Victorian premier refers gynaecologist to police | 7.30

Key Concepts

• Laparoscopic Surgery: Minimally invasive surgical technique using small incisions and a camera.
• Endometriosis: A condition where tissue similar to the lining of the uterus grows outside of it, causing pain and potential infertility.
• Opera (Medical Regulator): The Australian Health Practitioner Regulation Agency, responsible for regulating health practitioners.
• Legal Professional Privilege: Protects confidential communications between a lawyer and their client from disclosure.
• Clinical Governance: The system by which healthcare organizations are directed and controlled.
• Whistleblower: A person who exposes misconduct within an organization.

Failures in Patient Safety: The Case of Dr. Simon Gordon

This report details serious concerns regarding the practices of Dr. Simon Gordon, a laparoscopic surgeon in Melbourne, and the systemic failures in oversight by both Opera (the medical regulator) and Epworth Hospital. The core issue revolves around allegations of unnecessary and excessively radical surgeries performed on women with endometriosis, leading to significant patient harm and a perceived lack of accountability.

Patient Experiences & Initial Complaints

Claire Gallagher and Sophie Wilkinson both underwent laparoscopic surgeries with Dr. Gordon for endometriosis. Both women reported experiencing significantly more pain and difficulty recovering compared to previous surgeries. Gallagher stated, “I couldn’t believe how I felt when I woke up. I couldn’t move…didn’t feel anywhere near as grueling and terrible as what I felt after this.” Wilkinson described her post-operative pain as “horrific,” including “screaming in pain” and “crying.”

Following their surgeries, both women sought a second opinion from a professor of gynecology at Epworth Hospital. The professor’s multidisciplinary team concluded that Sophie Wilkinson’s surgery was “neither necessary nor helpful.” He further stated that Dr. Gordon’s surgeries were “extreme and radical,” removing “way too much tissue” from the uterus, significantly increasing the risk of future surgical complications. This prompted the women to file complaints with Opera.

Opera’s Response & Criticisms

Despite the severity of the complaints and the expert medical opinion, Opera initially deemed Dr. Gordon’s actions to be within “an acceptable standard.” This decision has been heavily criticized. The professor who reviewed the cases believes Opera “dropped the ball” by failing to obtain an independent assessment from an endometriosis expert and instead accepting Dr. Gordon’s account of the procedures. Opera initially communicated to Sophie Wilkinson in October that there was “no indication that an inappropriate amount of tissue was removed.” However, following renewed pressure, Opera has now launched an investigation and agreed to reconsider the complaints, acknowledging it is “rare for the regulator to seek independent advice.”

Epworth Hospital’s Role & Concerns Regarding Legal Privilege

The report also raises concerns about Epworth Hospital’s handling of complaints regarding Dr. Gordon. Nurses who expressed concerns about his practices were advised by the hospital’s chief medical officer to submit their complaints through Epworth’s lawyers, which would invoke “legal professional privilege.” This means the communications would be confidential and not accessible to potential plaintiffs.

Plaintiff lawyers representing Gallagher and Wilkinson argue this advice was potentially designed to shield the hospital from scrutiny and prevent patients from understanding what the hospital knew about Dr. Gordon’s practices. As one lawyer stated, “This is what I find very difficult to understand in this circumstance is ultimately there were many layers to try and protect patients and they all seem to have failed.” Epworth Hospital denies this allegation, stating that the legal advice was not intended to prevent patients from accessing their health information and has commissioned an external review of its clinical governance.

Systemic Issues & Government Response

The Victorian Premier acknowledged “systematic issues” within the private health system, highlighting a culture where concerns raised by health professionals are silenced. A health professional interviewed for the report expressed fear of speaking out, a situation the Premier deemed “not acceptable.” The Premier emphasized the need to end the practice of “senior and powerful doctors protecting other senior and powerful doctors.”

To address these issues, the Premier has tasked Safer Care Victoria with overseeing Epworth’s clinical governance review and has written to the Victoria Police Commissioner, suggesting that performing unnecessary surgeries could constitute a crime requiring investigation. The Premier stressed the need to send a “message to health professionals about the sorts of standards we expect here in Victoria.”

Conclusion

The case of Dr. Simon Gordon exposes significant failings in patient safety protocols within the Victorian private health system. These failings encompass inadequate regulatory oversight by Opera, potentially obstructive practices by Epworth Hospital, and a concerning culture of protecting powerful medical professionals. The ongoing investigations and government response signal a commitment to addressing these systemic issues and ensuring greater accountability and patient safety in the future.