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A statement to the Australian senate describing Tenet's departure from Australia, my role in it , and its attempts to silence me.
This is the senate statement made by Senator Herron copied from the online Hansard. The full statement was printed in the journal Healthcover in its March 1996 edition.
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Australian Senate Hansard for 28th November 1995
Dr Michael Wynne
Senator HERRON (Queensland) (7.48 p.m.)--I rise today to bring to your attention the case of Dr Michael Wynne. Dr Wynne, a Queensland surgeon, has been a whistleblower in regard to the conduct of National Medical Enterprises. His case illustrates the way in which the law can be misused to stop whistleblowers from speaking out and the fact that multinational companies can pursue whistleblowers from outside Australia. National Medical is one of the largest and wealthiest owners of hospitals in the United States of America. It purchased a controlling interest in the Western Australia company Markalinga in December 1991. Markalinga was renamed Australian Medical Enterprises.
National Medical has recently paid out hundreds of millions of dollars to settle actions which include fraud, bribing doctors and even, extraordinarily, kidnapping patients. Over half of National Medical's US hospitals are now listed in a guilty plea to pay bounty for patient referrals. Australian Medical contracted to pay National Medical over $1 million a year for the services of a senior National Medical administrator and for access to National Medical's business expertise.
Dr Wynne first became alerted to National Medical's practices in 1988 when he went to Singapore following the death of his son. This was long before they were exposed in the United States but his protestations then fell on deaf ears.
In 1992 and 1993 Dr Wynne personally undertook an investigation of National Medical's practices, traveling to the USA at his own expense. The documents he brought back were a factor that caused the health department in New South Wales to advise against the granting of licences. The health department stressed the `lack of frankness' displayed by Australian Medical in its dealings with the department. National Medical claimed that the US directors of the Australian company knew nothing of the fraud. They claimed this occurred in a few hospitals only.
The health department was overruled by a judge delegate. Subsequent documents obtained by Dr Wynne from the USA included monthly reports to Australian Medical's US directors. These reported on the business practices in the hospitals where the fraud was perpetrated. The company's further expansion was restricted and they have now left Australia. This is in no small measure due to Dr Wynne's efforts.
As I mentioned previously, Dr Wynne's suspicions were aroused in 1988 and over the next few years he made his own confidential inquiries. He was concerned at the adverse consequences of National Medical's practices for patient care. He took action through the Singapore Medical Council and two doctors were suspended from practice.
In August 1991, Dr Wynne wrote to the chairman of the Singapore Medical Council to advise him of his concerns about National Medical's business practices in Singapore. I quote from this letter:
It (the information he obtained) suggested the exploitation of patients and the presence of unscrupulous and criminal activities in some portions of the medical services provided.
Those who ran the hospitals in Singapore subsequently became directors and administrators in Australian Medical. During 1993, Dr Wynne repeatedly raised his concerns with Australian Medical's Australian directors. Instead of addressing his concerns the company's lawyers threatened him with an action for defamation.
In October 1994, Dr Wynne obtained court documents from Singapore. In these a surgeon, Dr Alan Ng, alleged in evidence that hospital administrators, including those in Australia, had offered him financial rewards based on the number of patients he admitted to this hospital. The hospital's lawyer accepted that these negotiations had taken place but accused the doctor of proposing the unethical practices.
Before that trial the hospital indicated that several of those present at the meetings with Dr Ng would give evidence. The hospital did not call any of its witnesses to challenge Dr Ng's evidence, nor did they produce any evidence to support the slur they cast on his integrity. Subsequent to this, National Medical has pleaded guilty to identical practices in the USA.
Dr Wynne now felt an obligation to act. He was guided by the directive of the World Medical Association. This was formulated by the World Medical Assembly in October 1993. Both the Australian and the American medical associations are members of the World Medical Association. This directive states:
Should medical practitioners perceive circumstances which might adversely affect patient health, it is their duty to inform responsible authorities so that remedial action may be taken.
Should responsible authorities decline to take remedial action, reasons for the decision should be made known to the medical practitioners who reported the circumstances. Should such notification not be provided or should the rationale for the decision prove unconvincing, the medical practitioners concerned have a duty to take further actions.
Singapore authorities had not been receptive to Dr Wynne's concerns. Dr Wynne took steps to inform doctors in Australia and Singapore of National Medical's business strategies. He attempted to warn them of the pressures to which they might be subjected and the inducements which they might be offered.
Dr Wynne also took these court documents to Mr Griffin, Australian Medical's Australian chairman. Dr Wynne asked Mr Griffin to stand these persons aside while the matter was investigated. Mr Griffin refused to do so. The persons concerned had all been promoted. Some held senior positions in National Medical's empire and in the Federation of American Health Systems. This federation is a powerful group representing corporate medicine in Washington. It is dominated by National Medical Enterprises and Columbia Healthcare. Dr Wynne sent the court documents to this federation. They have never been acknowledged.
Soon after this, Dr Wynne received threats of defamation actions from the Singapore hospital, from Australian Medical and from Denis Brown, the National Medical administrator appointed to run the hospitals in Australia. These threats demanded that Dr Wynne sign retractions and admit that the aspersions he had cast and the allegations he had made were totally without foundation. Dr Wynne refused.
Denis Brown commenced a defamation action in March 1995. Dr Wynne made three applications to the court for orders that Brown detail properly what his claim was. Seven months later when Brown withdrew his action he had still not properly formulated his claim. Company reports indicate that National Medical funded this action. Brown's expenses exceeded $63,000.
Three days after Brown withdrew his action, Dr Wynne was served with a writ from the Singapore hospitals. Dr Wynne does not believe that he has overstepped the limits of legitimate comment but he is aware that the law in Singapore does not encourage whistleblowers. He intends to contest this action. Both of these actions relate to Dr Wynne's attempts to fulfil his obligations under the World Medical Association's directives and warn his medical colleagues of National Medical's unethical business practices. Dr Wynne has not been cowed by these actions.
Under the agreement which National Medical made with the US justice department when it pleaded guilty to criminal charges in June 1994, National Medical set up an ethics committee and a compliance program. To escape its past, National Medical has changed its name to Tenet Healthcare. It claims that this new name with its positive associative meaning reflects a new commitment to integrity. I quote from National Medical's company report to the United States Securities and Exchange Commission:
Our compliance program is directed by a management level committee, chaired by Michael H. Focht Sr., president and chief operating officer, and supervised by the ethics and quality assurance committee of the board. We have made it very clear that NME will not tolerate ethical misconduct.
A curriculum vitae issued by National Medical in 1993 indicates that Focht was president of National Medical's international division at the time when Dr Ng alleged the company's vice-president and other staff were offering him unethical inducements. It also indicated that he was a director of the Federation of American Health Systems. He became a director of Australian Medical in 1993. He is therefore likely to have been involved in the decisions to refuse to investigate the Ng allegations and to prosecute Dr Wynne through the courts.
Dr Wynne believes that Tenet cannot claim a new integrity and a willingness to address ethical issues when at the same time it refuses to explain why it failed to challenge allegations of unethical practices and then launched defamation actions against those who challenge their failure to do so. Dr Wynne is asking National Medical to honour its public commitment to integrity and its statement that it will not tolerate ethical misconduct. He has asked Tenet's ethics committee to investigate the conduct of National Medical's international division in Singapore, to investigate their refusal to explain why they did not properly contest the Ng allegations and to examine the ethical implications involved in taking defamation actions against him.
He is particularly concerned at the possible
involvement of Focht in these activities because Focht is now in
overall charge of Tenet's compliance program. The welfare of patients
in Tenet's hospitals will depend on the integrity which Focht
displays in fulfilling his obligations under the compliance program.
Dr Wynne is asking his medical colleagues in the USA to support his
complaint. He believes that strong pressure will be required to
induce Tenet to confront the evidence he has supplied.
NB The Singapore hospitals withdrew the action and paid costs. There has never been any suggestion that the new owners of the hospitals have ever indulged in undesirable practices.
Formatted for WWW 29 December 1996 by Michael Wynne