SEPTEMBER 2008

IN THIS ISSUE

Please Select an Article to Read

• Australian Law Reform Commission’s Privacy Report – Health Update
• Special Commission of Inquiry into NSW Public Hospitals releases its First Report
• Pharmacists and Franchising
• Accessing funds in the current market environment
• Aged Care Update
• Amendments to the NSW Medical Practice Act introduce compulsory reporting of doctors for sexual misconduct, substance abuse and incompetent clinical practice
• Case note: Peer evidence as to competent medical practice
• Proposed changes to general requirements for labelling of medicines
• Windfall for Medical Insurers in Medical Malpractice Cases
• Protecting Root Cause Analysis in NSW private health facilities
• Case Note: Court Of Appeal reversal on Domestic Assistance Threshold under Civil Liability Act
• New procedures for Medical Negligence Claims in the NSW Supreme Court
• IVF Donors to lose anonymity under new legislation in New South Wales

 

Special Commission of Inquiry into NSW Public Hospitals releases its First Report

On 31 July 2008, the Special Commission of Inquiry into Acute Care Services in NSW Public Hospitals released its First Report.  The Report deals with the circumstances surrounding the appointment of Dr Graeme Reeves (the so-called “Butcher of Bega”) as a VMO obstetrician and gynaecologist by the former Southern Area Health Service.

Although the appointment of Dr Reeves was not specifically within the Commission’s terms of reference, the Special Commissioner, Peter Garling SC, has been hearing evidence and submissions about all aspects of acute care in NSW, including obstetrics.  Moreover, his terms of reference require him to inquire into and report on “any systemic or institutional issues in the delivery of acute care services in NSW public hospitals raised in submissions”.  The First Report contains a detailed review of the NSW Health policies and practices relating to the recruitment of Visiting Medical Practitioners at the time of Dr Reeves’ appointment.

Dr Reeves had practised as a specialist obstetrician and gynaecologist for many years prior to coming to the attention of the NSW Medical Board in 1997.  At that time, following a hearing of a Professional Standards Committee, the Board placed a condition on his registration requiring him to cease the clinical practice of obstetrics.  Dr Reeves was also placed on the Board’s “impairment” program which required, among other things, that his health be regularly monitored by a Board-appointed psychiatrist.

In February 2002, Dr Reeves applied to the Southern Area Health Service for appointment as a VMO obstetrician and gynaecologist to work at Bega and Pambula Hospitals.  He provided the Area Health Service with a copy of a letter from the NSW Medical Board that referred to Dr Reeves’ obligations under the Board’s impairment program, but made no mention of the fact that he had conditional registration that did not permit him to practise obstetrics.  Dr Reeves concealed this fact from the Area Health Service in what Mr Garling describes in his report as an act of “intentional and calculated dishonesty.”

The Southern Area Health Service appointed Dr Reeves as a VMO obstetrician and gynaecologist, and did not learn until November 2002 that he was not registered to practise obstetrics.  He was required to give an undertaking that he would no longer provide any obstetric services, but was permitted to continue practising gynaecology.  When Dr Reeves breached his undertaking by continuing to perform obstetrics, his appointment with the Southern Area Health Service was terminated. 

In his first report, Mr Garling identifies deficiencies in the NSW Health and Southern Area Health Service policies in place in 2002 which contributed to the failure on the part of the Area Health Service to ascertain that Dr Reeves had conditional registration prior to his appointment.  In particular, there was no requirement for independent verification of an applicant’s registration status with the Medical Board, nor any requirement to check the applicant’s past performance and disciplinary history and provide the Appointments Committee with a written record of a structured referee check. 

The report notes that a number of these deficiencies have since been rectified in current NSW Health policies.  The NSW Medical Board has also changed its procedures, and now provides on-line access to its registration database to enable confirmation of any conditions placed on a doctor’s registration.

The report is also critical of the Southern Area Health Service for failing to take adequate steps to prevent Dr Reeves from continuing to practise obstetrics after November 2002 when his conditional registration came to light.  However, Mr Garling concedes that the senior managers within the Area Health Service could not have expected the “level of defiance” Dr Reeves showed in continuing to practise obstetrics contrary to the specific direction given to him and his express undertaking.

The Special Commission is due to submit its Final Report by 30 November 2008.

Written by Julie Hamblin, Partner