment according to the guidelines but alter them in individual cases to suit their needs, whether physical, psychological, age related and so on.
“I hope I can be back doing what I do best, treating cancer patients with care and responsibility.”
FRIDAY NIGHT STORY
More than 350 people defied oppressive heat and turned out to support cancer specialist Kiran Phadke at a public meeting on Friday night.
It was standing room only at Southern Districts Rugby Club at Sylvania Waters.
Dozens of people stood for an hour and a half at the rear of the room, while more than 50 listened from the balcony.
Heathcote MP Lee Evans was among those present, and former state MPs from the shire, Malcolm Kerr, Allan Andrews and Lorna Stone.
Sutherland Shire mayor Carmelo Pesce sent his apologies, but still managed to get there late after another engagement, and stood with others at the back.
Speakers included Professor Denis King, chairman of the Illawarra Shoalhaven Local Health District Board, who said he was present in a personal capacity.
Other speakers included senior surgeon Kevin Hanel, well-known cancer services fund-raiser Phill Bates and former patients, Professor Barry Allen and Kim McGuire.
Professor King said most of those present would have preferred “to be sitting around the pool on this hot summer night’.
“It’s a sign of respect for Kiran that so many people have come here tonight,” he said.
Dr Phadke said he couldn’t believe how many people were present.
“I am overwhelmed by the support,” he said.
The meeting passed a two-part resolution that was supported by a petition, reading:
- In the absence of any adverse findings in respect of Dr Phadke’s oncology practices, that Dr Phadke be reinstated to practice oncology at both St George and Sutherland Hospitals with unconditional reinstatement.
- Dr Phadke be granted a three months extension to respond to findings in respect to his haematology practice.
A full report of the meeting will be published on the Leader’s website on Saturday.