Background
This case relates to the professional conduct of Dr Rakhi Basu when she worked as a junior doctor at Bacchus Marsh Hospital under the supervision of Dr Surinder Parhar, a senior doctor and the Director of Obstetrics between 2008 and 2011. During this period, there was a higher-than normal perinatal mortality rate at the Hospital – babies who died immediately before or after birth – a much higher mortality rate than would be expected from a Level 3 Maternity service.
The Medical Board of Australia (Board) alleged that Dr Basu failed to provide clinically appropriate obstetric care and/or keep proper clinical records of care provided, in respect of seven patients in her care who delivered their babies, four of whom experienced adverse outcomes including stillborn babies.
Dr Basu had qualified and trained in India, and, in her defence, argued that she was conditioned to a ‘culture of following directions of those in authority without question’. However, the Tribunal considered that the culture, conditions, and standards experienced in a different health system by an overseas trained doctor before becoming registered in Australia, could not be relied on by the doctor as a mitigating factor.
Dr Basu recognised early that her skills were deficient and commenced training to qualify as a fellow of the RACGP in 2012. She also undertook advanced training in Obstetrics in 2014, obtaining her Advanced Diploma in Obstetrics in 2015, the same year she became a Fellow of the RACGP.
Outcome
The Tribunal found that Dr Basu engaged in professional misconduct in respect of her record-keeping and her clinical care and that she was to be reprimanded. The Tribunal’s characterisation of Dr Basu’s conduct, and the determination made, reflected the particular circumstances, including that she was a junior doctor working under the inadequate supervision of Dr Parhar who had the ultimate authority to make some of the critical decisions.
The Tribunal’s decision also reflected other mitigating factors, including the fact that it had been 10 years since the last of the conduct the subject of the case, and there had been no further disciplinary complaints. Dr Basu was now ‘a safe and competent medical practitioner’. The Tribunal also considered that Dr Basu gained insight during the course of the proceedings, by way of her admissions of the Board’s amended allegations. She acknowledged that her records were deficient, and fully accepted that she had her own obligations to provide appropriate care.
The Tribunal was satisfied that the combined effect of its findings, the reprimand it had ordered, and the publication of its reasons (which will remain on the public record) will meet the needs of general deterrence, whilst giving proper recognition to the many mitigating factors evident in this case. The Tribunal noted that if there had been fewer mitigating factors – including if Dr Basu had been more senior at the time, had lacked insight, or had not taken the steps she had taken since 2011, the outcome would have been different.
Implications
This case highlights the individual responsibility every doctor has, regardless of their seniority, their overseas training and experience, or how challenging their workplace may be, to ensure that their own practice is safe, and consistent with the professional standards expected of them as registered medical practitioners.
To read the decision in Medical Board of Australia v Basu (Review and Regulation) [2022] VCAT 1206 (26 October 2022), click here.
