Corporate Governance Failure in Bundaberg Hospital: A Case Study

This report examines the corporate governance failures at Bundaberg Base Hospital, stemming from the appointment of Dr. Jayant Patel. It identifies breaches of conduct, including failures in credential verification, inadequate complaint systems, and a business-oriented approach prioritizing profit over patient safety. The report analyzes the negligence of hospital authorities, specifically Dr. Nydam, Dr. Keating, and Mr. Leck, and their roles in these failures. It also proposes governance and quality improvement mechanisms, emphasizing the importance of integrated systems, performance management, and effective complaint handling to ensure patient safety and quality of care. The report underscores the need for external evaluation of workforce skills and a balanced approach that fosters a good environment for rendering services and quality to patients.

Running Head: CORPORATE GOVERNANCE FAILURE
CORPORATE GOVERNANCE FAILURE
Name of the Student:
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Author Note:

1CORPORATE GOVERNANCE FAILURE
Answer 1
There are severe breach of conduct in Bundaberg Base Hospital when in 2004 Dr Jayant
Patel was appointed as the Senior Medical Officer. In this regard, there were four specific
corporate government practice that the hospital authority had violated in the process of not only
appointing Dr Jayant Patel out of provisions but also the aftermath where the authority failed to
safeguard the patient safety and the competency of the surgeon to operate a patient (Wilkinson et
al., 2015). It is considered to be a severe allegation for the Bundaberg Base Hospital authority
especially the Acting Director of Medical Services of Bundaberg Base Hospital, Dr Nydam and
later Dr Keating (Qphci.qld.gov.au, 2005).
In this respect, the case revealed a number of important aspects regarding the hospital
budgetary system. As per the legitimate system there are two ways that the hospital budget was
trying to finance. Firstly, there had to be a surgeon with Australian specialist qualification. For
an overseas trained specialist surgeon it was also required a clearance from the Royal
Australasian College of Surgeons (McEwen & Eldridge, 2016). The second was based on the
elective surgery throughput. The reason behind choosing Dr Patel as the best option the hospital
authority was intended to set the balance because an authentic recruitment required salary that
was way generous than the Queensland Health. The District Manager Mr Leck justified that it
was impossible for a district manager to exceed budget or he would be sacked.
The next failure was identified as the negligence of both the Medical board of the
hospital and the Queensland Health to check the credentials that Dr Patel was submitted to the
committee. In reality, Dr Patel had practiced in US but on the ground of disciplinary action the
US government seized his license to practice. Even he was unemployed for a year in the States.

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Therefore, it was the responsibility of the hospital management to cross check the credentials of
Dr Patel before appointing him as a Specialist surgeon (Gibson, 2016). This negligence from
management side led to a breach in the corporate governance framework and revealed the
incompetence of Dr Patel in a tragic and fatal way through the death of a number of patients.
In addition to this, the role of the higher authority and their leverage for Dr Patel was also
under the scrutiny of violation of the Australian Governance for Safety and Quality in Health
Service Organisation. The initial breach was made by the Acting Director of Medical Service of
Bundaberg Base Hospital, Dr Nydam who reluctantly skipped the practice of evaluating and
scrutinising through peer assessment and registered and appointed Dr Patel as the Senior Medical
Officer (Happell et al., 2015). The next breach was done by Dr Keating who despite of having
the knowledge that Dr Patel’s competence and skills were yet to be evaluated replaced Dr
Nydam as Director of Medical Service. As a result of that the credibility of Dr Patel became
unchecked.
The final allegation can be made on the context of maintaining adequate complaint
system to operate. It can be stated that Mr Leck was the responsible person who should address
the complaints from the colleagues of Dr Patel and from the patients as well. The principle cause
of such negligence was the way of treating hospitals. Based on the evidences it can be stated that
both Mr Leck and Dr Keating envisaged the hospital as a business enterprise where profit and
loss was accounted more than patient safety and quality of treatment. This business mentally was
equally responsible for damaging the corporate governance framework at Bundaberg Base
Hospital.

3CORPORATE GOVERNANCE FAILURE
Answer 2
There should be a feasible and effective governance mechanism that Bundaberg Base
Hospital will follow in order to bring efficacy into the practices of delivering an efficient
organisational mechanism. Therefore, a governance and quality improvement mechanism has to
be implemented by the organisation it will meet the primary purpose of providing quality
treatment to the patients. There are specific government policies and standards that all the
hospitals and health care institutes should follow. In this regard, the first aspect that the
organisations has to keep in mind is resembled with the quality improvement system. For
Bundaberg Base Hospital, an integrated system of governance and quality improvement system
has to be implemented. It will be effective to ensure patient safety and analyse the potential risks.
The next step will be associated with the performance and skill management system
where extensive scrutiny and evaluation of the managers and clinical workforce have to be
monitored and evaluated. For Bundaberg Base Hospital, there is already a process to evaluate the
performance and skill management. However, it is important for the organisation to employ an
external body that will take the responsibility of evaluating the ability and skills of the workforce
(Safetyandquality.gov.au, 2012). It will help to eradicate any kind of unethical practice created
within the organisation. In this regard, it can be stated that the role of the organisation is to set an
objective of providing high quality health care and treatment to the patients so that the patient
and their families can feel confident to visit in the hospital.
Furthermore, it is also important for the Bundaberg Base Hospital to procure an effective
compliant management system that will focus on the patient safety and quality. Any kind of
breach in the process or complaints against the hospital authority or the doctors can be addressed
through the use of complaints management. It is also the responsibility of the complaints

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management process to set patient rights and supports their engagement within the organisation
so that a benevolent and holistic nature of the organisation can be ventilated
(Safetyandquality.gov.au, 2015). It is important for the Bundaberg Base Hospital to set an
effective measure so that a balance between the ability of the doctors and efficient management
can be developed that in return foster a good environment for the organisation to render good
services and quality to the patients. The quality of corporate governance can also be developed
with the help of this mechanism.

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Reference
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patient-centred care in Australia?.
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(2015). Scoping review of research in A ustralia on the co‐occurrence of physical and
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McEwen, R., & Eldridge, J. (2016). Judges, juries and prejudicial publicity: Lessons from
empirical legal scholarship. Alternative Law Journal, 41(2), 110-114.
Qphci.qld.gov.au. (2005). Queensland Public Hospitals Commission of Inquery. Retrieved 5
September 2019, from http://www.qphci.qld.gov.au/final_report/Final_Report.pdf
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Safetyandquality.gov.au. (2015). Guide to the National Safety and Quality Health Service
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April-2015.pdf

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Wilkinson, A., Townsend, K., Graham, T., & Muurlink, O. (2015). Fatal consequences: an
analysis of the failed employee voice system at the B undaberg Hospital. Asia Pacific
Journal of Human Resources, 53(3), 265-280.