Mark Burton's doctor poorly supervised, tribunal told

By MARTIN JOHNSTON, Health Reporter

A doctor accused of inadequately caring for psychiatric patient Mark Burton, who killed his mother, received too little supervision, a medical tribunal has heard.

Dr Peter Fisher cared for Burton at Southland Hospital's mental health unit in February and March 2001.

A day after his discharge, Burton, who has schizophrenia, drove to Queenstown and killed his mother.

Dr Fisher denies malpractice charges laid against him in the Medical Practitioners Disciplinary Tribunal.

He had worked in mental health for 11 years but does not have the qualifications of a specialist psychiatrist and was employed instead as a "medical officer of special scale".

Yesterday, his defence lawyers called Waitemata District Health Board specialist psychiatrist and chief medical officer Allen Fraser as an expert witness.

Dr Fraser found fault with aspects Dr Fisher's care of Burton, including the brevity and seemingly superficial nature of interviews.

But he also blamed Dr Fisher's employer, saying it was inappropriate that he was allowed to function as an independent practitioner.

Dr Fisher did not seek an opinion from a specialist psychiatrist about Burton's refusal to speak openly about his delusions.

Dr Fraser said Dr Fisher should have paid more attention to the nurses' records of Burton's psychotic symptoms.

Supervision of Dr Fisher was inhibited by the health board's shortage of psychiatrists and its apparent assumption that a medical officer of special scale could function as one.

"Although Dr Fisher is not inexperienced, and he was a trainee in psychiatry in Liverpool for three years, he is not equivalent to a specialist psychiatrist and the Southland system erred in treating him as if he were."

But tribunal chairman Dr David Collins, QC, said the Medical Council's evidence was that under 1995 legislation Dr Fisher was not obliged to come under the "general oversight" of a specialist until mid-2001, several months after he cared for Burton.

Dr Fraser said that despite failings, the overall standard of Burton's care was fairly normal.

"It is unfortunate that that standard of care is accepted in New Zealand more often than it should be.

"It's not what I would expect or want in an inpatient unit. It is largely what people get."

Dr Fraser said Burton's carers focused too much on his use of alcohol and cannabis and too little on refining his dosage and type of anti-psychotic medication.

Family tragedy

* Schizophrenic Mark Burton fatally stabbed his mother, Paddy Burton, on March 31, 2001, the day after he was discharged from Southland Hospital's inpatient mental health unit.

* He was found not guilty of his mother's murder by reason of insanity.

* A report by the Health and Disability Commissioner concluded that care of Burton was sloppy.

* It criticised the Southland District Health Board and eight of its employees.

* The commissioner's prosecutor has charged one of them with disgraceful conduct or, alternatively, professional misconduct.

* The Medical Practitioners Disciplinary Tribunal hearing on the charges began in Invercargill, moved to Auckland yesterday and finishes today.