Mackay Base Hospital midwives are incensed senior staff members — who ignored for months their complaints about an obstetrician being a serious patient safety risk — are still working at the facility and have not been reprimanded.
A midwife told the ABC she desperately tried to protect her patients from the hospital's former director of obstetrics, George Campbell Du Toit, by scheduling elective caesareans and inductions of labour at times he was not working.
She said "women were getting maimed" and Dr Du Toit was conducting procedures without consent.
"Every meeting we would talk about him, his behaviour, his surgical skills, his putting women in the intensive care unit, doing unnecessary caesars, his caesar wounds."
She said despite raising serious issues with senior hospital leaders for "many months", nothing was done.
It was only when the midwife — who asked to remain anonymous to protect her job — approached patient advocate Beryl Crosby, that she started feeling her complaints were being taken seriously.
Living 600 kilometres away in Bundaberg, Ms Crosby contacted the Mackay Hospital and Health Service's former chief executive Lisa Davies Jones and successfully pleaded for an external review.
'These women were being butchered'
The ABC has seen an email from a different Mackay midwife raising renewed concerns that senior leaders, who were repeatedly approached about Dr Du Toit after he began as obstetrics director in September 2020, are still working at the hospital and had not undergone "performance management" over their roles in the patient safety debacle.
Retired Queensland Nurses and Midwives' Union organiser Sharon Eaton confirmed she attended meetings during 2021 with senior leaders at the hospital where Dr Du Toit was discussed.
"This is really damning ... because they knew about it from day dot," she said.
"They were very much the type of people — nothing to see here.
"The frustration from nurses and midwives was unbelievable because they felt like they were getting nowhere. There was not one that I know of that didn't feel that these women were being butchered, for want of a better word, and also that the obstetrician had to go."
Doctor has since resigned
In mid-2021, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists pulled the Mackay hospital's accreditation to train junior doctors in the specialty.
Dr Du Toit was suspended pending the outcome of the review, but he resigned in March, before the investigation was finished.
In June this year, the Office of the Health Ombudsman imposed conditions on his medical registration, including banning him from practising surgery.
The reviewers' damning report, handed down on September 30, talked of hearing "harrowing stories" and found many women had sustained "lifelong physical and mental harm".
Some women told them their birthing experience at the hospital was so distressing they did not want to have any more children.
The investigation team found that in 2021 the Mackay Base Hospital's caesarean section rate "concerningly increased" from 31 per cent to 43 per cent.
They also noted that 21 bowel, bladder and ureter injuries — known medically as hollow viscus injuries — were recorded in just over 12 months during obstetric and gynaecological surgery. The expected incidence for a hospital of that size would be no more than one.
"When trainee doctors and midwives tried to raise concerns in relation to consultant behaviours, clinical practice and outcomes, their concerns were dismissed by senior staff," the report found.
It also noted that earlier intervention would likely have prevented further patient harm.
"There were clear failures within the nursing/midwifery and medical leadership team at organisational and departmental level.
"The investigation team conclude there was an inadequate response to concerns raised by midwives and nurses within the Women's Health Unit to their senior leaders in relation to patient safety issues."
References to individual health workers and patients have been redacted from the final report, with the reviewers noting that when they identified below-standard conduct, they referred the matter to the Office of the Health Ombudsman.
D'Ath not aware senior staff still employed
Handing down the review findings, Queensland Health Minister Yvette D'Ath said she was not aware that senior staff who ignored serious complaints about obstetric and gynaecological services at the hospital were still working there.
In a later statement to the ABC, she said the investigation team did not recommend any additional disciplinary action beyond five people referred to when the report was released, who were no longer working at the hospital.
In light of the Mackay review's shocking findings, Ms D'Ath pledged that Queensland Health would set up a centralised reporting process to allow staff to escalate quality and safety concerns if they failed to be addressed at a local level in a timely or proper way.
She promised to meet with hospital staff on October 18, when she will also attend a forum with women traumatised by their treatment at the facility's Women's Health Unit.
The ABC understands at least some of the women who suffered bladder and ureter injuries during obstetric or gynaecological surgery at Mackay Base Hospital, were then operated on by urologist Dr Daryl Stephens, who was also recently suspended by the hospital "over staff concerns about patient safety".
In 2018, Dr Stephens — who began working in Mackay in January 2016 after relocating from Western Australia — was fined $30,000 for engaging in professional misconduct in that state during his time there.
Despite that, he was allowed to continue to work in Mackay, in part due to a severe lack of urological services in the region.
Dr Du Toit was employed at Mackay Base Hospital after his contract at the Albany Health Campus in Western Australia was not renewed.
"I don't think their recruitment policy for doctors is very good as a hospital, on the whole," Ms Eaton said.
"They seem to end up with people who have been side swiped from other jobs."
Dr Du Toit was also accused of causing severe bladder and bowel problems in a young woman after he operated on her for endometriosis in South Africa in 2004.
Court papers allege Dr Du Toit severed nerves in her bladder and rectum.
The outcome of that litigation is not known.
Complaints will be 'appropriately acted on'
In a statement last night, the Mackay Hospital and Health Service (MHHS) acknowledged the findings of the obstetric and gynaecology investigation, saying it has "taken measures to ensure patients feel safe and respected when they receive care and that staff are supported in raising concerns".
"This includes strengthening clinical supervision, education and training and investing in new senior leadership and senior midwifery positions to support accountability, a greater safety culture and oversight of all teams.
"The health service has also implemented the Speaking Up for Safety program to empower staff to speak up freely to communicate concerns about safely."
MHHS said any patient complaints, regardless of when the care occurred, would be "appropriately acted on".
"This includes providing patients with the appropriate emotional and psychological support," the service said.
Patients who had received substandard care are urged to call the service's dedicated phone line on (07) 4885 6244 Monday to Friday between 8:30am and 4:30pm.
