'Patel's hospital was under pressure to improve performance'

The hospital's former director of medical services, Darren Keating informed the court that there was great pressure to reduce patient waiting times from Queensland Health, local residents and politicians, The Courier Mail reported on Wednesday.He was being cross-examined on the 22nd day of a trial in which Patel, dubbed as 'Dr Death' by the media, is charged with three counts of manslaughter and one of grievous bodily harm in connection with the death of his patients.

Keating told Michael Byrne, the lawyer for Patel, how politicians were putting on pressure to have operations and treatment performed as close to "home" as possible. He agreed with Byrne that he had inherited a "difficult job" which had "horrendous waiting lists" of up to two years.

"It was a system that was grossly underfunded," Byrne said to which Keating agreed. Byrne asked if Keating remembered the then Premier Peter Beattie being re-elected with a promise to increase funding for Queensland Health, and hospitals being encouraged to apply for extra. Keating agreed that this was through increased elective surgery but there was no "impact" on staffing numbers. He also recalled a personality clash between Patel and the head nurse in the intensive care unit and agreed with Byrne that one of the areas of their clash was an increased workload for ICU.

He agreed that Patel had a hard work ethic and worked for long hours. Byrne suggested Patel had made an active effort to reduce waiting lists on which some patients had been waiting for two years."I suggest there were literally hundreds of ring-back green folders containing these cases which had not been attended to," Byrne asked. Keating said he did not know exactly how many, but that there were a number of them.

He also agreed with Byrne that there were some people at the hospital trying to undermine Patel. Earlier, Keating said that he had no idea that Patel was under disciplinary restrictions in the US when Patel was performing operations at the hospital.Keating said he had regular weekly meetings with Patel which involved a general rundown on surgery and the workings of Patel's responsibilities. "On a number of occasions he made suggestions about improving theatre efficiency and also increasing the number of clinics to see long-outstanding patients," he recalled. The suggestions were useful and, on the whole, they were adopted and it added to his impression that Patel was an experienced surgeon, he said.

He said he had a purely administrative role with Patel directly below him as the director of surgery. The jury was hearing the final leg of the crown case involving allegations that Patel was responsible for the death of patient James Phillips.