Channel 7 Today Tonight (Adelaide)
Dr Rabone and the Medical Board 5 April 2004

This version of the transcript has been edited by Dr Robert N Moles

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In order of appearance

Leigh McCluskey - presenter.
Mel Lowe - Member of the Board of the Barmera Hospital.
Graham Archer - producer and interviewer.
Jan - former nurse at the Royal Adelaide Hospital.
Professor Ross Kalucy - Member of the Medical Board of South Australia.
Dr Rabone

Program

Leigh McCluskey

Good evening. Tonight we raise questions about the drug using doctor who worked in South Australia and is accused of infecting at least a dozen of his patients with hepatitis C. Now the South Australian Medical Board hasn't taken kindly to our criticisms of its role in the handling of Dr Stephen Rabone. Even when they knew of Dr Rabone's drug abuse they didn't tell the community hospital where they allowed him to work and where innocent patients may have become the victims of his hep C contamination. Now we've also heard that nursing staff also had serious concerns about Dr Rabone's behaviour when he worked at the RAH years before. Perhaps if the Medical Board had asked the right questions they would have discovered that Dr Rabone's drug problems had been chronic for years. But instead, as Graham Archer reports, they let him practice over and over again.

Board member - Mel Lowe

I was devastated to know, to think, under my powers or that as a Board Member this was happening within the Hospital

Graham Archer

And these were people you knew?

Board member - Mel Lowe

Exactly.

Nurse - Jan

He shortened peoples lives, he's shortened peoples lives, not only his own.

Graham Archer

Last week we exposed the South Australian doctor accused of infecting at least a dozen of his patients with hepatitis C

Reporter on the street

[To Dr Rabone] Why didn't you tell these people sir, that you'd had a problem, and how are you still able to practice?

Graham Archer

The victims were unsuspecting people attending a public hospital for routine surgery - it could have been anyone.

Nurse - Jan

I thought that could be me on the table, that could be my mother, that could be my sister my brother someone I really love.

Board member - Mel Lowe

It was very rife throughout the community it was a well known fact because the nursing staff knew.

Graham Archer

So it was just common knowledge?

Nurse - Jan

That's correct.

Graham Archer

We also questioned the conduct of the Medical Board allowing a doctor with a serious drug problem to continue treating patients. The President at the time was Professor Ross Kalucy. And he's still on the Board.

Professor Ross Kalucy

I run the committee that looks at doctors' health. If a doctor is ill - I should say our Act requires that if a doctor goes to another doctor the Board is notified in case it endangers patient safety.

Graham Archer

Well it certainly did that. But Medical Board's response was call for the doctor - the spin doctor - engaging a PR firm to put out a press release denying all responsibility. With not even a hint of regret for what's happened.

Graham Archer

Having seen that story what do you think is an appropriate response?

Nick Xenophon MLC

We need a Parliamentary enquiry to get to the truth find out what happened and ensure this never happens again.

Graham Archer

Independent MP Nick Xenophon is a member of the committee set up to oversee the performance of bodies like the Medical Board

Nick Xenophon MLC

An overhaul is long overdue. This is something that goes beyond party politics. This should be something that gets bipartisan support because the health and safety of patients in the health system has to be a priority.

Graham Archer

The Board has tried to deflect from the damage by claiming Rabone was only in South Australia between 1988 and 1991. A check of their own files should prove this to be wrong. And if they took public interest as seriously as we do they might have discovered Dr Rabone was here as early 1981 - and had a serious drug problem even back then.

Nurse - Jan

And when I saw him on television I couldn't believe it was the same man

Graham Archer

Jan is an Adelaide nurse of almost 30 years experience.

Nurse - Jan

I worked in the Anaesthetic Department at the Royal Adelaide Hospital.

Graham Archer

So you closely attended the work of which ever anaesthetist was on at the time?

Nurse - Jan

Absolutely, absolutely.

Graham Archer

And as it turned out in the early 80's one of those anaesthetists was Dr Stephen Rabone.

Nurse - Jan

The circumstances were that remain vividly in my mind to this day. He asked me in a short space of time - he asked me to get him narcotics - Pethadine and in a short space of time - say half an hour to an hour - I got him four to five ampoules of Pethadine. And I remember the Registered Nurse saying when I collected the fourth or fifth one "What's he doing with them?" and I just shrugged my shoulders and said I don't know.

Graham Archer

However it wasn't long before she found out. Dr Rabone left the operating theatre for the toilet.

Nurse - Jan

He was gone for four five minutes.

Graham Archer

The operation going on?

Nurse - Jan

The operation - and I was left to look after the patient.

Graham Archer

And when he returned?

Nurse - Jan

He was just walking around like he wasn't an anaesthetist - he didn't care about the patients - the minute he got to me - I just had a panic attack - a massive panic attack. Here he is floating around - I've got him 4 to 5 ampoules of Pethadine in a very short time - and here is the patient waking up.

Graham Archer

Did you have genuine fears for the welfare of the patient?

Nurse - Jan

Absolutely, absolutely, my heart was in my throat - I couldn't get out of there fast enough.

Graham Archer

Jan's shift ended but the operation went on. So she informed another nurse of what was happening.

Nurse - Jan

I said please go down - Steve Rabone is down there and I think he's taken the Pethadine - please, please, please go down and check that I'm not hallucinating.

Graham Archer

Later that night the nurse called Jan at home.

Nurse - Jan

She said she got down there and she said "you're right - he was as high as a kite".

Graham Archer

Did you raise it with anyone?

Nurse - Jan

I did, I did. I thought - I'm just this small fish in this place - am I going to get into trouble?

Graham Archer

What's the policy with doctors who you know?

Nurse - Jan

But I thought I had to do it for other people. What if someone had died - choked on their own vomit - and he's just floating around?

Graham Archer

Jan approached a senior doctor who admitted they suspected something but had to catch him in the act.

Nurse - Jan

And I left really disillusioned. So he stays - if it was me and I stuffed up I would not be there.

Graham Archer

As far as she knows no report was made. But later the doctor confided to Jan.

Nurse - Jan

He said Steve Rabone has not re-applied to the Royal Adelaide - he's going to Melbourne as a GP and it will be more accessible to him there.

Graham Archer

So the implication was - as long as he's off our hands we're not too worried?

Nurse - Jan

That's how I understood it - that 's exactly right yes, yes, yes.

Graham Archer

In fact he went to New South Wales and predictably his drug habit intensified. The authorities stepped in twice over the next four years to limit his access to narcotics. Of course, this failed. And when he applied to come back to South Australia he was still addicted, but said nothing, and it seems no further questions were asked. And the Board still claims its actions were appropriate.
When you saw our story and saw what had happened to his patients when he came back to Adelaide - South Australia - what did you think?

Nurse - Jan

I was horrified - and I thought, oh - it's Steve Rabone.

Graham Archer

The rest, sadly is history. But the Board also criticised us for unfairly expecting Professor Kalucy to recall a case 13 years old. But that's not the case either. In 1999 professor Kalucy's Board resisted the victims' efforts to get the documents they needed by opposing access to their files, thereby hampering any public health investigation. But, it seems, the patients weren't the only ones the board the Board kept in the dark.
Was the Barmera Hospital Board told about Dr Rabone's drug history?

Board member - Mel Lowe

No, not to my knowledge.

Graham Archer

So you were completely ignorant of his background?

Board member - Mel Lowe

That's right.

Graham Archer

Mel Lowe was on the Barmera Hospital Board at the time Dr Rabone was given admission rights by the Medical Board.
Was the Board aware that there were conditions placed on his practice?

Board member - Mel Lowe

No, no not at any time.

Graham Archer

So, here's the body responsible for running the hospital and it's kept completely in the dark?

Board member - Mel Lowe

That's correct.

Graham Archer

What do you make of that?

Board member - Mel Lowe

Well, I would have thought it would be the responsibility of someone along the line to let the Board know so it could run the hospital the way it should be run.

Graham Archer

Now there was a member of the Board who was the supervising doctor who knew doctor Rabone had problems - but he kept it to himself. Did that concern you?

Board member - Mel Lowe

Yes it did. And it was only at later times I found that out - and that was never ever discussed in front of anyone on the Board to my knowledge.

Graham Archer

So there was a member of the Board who did know but because he was a doctor didn't disclose it?

Board member - Mel Lowe

Well I presume so. I don't know of his - I can't speak for him. But I certainly presume that would have been the case.

Graham Archer

That information was revealed on this program. When the cloak of confidentiality has been lifted we can see just how much at the mercy of the Medical Board's code of silence we are. But even when the Hospital Board became aware of problems - and contacted the Medical Board nothing much happened.
And you're saying that the response you got there was very slow?

Board member - Mel Lowe

It was very slow indeed.

Graham Archer

This, in contrast to the claims by the board's they acted promptly in their pr statement.

Board member - Mel Lowe

I used to go home from Board meetings and I couldn't sleep at night just thinking about the re-occurrence that could happen.

Graham Archer

And they let him continue practising? In another state?

Board member - Mel Lowe

It absolutely amazes me that that can be allowed to happen.

Graham Archer

The Medical Board's spin doctors say the conditions he signed up to clears their name. But he'd practiced under conditions for years and things just got worse. Whatever they thought at the time, how can they now say they acted appropriately?

Board member - Mel Lowe

Well I would have thought it would be any different and I can't understand why something wasn't done even before this.

Graham Archer

Meanwhile we still don't know how many patients have been affected here or in New South Wales.

Nick Xenophon MLC

At the very least the Government - the Health Minister Lea Stevens - should be undertaking a survey of all those patients of this particular doctor at the Barmera Hospital or any other patients of his to ensure they haven't been infected or impacted on in anyway.

Graham Archer

But so far the Health Minister Lea Stevens like the Medical Board has failed to express much interest in those innocent people now carrying this potentially fatal disease. Even though he denies responsibility, doctor Rabone himself has at least thought about it

Dr Rabone on the street

It was very, very sad what happened, very sad. It was very, very sad.

Graham Archer

Of course, there's not much chance for remorse when the Department which is there to ensure public health is protected - is engaged in legal action against the very people they were supposed to protect. All we can do is present the facts. The rest is up to our reluctant politicians.

Reporter on the street

You deny giving hep C to your patients by sharing needles? You deny that categorically?

Dr Rabone on the street

Absolutely.

Board member - Mel Lowe

My main concern now is that if one doctor has gone through all this procedures and getting away with it when's going to be the next one?

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