A BASE BOARD
Dear Reader, we now need to look at the sorry saga of my patient DF and the Medical Practitioners Board of Victoria. Part of her Affidavit was read to the Open Hearing of 2006, but most of what was read at the Hearing was censored from the transcript, and there was no reference to the written submission (of which this saga formed part) in the Reasons – it was ignored.
Perhaps the best place to start is with the patient’s Affidavit:
State of Victoria
I, [Patient DF]
Invalid Pensioner, make oath/affirmation and say that: -
1) I was born on 12/4/1968. I developed Crohn’s disease when I was 14 years old, and had my ileostomy and bag when I was 21 years old. Over the years I have had multiple operations with removal of more bowel, drainage of abscesses, and changing stoma sites.
2) Apart from Dr John Nettleton and Dr Traill, I have not attended any other doctor for day-to-day management outside hospital. Dr Nettleton referred me to Dr Ross Elliott. After the medical treatments failed, I saw Mr R Woods, the surgeon, for surgery and most outpatients consultations. I saw Dr Nettleton for pain management until I changed to Dr Traill
3) About 1997 I commenced stronger medications by injections under Dr Nettleton. I was having increasing pain from bowel obstructions, abscesses and skin ulcers.
4) About 2000 to 2001 there commenced a significant deterioration of my condition, with long bouts of obstructions and anorexia, forcing hospital attendances. In September 1999 my weight was 69.5 kg, in September 2004 40.2 kg and, in August 2005, it was 47.1 kg. My medications changed to cover the pains which fluctuated by the hour, the day and the week. There was no real improvement over the ensuing years, with relapses and remissions of blockages, abscesses and pain.
5) My life has been dominated by my condition. I spent most of my time in bed or on a couch. As a hobby, but only when I felt up to it, I did needlework. I try to get up and go out shopping. During good times and adequate medication, I may be able to do this twice a week At other times, and without medications, I cannot even do simple tasks, like toileting. At times I wanted to die because it was so bad. If forced to endure the pains, I think I would gas myself. Without my medications I would have no quality of life. I have to work with my medications on an hourly basis to have a life.
6) In early 2005 there was a marked deterioration in my condition and I was admitted to St Vincent’s Hospital, where I was an Inpatient from 25/1/2005 to15/4/2005. I had further surgery, with wound breakdown and a high fistula leaking bowel fluid day and night, so that I had to wear towels or nappies across my stomach and was confined to bed or chair like an infant. When my bags leaked (most of the time) I developed excoriated skin and burns. To have bag/dressing change intervals longer than 4 hours was considered good! I was a cot case. After short spells at home, I had to be readmitted with my salts deranged. That was in June 2005.
7) Pain was always a problem and I was on intravenous drips for it and the salt imbalances caused by the high fistula. When I seemed to be holding my salts in range, there was talk of me coming home.
8) When I was in hospital in June and September, I was in a medical ward and I was uncertain who my Consultant was. If I saw him, I could not be certain if I would identify him. I did see Sally Bell in Outpatients
9) In June-July there seemed to be two forces within the hospital a) A group including Eugene, which allowed me activities and looked to physical improvement before considering other issues and b) A group involving Simon Brown, who seemed to change everything, not only for me, but for others in the ward. Treatments for pain were decreased without consideration of my physical condition, seemingly as a policy.
10) There was a decision to modify my medications on a weekly basis. Then it was daily and without discussion, which was not realistic. Because the Simon Brown group did not seem reasonable, I discharged myself.
11) I was always concerned when I saw Dr Traill after any admission and discharge, because the discharge information given to him always seemed different, both from what I knew of my medications within the hospital, and what they told me on discharge. It seemed as if they were telling lies.
12) Dr Traill said to me on a number of occasions, that he was never included in any conference for an ongoing, negotiated management plan centralized by the Hospital, and which would be suitable to me. He said that he had spoken to hospital officers about this.
13) When Dr Traill tried to follow the hospital’s discharge reports, the jump between inpatient (IV) and outpatient levels (Oral/patch), was most unrealistic and unbearable, which drove me back into the hospital. It was the timing, not the principle of medication changes which I could not accept.
14) My surgeon has told me that I have had so much surgery that I can never have any more inside by abdomen. This means that I am as good as I am ever going to be, which at the moment is not very good. I have thought about my medications and how I am, and I believe that, without my medications for pain, my quality of life would be, for all intents and purposes, zero.
15) Prior to the discharge (8/7/2005) before the last admission, Simon Brown said to me, (to the effect) that I “had to find another doctor (outside) because Dr Malcolm Traill* did not have the license to provide the medications that I needed, and that he was under investigation.” (*He used Dr Traill’s full name which, to me, indicated that he knew, [or knew of] him.) I found this hard to believe, because I had not had any problem with prescriptions written by Dr Traill. He was giving directions, including that correspondence was not to be sent to Dr Traill. I told Simon that I had only ever seen Dr Traill or Dr Nettleton. He made it quite clear that a Discharge Summary would not be sent to Dr Traill. Under this pressure, I nominated Dr Nettleton, even though I had only briefly seen him 20/6/2005 for a Specialist referral to Dr Traill. Otherwise, I had not seen him since 2003, when I obtained an original referral from him for Dr Traill. I still regarded Dr Traill as my treating doctor, and I believed that I could pick up the Discharge Summary from Dr Nettleton. Simon said that (to the effect) “I will talk to Dr Nettleton when you get out, so you will have a doctor.” I was upset, angry and tearful about this confrontation, and it took my friend about an hour and a half to calm me down. I found this all very humiliating and made me suspicious. On or about 2/7/2005, I had my friend camcord the medication sheet because I believed that more false information would be released upon discharge.
16) On the day of discharge I saw Sandra Middleton. I was under the impression that she was from Pain Management, but she seemed to be asking all the wrong questions and, once again, I became concerned.
17) I made an appointment to see Dr Nettleton. It was at midnight! I forgot it and made a new appointment. I saw him on 19/7/2005. He said that (to the effect) “the hospital has rung and I have heard that you have been through a lot.” He asked me if I used to see Dr Traill. I said “yes.” He then asked me to sign an authorization to obtain file(s), which I believed was for him to obtain my files from Dr Traill for his (Nettleton’s) assumed continuing management. He did not explain what it was I was signing, and for whom and, in the circumstances I trusted what he said to the extent that I did not read the document closely. I asked for a photocopy of the documents, including the discharge summary from the hospital. He went off to do this, taking some papers with him and leaving others, including the signed document, on the desk.
18) I had a look at the documents left on his desk in his absence and realized that I had signed for more than I had been told or had explained to me. I felt so angry that I had been tricked.
19) He returned with photocopies which added little. I asked for the nurse to photocopy what was on the desk and he said (to the effect) “you don’t need it.” But I had signed it and felt that I was entitled to it and I needed it. When I saw the Medical board logo on later letters, I recognized it from the document(s) on the desk. I am certain of this recollection.
20) I received from him a copy of the Discharge Summary and a letter from the Medical Board to Dr Nettleton, dated 13/7/2005, (Exhibit DF.1 [see below]). This seemed extraordinary in that I had not seen Dr Nettleton in any ongoing capacity since before about 1999, having only seen him briefly 20/6/2005 for the Specialist referral, and the Board was writing about a notification from Dr Nettleton, claiming that my identity was unknown, yet my initials are below the writer’s name! (The Discharge Summary did not appear to have any suggestion for a notification to the Medical Board.)
21) I received no prescription from him. I went home and contacted Dr Traill, telling him what had occurred. Dr Traill assured me that his Permits to prescribe were in order and current, and there was no problem that he knew of.
22) After I was re-admitted on 12/9/2005, Dr Traill came to visit me on the 19/9/2005. He brought a camera and photographed the drips, to document what I was receiving intravenously. As far as I am concerned, the same medications continued to be given at about the same rate until I was discharged – I was unplugged, and home I went on 24/9/2005, for Dr Traill to take over.
23) Since then, I have received letters from the Medical Board to have me change my cancellation of the authorization. In reply, I have indicated that I was not pleased with the way Dr Nettleton tricked me as part of some secret scheme and deception involving St Vincent’s Hospital, the Medical Board and him (at least).
24) The document that I signed did carry my name (Exhibit DF.2 [see below]) so, as shown by subsequent letters from the Board, which also included a copy of the signed document, my name was not removed (with the rest of the authorization) from the office of the Medical Board as I had instructed.
Sworn at _Heidelberg_____________________
in the State of Victoria, this _20th___day of
Signature of deponent making this Affidavit
Signature of authorized witness
The authorized witness must print or stamp his or her name, address, and other title under Section 123c of the Evidence Act 1958 [Vic.]. Person qualified to take Affidavits in Victoria include:
· The holder of an office in the public service of Victoria that is prescribed as an office of which the holder may receive Affidavits
· A member of the police force of or above the rank of sergeant or for the time being in charge of a police station
· A Solicitor who is a current practitioner
· A Justice of the Peace or a Bail Justice
· The Registrar or a Deputy Registrar of the Magistrates’ Court
Please note that the following persons are NOT qualified to take Affidavits – dentists, doctors, pharmacists, teachers, bank managers, accountants
Extracts from my contemporaneous diary sheet notes
Mid July 2005, after discharge from St Vincent’s Hospital, D claimed that she had been told that the Summary/Discharge notes would not be sent to me because I am “under investigation;” – they wanted her to attend another Doctor. She nominated Nettleton. She did contact him for a referral to me – he said (that) he would fax. one – but it never came. She applied to FoI, St Vincent’s for a copy of her file – she believes the policy of bypassing me is on a computer screen.
19/7/2005. She rang during (the) day and left (a) message – I rang back and left message – she responded. Says she has a letter saying that I am under investigation/s.
13 July 2005
Private & Confidential
Dr John Nettleton
Bundoora Medical Centre
39 Plenty Rd
BUNDOORA VIC 3083
Dear Dr Nettleton
Notification regarding Dr Malcolm A Traill
The information you have provided to the Medical Practitioners Board of Victoria has been considered and the Board wishes to progress to an investigation of the matter.
In the initial stage I have prepared a letter to your patient requesting her authority to access her medical records. Without such authority the door is left open for Dr Traill to refuse to provide information, should he so choose.
As the identity of the patient is unknown to the Board I ask that you be so kind as to address and forward the letter, which is attached hereto for which I thankyou.
For any inquiries please contact Christine McIntyre, Case Manager on & 9655 0560.
Manager Professional Conduct Department
Encl: letter to patient D.F.
You may note that the Reference number does not have Mr Smith’s initials ! – almost all issues involving me prior to this letter had “JHS” as part of the Ref. number. (Some of my concerns about Mr Smith had been placed before the MPB in April, with the Hearing 2005.)
THE SIGNED AUTHORIZATION
Location: Level 16,150 Lonsdale Street, Melbourne VIC 3000
Postal Address: PO Box 773H, Melbourne Vic 3001
Professional Conduct Department: 9655 0560
20 Jul 05
FORM OF AUTHORITY
To be completed by the patient authorising the Medical Practitioners Board of Victoria or its solicitors to obtain medical information from hospitals or doctors involved in the matter.
My name is:…………DF…………………………………………………………………
My Date of Birth is: 12 - 4 - 68
I hereby authorise X*……………………………………………………….
release to the Medical Practitioners Board of Victoria and its solicitors all
medical records and
reports concerning my medical condition and treatment.
to the Board and/or its solicitors about my condition and the treatment
Witness’ name…………………Joy Turner………………………………............
Note: Anyone of legal age may witness this Form of Authority.
*A sticker was attached with the request “Please note the name of the Doctor. Thank you.”
20/7/2005. I called-in. She produced (the) letter. Says Nettleton said (that) he would send referral. Claims he said that “they” want to have me deregistered. She gave me a copy of (the) letter from (the) MPB, 13/7/2005. . .
21/7/2005. D wrote letter to Nettleton, and V witnessed (it). She was adamant that she was not informed about the authorization before she signed and wasn’t given a copy. . . Claims to be keeping notes.
25/7/2005. D states Nettleton’s clinic rang her with results ~ one hour after I left her. . .
5 September 2005
Private & Confidential________________________________
(Suburb) VIC 3-
Dear Ms DF
Dr John Nettleton
The Medical Practitioners Board of Victoria has received a copy of the letter you sent Dr Nettleton on 21 July 2005 in which you retracted the permission you had given on 19 July 2005 for medical practitioners to provide information from your file to the Board.
In your letter you expressed concern that information may have been already accessed. I can assure you that no information has been accessed or even requested.
The Medical Practitioners Board of Victoria is the statutory organisation set up by legislation to protect the public from doctors who are unqualified, unprofessional in their conduct, impaired by ill-health or practising at a poor level. Dr Nettleton expressed his concerns that another practitioner who was treating you may have been managing your case inappropriately. The legislation gives any person the right to report such concerns, and it appears that Dr Nettleton was acting in your best interests.
The Board is an ethical organisation and requested your authority to proceed. You will note that the authorisation you signed does not in fact authorise the Board to do anything - it authorises a medical practitioner to access your records to obtain information. You did not complete the name of the doctor you were authorising, but I can assure you that the Board would only have used this form to seek a response from the doctor about whom Dr Nettleton expressed concerns. Your authorisation for that doctor is necessary otherwise that doctor would not be able to answer the issues that would be put to him.
By way of example, if the Board asked the doctor to explain his reasons for giving you specific treatments, he would not be able to reply unless he could access your records to find what he prescribed, when he did so and the reasons. Your authorisation was to allow him to do that to provide his response to any allegations against him.
As the allegations are serious, the Board requests you to reconsider about the authorisation. I have attached a copy of the form you already signed and ask you to consider adding the name of the doctor under question and returning it to us.
L 16, 150 Lonsdale St GPO Box 773H Facsimile: 03 9655 0580 Telephone General: 03 9655 050
Melbourne Vic 3000 Melbourne Vic 3001 email@example.com Registration: 039655055
If you wish to discuss the matter, please call Dr Conn Constantinou, an investigating officer to the Board, on 9655 0560.
Clare L Lethlean
Manager Professional Conduct Department
Encl: copy of your form
CC: Dr Nettleton
8/9/2005. . . Arrived at DF’s at ~09:45 h. She reported (that on) 7/8 (sic; try “7/9”) Nettleton’s receptionist left message to call him. She tried ~20:00 h, but recorded message. She tried 8/9 ~09:50 h – not in – try after 13:00 h. Will let me know.
9/9/2005. She tried ~4 times to contact him – not available/no reply; “can’t be too urgent.”
12/9/2005. Claims to have tried to contact Nettleton – not available/no reply. Concern about going to hospital – what to tell ?
15/9/2005. I called-in. D è Hospital ~2 days (ago). Saw VN. Says Nettleton not calling back. Two days (ago) received letter from MPB ? saying why they wanted a release authorization signed, and mentioned my name. He may get copy of it for me ! He rang ~12:30 h – he has a copy of (the) letter – me to pick up – (at) home all day tomorrow.
16/9/2005. I called to see VN – not in !!
17/9/2005. ~09:00 h, VN rings in – letter to be in letter box today (or) Monday. (At) ~10:20 h D rings. Letter defamatory. Long talk. Wants me to be “father” & “next of kin.” I said I will try to call in and see her* ~ midday Monday 19/7. She wants me to meet her doctors. (*She was in St Vincent’s Hospital)
19/9/2005. I visited D* (I picked-up letter). She signed authorization for Nettleton and letter for MPB (which was posted this afternoon ~17:00 h). She reports that Kerry implied that I was not a proper Doctor – I was unqualified. Noted that Nettleton gave first injections. I photographed infusion pumps.
24/9/2005. She left hospital. No comments made or pressure regarding prescriptions. No discharge note. It has been asked-for. No letter.
LETTER FROM MPB TO PATIENT DF
(The MPB was not supposed to know or hold her identity and address)
26 September 2005 Private & Confidential
(Suburb) VIC 3-
Dear Ms F
Dr John Nettleton
I refer to your letter dated 19 September 2005 noting that you did not receive a copy of the Form of Authority.
In a letter from the Board dated 5 September 2005 you were asked to reconsider your revocation of the signed Form of Authority that was provided to you by Dr Nettleton. The Board had asked whether you could add the name of the doctor in relation to the issues raised by Dr Nettleton.
Your signed Form of Authority is required to obtain a report from Dr Traill in relation to your previous management. The information received will be used in the Board's investigation and not released to any other persons. I trust the information I have provided clarifies the Board's request.
For any enquiries please contact Ms Chris Mclntyre, Case Manager, on 9655 0560 who will be able to explain this to you in person.
Manager Professional Conduct
Encl: copy of signed Form of Authority
L 16, 150 Lonsdale St GPO Box 773H Facsimile: 03 9655 0580 Telephone General: 03 9655 0500
Melbourne Vic 3000 Melbourne Vic 3001 firstname.lastname@example.org Registration: 03 96550555
Australia Australia www.medicalboardvic.ora.au Professional Conduct: 03 9655 0560
29/9/2005. Letter from MPB arrived – dated 26/9 – produced photocopy of authorization under Nettleton !!
3/10/2005. D writes letter è Lethlean. Nettleton didn’t cancel authority – she doesn’t know what it’s all about and (I) advise how to make a complaint about Nettleton ! Posted that PM.
I visited Dr J Nettleton
6/3/2006. Nettleton. Ushered into room ~14:35 h. Receptionist (at) ~14:45 h “He knows you are waiting – he has to make a ‘phone call.” Seen ~15:00 h. Lasted ~5 min. (Perhaps he was telephoning Mr John Smith for instructions ?)
Mention was made of the referral request in 2005. He claimed concerns over the referral (indefinite [time] requested), with what appeared to be a photocopy of a referral slip. He knew she was having injections of narcotics and wanted to “check with the Board.” Knew she was taking (oral slow release narcotic). Denied telephone/personal communication with St Vincent’s Hospital – claims (received) only the Discharge letter. He knew I was a Specialist.
DF was seen the next day (from my contemporaneous notes) -
7/3/2006. (She had made) no recent request for (a) referral slip ??
Nettleton started injections of Pethidine (= Demerol; meperidine)
She claimed that Nettleton had told her about the second visit (July) “poor bugger; really sick” and indicated (that) he had spoken to (the) hospital and knew what was going on.
(1) To this day (November 2007), I have not received any correspondence from the Board regarding the alleged complaint. This means either :
i A complaint was received, but that it was dismissed as trivial or vexatious – highly improbable, in the light of the ongoing correspondence, as detailed here (plus more), or
ii The alleged complaint was a creation of the Office of the Medical Practitioners Board of Victoria and collaborators (almost certainly). One may wonder if the activities ever came to the attention of the Board proper.
(2) The patient claimed that the document that she signed was presented to her with a comment (to the effect) “Just sign here.”
(3) Dr Nettleton was instructed by the patient not to forward the authorization on or, if it had been forwarded (it had), to have the MPB cancel it. This did not occur – her instructions were ignored.
(4) Professor Paul Desmond was involved, reported to be overseeing DF in the Hospital. (He seems to have been approached, in writing, by the Office of the Board (Mr John Smith) in 1997-8 for an “expert” opinion on the use of Lithium for Hepatitis C. The Board’s request letter to him at that time, was not produced subsequently under Freedom of Information (“FoI”). It should have been. A special relationship with the Office of the Board may be assumed. I Summonsed him before the VCAT Hearing, but he didn’t turn up and, like most of the others Summonsed, was never in a position to be asked to explain his roles.)
(5) The responses by the “Board” would, on occasions, seem too speedy for a properly constituted Board meeting, with a prior, issued agenda. The decision-making would seem to be within the Office of the Board independent of the Board.
(6) There can be little doubt that the Office of the Board was involved in plotting, scheming and planning. The operation involved, in addition to the Board’s Officers, Officers of St Vincent’s Hospital and Dr John Nettleton (at least). Some of the latter’s claims :
· That he had not communicated with the staff of St Vincent’s Hospital;
· That his concerns were merely over a referral slip for me, a Specialist,
would, in the light of the documentation, hardly seem credible.
(7) Dear reader, you may wish to pause now, and ponder on whether the activities of the Office of the Medical Practitioners Board of Victoria (as detailed above) have represented an isolated and one-off aberration, or whether they constituted part of a much larger campaign, involving the PSR, the Drugs & Poisons Unit and commercial interests. In this connection, I may quote the prophetic comment by a patient (and probably a “double agent,” who predicted some events) – “It’s personal; ‘they’ want you out of the system.”
(6) The aim here seemed to be to do what the HIC had done under the PSR Scheme – find some excuse to have a Panel of very wise and carefully selected “experts” tear apart, and closely scrutinize, all my clinical records, so as to find fault with almost everything – just as was done by the PSR Committee and, somewhat similarly, by the “experts” in the UHF Hearing of 2005 and 2006, when they pursued their campaign of defamation under privilege. Determinations invariably lacked parity with other cases.
(7) From what Patient DF saw and heard (see earlier), there can be little doubt that “they” were out to have me deregistered – by any possible means – and by all known methods; if “they” couldn’t find the evidence, they created it !
Malcolm A Traill 18/11/2007
Copyright © MA Traill November 2007, October 2009
Postscript (16/10/2009). The name "Clare Lethlean," as appears above, and related to the Board's nefarious activities, also appears as a Senior Associate of that obnoxious legal firm Minter Ellison. If there are two individuals involved, there would be a remarkable coincidence. If there is only one individual, with dual roles, the Board and Minter Ellison would have created an extraordinary relationship.
Date Medical Practitioners Board - Events of Interest
27/5/2004 Formal Hearing – Referral from the PSR
26/4/2005 Formal Hearing – First Part (3 day) – UHF Treatment
13/7/2005 Letter from Board to Dr Nettleton
18/7/2005 Formal Hearing Second Part (3 day) – UHF Treatment
19/7/2005 Patient DF unwittingly signs authority for Nettleton/Board
19/12/2005 Formal Hearing; Conclusion – UHF Treatment
28/3/2006 Formal Hearing; Finding – Drugs & Poisons
15/5/2006 The VCAT Appeal (6 day) – UHF Treatment
25/8/2006 The VCAT Order – UHF Treatment
12/10/2006 Formal Hearing; Determination – Drugs & Poisons
 The Drugs & Poisons issue – see elsewhere on the website (refer to “Kangaroo Court”)
 The Affidavit is presented here unsigned and with her identification details eliminated. A full signed copy was tabled with the Panel for the Hearing of 2006, after the Finding was announced
 Costs and other impediments meant that her massive file was never produced.
 This, and all other letters have been copied by OCR (to aid anonymity). Whilst all have some editing, the text, message
and general format are unchanged. Logos, the patient’s identification details and signatures have been removed
 Letter 21/7/2005 – the MPB received the signed authorization on 20/7/2005 (see earlier)