Thursday, May 22, 2008

Public hospital tries to dodge blame for incompetent surgeon

The Alfred Hospital has absolved itself of legal responsibility for the botched surgery of disgraced surgeon Thomas Kossmann, despite a review finding that his work as the Melbourne hospital's head of trauma put lives at risk. Although patients were subjected to unnecessary and bungled operations, Bayside Health chief Jennifer Williams said yesterday she did not expect to pay compensation. "From the information I have about the nature of the complaints, I would not envisage an insurance claim, but that would be a matter for future consideration," she said.

About 20 patients have contacted the hospital expressing concerns about operations Dr Kossmann performed on them, and the hospital has written to about another dozen. Slater & Gordon lawyer Paula Shelton said the hospital appeared to have breached its duty of care to the patients, and she encouraged them to come forward to discuss potential claims. "There's very good authority to say the hospital is responsible for the behaviour of Dr Kossmann," she said.

But Ms Williams refused to accept any responsibility for the hospital employing Dr Kossmann or for his bungled surgery, although she admitted the Alfred did not check the exaggerated claims in his CV and relied on the Royal Australasian College of Surgeons' assurances about his competence.

Orthopedic surgeon Bob Dickens yesterday released the findings of a damning peer review into Dr Kossmann, which were first revealed in The Australian last month. Mr Dickens, who headed the review panel, found Dr Kossmann had exaggerated his experience on his CV, conducted risky and unnecessary surgery and rorted government insurance agencies, including the Transport Accident Commission. He called for a sweeping audit of the Alfred's audit procedures, as well as the billing of Dr Kossmann and all other Alfred trauma surgeons.

The review has sparked a row between the college of surgeons, which blamed the hospital for not detecting the professor's surgical failings, and the hospital, which accused the college.

Mr Dickens's panel investigated 24 cases involving Dr Kossmann and found problems with 13, including grave errors. "Lives were put at risk. There were examples of catastrophic bleeding where there was difficulty getting control of the bleeding," he said. He cited other examples where a poorly placed screw in a heart had to be removed in a second operation, and how Dr Kossmann caused a hemorrhage in one of the main arteries supplying the brain during another procedure.

He said no one died as a result of the bungles, but patients were exposed to unnecessary risks, including infections. He questioned the college's decision to allow Dr Kossmann to practise without sitting the examination for foreign doctors. But college vice-president Ian Dickinson said the college had not erred in exempting Dr Kossmann from the exam. He blamed the hospital for failing to detect the failings through its audit and peer-review processes, and accused Dr Kossmann's previous employers of providing "glowing assessments" of his work.

Dr Kossmann, who resigned from the Alfred last month but denies wrongdoing, branded the review a "witchhunt" and said the press conference was a "show trial".

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More socialist paternalism for Australian blacks

Blacks must NOT be treated as individuals, apparently. All "for their own good", of course

Fifteen years after the passage of the historic Mabo legislation, the Rudd Government has flagged sweeping changes to native title to ensure the benefits of the mining boom flow to Aboriginal communities and are not locked up in trusts or frittered away. Indigenous Affairs Minister Jenny Macklin, delivering the third annual Eddie Mabo Lecture in Townsville, said yesterday that native title legislation was too complex and had failed to deliver money to remote Aboriginal communities, despite lucrative agreements with mining companies. She said changes to native title should be used "as part of our armoury to close the gap between indigenous and non-indigenous Australians".

Under the changes flagged yesterday, Ms Macklin wants direct payments to individuals minimised in favour of payments that create benefits for the whole community. "It is not tenable for people to continue to live in overcrowded housing in dysfunctional, despairing communities while substantial funds, nominally allocated for their benefit, are either locked up in trusts or distributed as irregular windfalls to be frittered away with no long-term good," she said. "The policy challenge is to both respect the rights of native title holders and claimants to make such agreements in relation to their land, and to make sure that the funds which flow are used to make a difference to their lives and to the lives of their children and grandchildren."

In what could be interpreted as a criticism of the first Native Title Act passed by Labor in the early 1990s, Ms Macklin said there was a need to look hard at the "structures and institutions we have put in place", and to make sure they were working effectively. To that end, the Rudd Government would work up a reform package over the next six months in tandem with the development of its Indigenous Economic Development Strategy.

"We want to actively explore the scope to encourage the negotiation of comprehensive settlements as an alternative to the convoluted claims processes currently in place," Ms Macklin said. "We will need to look at encouraging stakeholders to change the ways payments are negotiated and structured to improve accountability and provide greater assurance to indigenous interests."

Ms Macklin said she and Attorney-General Robert McClelland would convene a small informal group of key players involved in native title to work through these issues, including leading indigenous academic Marcia Langton and Ian Williams, a member of the Argyle Native Title Trust. Ms Macklin said at least three areas needed fundamental change: improving the "overly complex and exceedingly slow" native title claims process; improving representation for the indigenous people making claims; and ensuring that the income streams raised as part of native title agreements were properly distributed.

In 1992, the High Court overturned the legal concept that Australia was unoccupied, or terra nullius, when Europeans arrived. The so-called Mabo decision was followed by the creation of the native title regime in 1994 that has to date resolved 1200 claims. But according to the National Native Title Tribunal, there are more than 550 live claims, including at least 120 that were lodged more than 10 years ago.....

The most controversial part of her Mabo speech was the suggestion of government interference or regulation in the distribution of funds raised through agreements between landholders and mining companies. But Ms Macklin was unapologetic about exploring the option. "There will be a need for hard-headed leadership from indigenous interests," she said. "We would all have cause for shame if the huge proceeds expected to flow to indigenous people from the mining boom are not harnessed to help close the gap between indigenous and non-indigenous Australians," she said....

Ms Macklin gave the speech shortly after renaming the James Cook University library after Mabo, who was a 34-year-old gardener at the campus when he discovered he did not own his traditional homeland of Mer Island [Interesting: "Mer" is the original native name. It is shown on maps as "Murray" Island. In 1933 Ion Idriess wrote a novel called "The drums of Mer", which I greatly enjoyed reading when I was a kid] in the Torres Strait.

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Flannery, the dotty false prophet

YOU'D think a record of dud predictions would shame Alarmist of the Year Tim Flannery into silence. But, no. It seems this professional fearmonger has learned instead that global warming is a faith that grows on panic, not facts. So, undaunted, Flannery this week amped up the hype to warn that global warming was now so terrifying we may have to change the colour of the sky. As a "last barrier to climate collapse" we might within the next five years have to fire the "gas" sulphur (actually a solid) into the stratosphere to keep out some of the sky's rays.

There are obvious problems with his plan. First, Flannery concedes "the consequences of doing that are unknown". Second, some lousy consequences are known - for a start, sulphur is an element in acid rain. But third, global warming in fact halted in 1998 - a basic point confirmed by almost all measuring bodies but not yet by Flannery.

How Flannery gets away with such flummery has been a mystery to me, but I blame in part our extraordinary groupthink. For instance, while 31,000 scientists were happy this week to sign a petition in the United States denying there was convincing evidence that man's gases caused catastrophic global warming, I can't think of more than a dozen in Australia who'd dare do the same. And I can think of even fewer journalists who'd back them if they did. That's why Flannery is still treated as a hero of the ABC and The Age, despite a string of predictions that should have made him a laughing stock, not 2007 Australian of the Year. Here's a condensed list.

* Three years ago he warned global warming could leave Sydney's dam's dry by 2007. They are two thirds full.

* Perth would be so devastated by drought that it would be a "ghost city" in decades. In fact, the city has just recorded its wettest April on record.

* The ice caps would melt so fast that the seas would lap the roofs of "an eight-storey building". In fact, the United Nations' influential IPCC, itself accused of alarmism, says at worst the seas will rise this century by 59cm.

* Hurricanes would become more frequent. In fact, the long-term trend of hurricanes and cyclones is highly disputed, as is any link to warming.

The hype pushing the global warming scare is the most sustained assault on reason in my lifetime. While Flannery remains a prophet, the rational should tremble, even before he starts firing sulphur into our sky.

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Reading, writing and all things irrelevant

THE social engineers are hard at it again in our schools. Now they have added gambling studies to the endless list of non-core subjects required to be addressed in a day that is something less than six hours long. Across the state, teachers' cupboards are bulging with "resources" on road safety, personal health, obesity, safe foods, civic pride, values, drugs and alcohol, multi-culturalism, child protection, life skills, bullying and anti-homophobia. There's even a program now to teach rugby league in primary classrooms, promoting NRL players as role models for students. Not long ago it was recommended students be taught how to prepare for bushfires.

Despite a stream of warnings, schools are drowning in a sea of worthy but non-essential subjects peddled by well-meaning but misguided people -- usually politicians. It is generally accepted schools should spend at least 80 per cent of their time on key subjects of the curriculum, while the remaining 20 per cent is shared between an exhaustive list of other activities. Governments love to trumpet the success stories of the education system but thousands of students are still struggling with basic work such as reading, comprehension and numeracy.

Sure, the mandarins at the Department of Education and Training will claim they are getting round the problem of subject overload by integrating disciplines so that more than one can be studied at once. The idea is the kids can bone up on their numeracy skills while working on a gambling program. Or some literacy work can be included in lessons on personal health. But even with double or multi-skilling, the school day is in danger of becoming so overloaded with non-core subjects that the depth and quality of literacy and numeracy has to suffer.

For some time principals have feared their schools are becoming a dumping ground for programs that amount to little more than "social engineering". A few years back one school leader calculated that more than 60 extra education tasks were proposed in a 12-month period -- most of them by politicians or community interest groups. Many teachers believe most of these are issues that should be dealt with at home and are hot in claiming that parents have been abrogating their responsibilities.

Over the next three days a million students in Years 3, 5, 7 and 9 will sit the first national assessments in literacy and numeracy. In a country as wealthy and healthy as Australia, good results will be expected. But our children and their teachers could be going into these tests ill-prepared. Maybe Prime Minister Kevin Rudd needs to call another 2020 summit to work out exactly how schools should be spending their precious time. Before all the programs piling up on their desks collapse under their own weight.

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