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RUBY:

From Schwartz Media, I’m Ruby Jones. This is 7am.

When nurse Amanda Duncan walked into parliament house in Tasmania last year, she was supposed to be giving evidence about ambulance ramping.

But what she actually spoke about was something completely different, and far more shocking.

She claimed hospital management had been altering death certificates, meaning deaths that should have been investigated were quietly recertified.

Those revelations triggered a public inquiry but questions have been raised about its scope and accountability, as new cases emerge that extend far beyond the initial inquiry including to other hospitals.

Today, writer and former editor of The Monthly Nick Feik, on his investigation into falsified death certificates and revelations of a broken health system.

It’s Thursday, March 13.

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RUBY:

So, Nick, you've been looking into the Tasmanian health system and it seems like there are some things that have been going seriously wrong there over a long period of time. So to start with, tell me about where this particular story begins.

NICK:

So this one begins when Nurse Amanda Duncan, a Launceston nurse, speaks at a public inquiry. So last year she appears at a public inquiry into ambulance ramping and under parliamentary privilege, she drops a bombshell.

Audio excerpt — Amanda Duncan:

“I have received 11 reports from doctors and nurses who have disclosed alleged misconduct relating to the death of a patient, including falsified medical certificates of death.”

NICK:

So the way that it should work is that all reportable deaths that occur in hospitals, those relating to like medical procedures, treatment or lack of, must be referred to the coroner. And this is supposed to provide a check on medical malpractice and to ensure that families know that their loved ones' deaths are being accurately recorded, and they find out whether or not, you know, it was preventable and what could be learnt from it. And you know, the documentation around patient deaths, it affects insurance claims, negligence claims, malpractice, worker liability and registration, it also affects hospital performance numbers. And you know indirectly health and government finances.

So the false reporting of deaths, you know, it's a criminal offence to potentially avoid this kind of scrutiny. And that's what appeared to be happening. At least 11 cases were raised by Amanda Duncan that avoided coronial investigation. And then her testimony led to an independent inquiry.

RUBY:

Okay. Tell me more about that independent inquiry. What did it find?

NICK:

Essentially, it found that we were looking at an even bigger scale. So the inquiry was led by a professor, adjunct Professor Debora Picone, and it soon identified further 63 cases of interest. It was investigating irregular practices in death reporting at this particular hospital Launceston General Hospital, and concerning a particular former staff member.

Audio excerpt — News Reporter (ABC):

“Doctor Peter Renshaw is at the centre of these allegations. He was the executive director of medical services at the hospital for almost three decades.”

NICK:

He's been reluctant to speak publicly, but he has issued a statement. He denies all allegations of wrongdoing.

Audio excerpt — News Reporter (ABC):

“He responded in an email saying I deny absolutely and categorically any wrongdoing, breach of the law or policy in relation to either the reporting of matters to the coroner or the completion of medical certificates of death.”

NICK:

And ultimately, the review examined 86 medical records and its findings, which were released in June last year, were incredibly damning. The review referred 29 new cases to the coroner for investigation and found 28 to have inaccurate documentation. It found the former staff member had engaged in a repeated pattern of acting outside the scope of the law. So it raised, you know, terrible questions.

And this is bearing in mind, just looking at two years of the Launceston hospital records over the 20, that this staff member had been involved, and it was only looking at Launceston, not more broadly, but it's still the tip of the iceberg.

RUBY:

Okay, so we're looking at dozens of cases of deaths allegedly not being reported to the coroner when they should have been, which I feel like I should underline, as you say, that is a criminal offence. So what happened then? Once this inquiry made those facts public, what did the health department do? What did the Justice Department do? What did police do?

NICK:

So the short answer is not much. The government response has been tepid at best. They promised to improve their processes around death reporting, The police, having earlier told Amanda Duncan that they weren't going to launch an investigation. Amazingly found that they didn't have sufficient evidence to press charges. The coroner's office, who had been pegged by the independent inquiry for being involved in the non referral of some of the cases, had refused to speak to the Picone review.

And weirdly, the health Secretary told Parliament that they'd literally be manually pulling files off a shelf in a randomised process. Now, unsurprisingly, this process hasn't led to any further findings, any further reports. So in some respects, all the whistleblowers and a lot of families are still hanging.

The new investigations that I've been doing indicate not only did the Picone review look at a very, very small subset of the cases that the government should know about. The cases stretch beyond Launceston General Hospital. The health department is still refusing to publicly acknowledge that there might be other hospitals involved, but I'm aware of staff from at least four other hospitals reporting to the health department about incorrect documentation of deaths, failures to send reportable cases to the coroner, improper input into the death reporting processes by the LGH management.

I've heard of cases with someone from a regional hospital finding that there was a second death certificate issued for a patient, two death certificates for the same person in the system. New accounts and allegations are emerging weekly. They stretch back in time further and they involve the current hospital management.

RUBY:

Coming up after the break - who is responsible?

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RUBY:

Nick, you’ve been looking into the deaths of dozens of people in hospitals in Tasmania, who should have had their cause of death properly investigated but didn’t. So tell me when you started digging into this, what did you find?

NICK:

I mean, I'd like to just give you one example of one case and the effect it can have on someone's life. So I spoke to a woman called Trish Davis, whose partner, Graham Davis, he was admitted into Launceston General Hospital for elective surgery in 2018. So following his procedure, he had a wound that became infected and it was mistreated such that he wasn't given antibiotics for a week. He died in the Launceston hospital, but his death wasn't reported to the coroner. Trish Davis, who was suddenly a widow, contacted the hospital and she suspected mistreatment or the misreporting of her husband's death.

RUBY:

So she thought that the symptoms that he'd had while in hospital didn't match the cause of death.

NICK:

Exactly. She tried to get it, referred to the coroner. She was knocked back several times. She went to the Health Complaints Commissioner. Eventually, the coroner did agree to look at it and sure enough, found that the cause of death was not a pulmonary embolism as had originally been put on the death certificate. He died of sepsis. So this really was a case of mistreatment in the hospital. Now, the death of her husband. She's been working to find out what happened for six years. And she had two incorrect death certificates. Her whole life has been turned upside down by this case. This is one case.

RUBY:

So what is actually going on here? Is this incompetence in hospitals? Is this malpractice being covered up? I know each case has its own nuances, but how is it possible that happening on a systemic level?

NICK:

I think there's a cultural problem that has developed over years. The Launceston General Hospital has had resource issues for years. It's had emergency department kind of waiting list and ramping issues for years. And I think over time, the hospital management basically decided that some cases would be easier just to sweep under the carpet than to have fully investigated.

RUBY:

And has there been any accountability at all in terms of senior hospital staff?

NICK:

So the former head of the hospital has had his AHPRA registration suspended, but there's been no explanation as to why the registration was suspended. He was cited for misconduct in relation to an earlier issue that I reported on as well, to do with a paedophile who was working as a nurse in the paediatric unit at Launceston General Hospital for 19 years, so under the same management. We don't know which of the reasons is behind the cancellation of his registration. But what we do know is that there hasn't been any police charges, no detailed police investigations, very little reaction at all.

RUBY:

Okay. I wanted to kind of ask you, I suppose, about accountability here, because it seems like what's happening is obviously this huge breach of trust. People are going to a hospital, their relatives are going in, they are not getting the right information about what's actually happened to them while they've been in the hospital's care. And then on top of it, there is this kind of sense of evasion of people having to wait years and pursue things on their own, using their own time, their own money in order to get any answers. And it seems like there is no one from hospital management up to government departments to police who want to take responsibility or to pursue this any further. So I suppose my questions are firstly, why do you think that is? And secondly, what is the effect of that?

NICK:

The effect is a general lack of trust in the health system, unfortunately, and it's devastating for people in northern Tasmania to feel that the health system might not be transparent. The idea that you might not be able to trust what you're being told by your doctor. For years, these rumours had been flying around among doctors and nurses at the Launceston General Hospital, and really, it was the bravery of Amanda Duncan to front up to a parliamentary inquiry and say, I've got these reports, I can provide this evidence.

But, you know, to watch for six months after she fronts up to this parliamentary inquiry, to watch it just be covered up again, to have an inquiry called that would only look into a fraction of what the problem is. It seemed like a deliberate act of evasion to me, not accountability. Calling an inquiry seems to now be a way of kicking the can down the road. So you announce terms of reference that will only look at a fraction of what the problem is. It takes six months. You then agree to implement the recommendations and then they don't get implemented. And years later you still have the same problems.

And you know, one more thing I would add is that if something like this had happened at the Alfred Hospital or Saint Vincent's in Melbourne or, you know, the biggest hospital in Sydney, we'd be talking about this nationally for months. And yet, because it happens in Tasmania, it doesn't get any national reporting. There's 29 cases just from a desktop review that should have been reported to the coroner. This is 29 families who don't know how their loved ones died. It goes way beyond just some paperwork problems. It's not just maladministration. This is a serious systemic problem. Anything could have happened.

RUBY:

Nick, thank you so much for your time.

NICK:

Thanks very much, Ruby.

RUBY:

You can read more of Nick Feik's investigation in this weekend's edition of The Saturday Paper, at thesaturdaypaper.com.au

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RUBY:

Also in the news today,

Prime Minister Anthony Albanese has ruled out imposing reciprocal tariffs on the United States, in retaliation against the Trump administration’s 25 percent tariffs on steel and aluminium, which came into effect overnight.

Anthony Albanese says his government will continue to advocate for trade with the United States “at every level, through every channel”, and that discussions with the Trump administration are ongoing.

And, it appears President Trump has attempted to boost the sales of his biggest political donor Elon Musk in a doorstop held in front of the White House yesterday.

With Elon Musk by his side, and a sheet of paper in his hand clearly listing the cost of Tesla vehicles, Trump told the media he personally will be buying a new Tesla, before getting into one of the vehicles and pretending to drive it.

The sales pitch came after Tesla stock plunged more than 15 per cent, in one of the company’s worst trading days since it went public in 2010.

I am Ruby Jones. This is 7am. See you tomorrow.

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