Doctor accuses Te Whatu Ora of ‘conspiracy’ to avoid public scrutiny of unsafe radiology practices

A senior doctor has accused Te Whatu Ora - Health New Zealand of a “conspiracy” to avoid publicly disclosing unsafe radiology practices that harmed multiple patients, the Herald can reveal.

In an extraordinary step, Dr Bryan Wolf, a consultant radiologist in Hawke’s Bay, has asked the Ombudsman to investigate what he describes as the national health authority’s failure to inform the public about significant safety risks in the radiology service where he is a senior medical officer.

The Herald has obtained two letters Wolf sent to Chief Ombudsman Peter Boshier in July in which he alleged that Te Whatu Ora withheld important information despite his insistence it be made public and questioned its commitment to accountability.

“I believe this can now reasonably be labelled a conspiracy to defraud the general public of their knowledge and health,” he wrote in one of the letters, which have not previously been reported.

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Late last year, Wolf alerted Te Whatu Ora’s board and national leadership to problems he alleged put patients and employees at risk of “permanent, life-altering physical, emotional, psychological, cultural and professional harm”, according to his letters to the Ombudsman.

In response, Te Whatu Ora commissioned a review of Hawke’s Bay’s radiology department which was completed in April. According to people who have seen their report, the reviewers found long-standing flaws in systems and a culture that endangered patients and left staff feeling isolated and helpless.

At the centre was an IT system so defective that radiology reports were not delivered to doctors who requested them and clinicians were forced to adopt risky workarounds.

The review raises wider questions about the quality of patient care, staffing levels, technology systems, governance and accountability in hospitals at a time when New Zealand’s health sector is under enormous strain, one of the sources said.

But the report was not made public after it was completed, and Te Whatu Ora refused to release it when a journalist at RNZ requested the document under the Official Information Act in May, on the grounds that disclosure would identify a whistleblower – Wolf.

Wolf was infuriated by the decision not to release the report. In one of his letters to the Ombudsman, he said he made it clear to the reviewers and Te Whatu Ora executives that he wanted the public to know about the safety issues and did not expect his identity to be protected.

“Beyond any reasonable doubt, the Te Whatu Ora board and executive leadership team were exhaustively and intimately informed of my consent to open disclosure and my desire for institutional transparency,” Wolf told the Ombudsman.

Wolf described Te Whatu Ora’s decision to withhold the report as “grossly oppositional to the public’s interest” and its use of whistleblower-protection laws to justify non-disclosure as “egregious”.

“This OIA refusal furthers my written concerns that Te Whatu Ora is an organisation expecting to be unaccountable to the public and external oversight agencies,” he wrote to Boshier.

Dr Bryan Wolf, a consultant radiologist in Hawke’s Bay, has asked the Ombudsman to investigate what he describes as the national health authority’s failure to inform the public about significant safety risks in the radiology service where he is a senior medical officer.

Wolf declined to comment for this article. The Ombudsman’s office had not responded to a request for comment at the time of publication.

After the Herald contacted Te Whatu Ora about Wolf’s allegations last week, the authority reconsidered its decision to withhold the report. A spokesperson said it is now preparing to make the document public “as soon as we can”.

Richard Sullivan, Te Whatu Ora’s chief clinical officer, told the Herald there had not been a deliberate attempt to conceal unsafe practices from the public and that Te Whatu Ora had followed legal advice on refusing RNZ’s OIA request.

“We’re not trying to hide anything,” Sullivan said.

Sullivan praised Wolf for alerting national leadership to the safety problems. “We should be thanking Bryan. He saw some clinical issues, he raised concerns. And that was taken seriously.”

Sullivan said Te Whatu Ora is working through 18 recommendations made by the reviewers, including conducting a thorough investigation of the harm patients suffered because of the unsafe practices. Other actions it is taking to improve the service include technical upgrades, improved operating procedures and a new CT scanner.

Sullivan said he has been assured Hawke’s Bay’s radiology systems are now “safe and stable”, although “we have got a long way to go” before they are optimal. He was confident other hospitals have not experienced the same level of harm because of these problems.

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Wolf was not the first person to raise the alarm about defective systems in hospital radiology services.

In September last year, an official at Te Whatu Ora circulated a memo identifying “alarming” systemic problems in hospitals in the lower North Island.

These included scan results not being sent to doctors who requested them, life-threatening conditions being missed because scans of different body parts were not linked, and radiology staff being so “jaded” by bad systems that they stopped reporting problems to their superiors.

“In working through this paper, I have been alarmed at the clinical risk inherent in the system, the acceptance of such risk in the region and extremely laborious mitigation processes districts are willing to undertake to try to mitigate these,” the memo’s author said. “They are not raised anymore and simply accepted.”

According to the memo, which was first reported by RNZ last September, these dangerous practices were common across the region and had a high chance of “patient death or life-changing delay to treatment”.

Soon after that memo was circulated, Wolf began raising his own concerns to Te Whatu Ora’s leadership.

In one of his letters to the Ombudsman, Wolf said Te Whatu Ora had forced him into a position where he had no choice but to take his concerns outside the organisation. He said he felt betrayed by his employer and was worried about the professional consequences of speaking out.

Sullivan told the Herald: “Clearly, Bryan is very distressed over this, and that’s not okay. None of our staff should feel that way. None of our staff should feel that they need to write to everybody to be heard.” Sullivan had a meeting with Wolf to discuss his concerns on Friday.

Wolf has also alerted Health Minister Dr Ayesha Verrall’s office to the problems he identified.

In a statement, Verrall said: “I have been briefed by my officials on safety concerns raised regarding the Hawke’s Bay radiology department, including the external review report. I expect Te Whatu Ora to implement the report’s findings in full.”

Alex Spence is a senior investigative journalist based in Auckland. Before joining the Herald, he spent 17 years in London where he worked for The Times, Politico, and BuzzFeed News.

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The Herald will continue reporting on the impact of the staffing crisis in New Zealand’s hospitals and we need your help. Do you have information on this topic? Have you or someone you know missed out on treatment because of these problems? Are you a hospital employee working under difficult conditions? Do you have documents that can help us shed light on these issues?

We want to speak to as many people as possible who have experience in the system, to ensure our reporting is thorough and accurate. You can reach the Investigations Editor Alex Spence by email (alex.spence@nzme.co.nz), secure Signal messaging (0272358834), or post (The New Zealand Herald, Private Bag 92198, Victoria St West, Auckland CBD 1142). We can’t reply to all submissions because of the volume we receive. We will not publish your name or identify you as a source unless you want us to.