defamationwa

TO all the people mentioned in my websites

As far as I am aware, I have not breached any defamation laws.

The topics that I have raised in my websites, mainly, concern problems that I have encountered in my efforts to receive medical treatment for my eye conditions. The fact that I may suffer from a rare eye condition is largely irrelevant. In fact, because I suffer from a rare eye condition it only means that the failure or lack of treatment that I have experienced is even more reprehensible. I have not gone out of my way to maliciously or deliberately malign any person’s character or reputation. It so happens that I may have been subjected to cruel and inhumane treatment due to the lack of action on the part of certain members of the medical profession and the relevant Government Authorities and that I may have used one or two words out of context, but that is understandable under the circumstances.

The Defamation Act 2005 (The Act ) states that the law of defamation in Western Australia does not place unreasonable limits on freedom of expression and, in particular, on the publication and discussion of matters of public interest and importance.

The matters that I have raised in my websites are all to do with the lack of medical treatment and attention that I have experienced from certain members of the medical profession and the relevant Government Authorities and all of these are matters of public interest and importance . Under the Act, I am entitled to the publication and discussion of these matters. You may say that all I did was to recall the history of events as they occurred to me. If anyone has a different version of events or is offended by my version of events, then I am quite willing to consider altering my website or I am even willing to consider publishing their version of events on my website.

I would surmise that a possible excuse for their lack of action would be that as I suffer from a rare eye condition, then, nothing could be done for me. Though, to date, no one has offered that as an excuse to me. They are not prepared to offer such an excuse because they know that it is not true. There is treatment available for cases such as mine and it is outlined in my websites. It would be different if I were suffering from say retinitis pigmentosa. In that case nothing could be done for me and I would have to be left to my own resources. The fact remains that I do not suffer from retinitis pigmentosa. The problem in my case is that no one knows what lenses to use during a cataract operation for me.

Then there is the question of the lack of eye specialists for the treatment of glaucoma in Perth, the need for a new eye hospital in Perth, the abysmal treatment provided for patients at the Royal Perth Hospital Department of Ophthalmology , and the question of what currently happens to patients suffering with keratoconus and requiring cataract surgery. Surely all of these qualify as matters of public interest and importance.

I refer to Section 30 (3) (h) of the Act:

In determining whether the conduct of the defendant in publishing a matter about a person is reasonable a court may take into account whether the matter published contained the person's side of the story and if not whether an attempt was made by the defendant to obtain and publish a response from that person.

Mark McGowan

I refer to my letter to Mark McGowan dated 23 October 2018:

To: Mark McGowan

Subject: My Website

I am in the process of setting up my website.

It is my intention to post the attached documents on my website.

As you feature prominently in those documents, I have decided to give you the opportunity to object to anything that you may find defamatory or objectionable in those documents.

If I do not hear from you within the next 7 days, then it can be deemed that you find nothing in those documents to be defamatory or objectionable and that you have no good reason for objecting to my posting those documents on the World Wide Web.

I have to say that to date, I have not received a reply to that letter.

Roger Cook

I refer to my letter to Roger Cook dated 23 October 2018:

The letter was the same as the one above.

I have to say that to date, I have not received a reply to that letter.

Ben Wyatt --- the useless local member

No attempt has been made on my part to obtain a response from this individual. Judging by his lack of interest concerning my previous communications to him I very much doubt that he would even bother to reply. Besides, he did not feature prominently in my websites and I do not think that he would take offence at being called useless. I am sure that being a politician he has been called a lot worse.

Kate Doust --- the other useless local member

Ditto for Kate Doust.

Dave Kelly, Simone McGurk, Peter Tinley, Rita Saffioti, Paul Papalia, Ben Wyatt, Mick Murray , John Quigley , David Templeman , Francis Logan, Alannah MacTiernan ,Michelle Roberts, Sue Ellery, Bill Johnston, Stephen Dawson.

Yaz Mubarakai, Lisa O’Mally , Stephen Price, Martin Pritchard, Amber Jade Sanderson, Jessica Shaw, Jessica Stojkovski, Dr Sally Talbot, Mattew Swinbourn, Kate Doust, Chris Tallentire, Cassie Rowe, Samantha Rowe, Margaret Quirk, Reece Whitby , Sabine Winton , Lisa Baker, Dr Tony Buti, John Carey, Robyn Clarke , Alanna Clohesy , Adele Farina, Mark Folkard, Janine Freeman, Emily Hamilton, Mattew Hughes, Kyle McGinn, David Michael, and Simon Millman.

Ditto for all these members of the McGowan Government.

Dr Stafford at the Emergency Department at Royal Perth Hospital

A vain attempt was made by me to obtain Dr Stafford’s side of the story.

On 6 November 2017, I complained to HaDSCO about the treatment that I had received at the hands of Dr Stafford.

On 1 December 2017 HaDSCO wrote back to me:

Further to our discussion on 15 November 2017, I refer to the complaint you submitted to HaDSCO.

Your written complaint has been forwarded to the Royal Perth Hospital Consumer Engagement Unit (CEU) and their response will be provided directly to you. The CEU should be in touch with you to provide details of their process and timelines. The file with HaDSCO will be closed to allow this process to take place.

Erica John

On 19 December 2017 I wrote to HaDSCO:

I refer to your letter dated 1 December 2017.

The CEU did not provide me with any timelines. So I decided to obtain my own information...............

I feel that I have waited long enough. My case was an emergency case on 13, 15 September 2017 and it still remains an emergency case today. In such cases your requirements to take reasonable steps to resolve the matter should be moderated. In any event, how does RPH propose to resolve the situation? I have not heard one word from them so far.

On 20 December 2017 CEU wrote to me:

The CEU has been contacted by HaDSCO on your behalf regarding your concerns with the treatment provided in the Emergency Department at Royal Perth Hospital on 13, 15 September 2017.

It appears from your complaint issues that there may be some misunderstanding as to the role of and treatment provided by the consultant in the ED. The ED Consultant referred you to the RPH Eye Clinic for review of your condition and options for treatment.

In relation to the attendance of Security staff in the ED, staff advise that they could not meet your request for an immediate solution to your eye problem and you were not willing to leave the treatment area which other patients were requiring access to. It was felt necessary at the time for security staff to escort you from the area.

Emma Jasper

On 2 January 2018 I wrote to HaDSCO:

Complaint Re: Dr Stafford ED RPH and Emma Jasper CEU

I refer to the CEU letter dated 20 December 2017 which I received on 22 December 2017.

None of the issues raised by me have been addressed.

There is no misunderstanding on my part. I went to RPH because I was suffering from acute pain due to out of control glaucoma. I regard this as an emergency situation. I did not go there in order to make an appointment for a cataract operation. Dr Stafford’s only treatment for me was to show me to the door.

According to Dr Stafford , on 15 September 2017, she told me that she had arranged an appointment for me for a cataract operation on 10 November 2017. There was no mention of a review of my eye condition.

I am already aware of the options that are available to me. My options are severely limited. Every eye specialist in Perth that I have approached refuses outright to carry out a cataract operation for me. The reason is that I suffer from keratoconus. To date, no one in the world has managed to solve the problem of what lenses to use for a person suffering from keratoconus. The eye specialist scheduled to carry out the cataract operations at RPH on 10 November 2017 was Prof Morgan. He has no idea of what lenses to use for me either. If he does have an idea, perhaps he could tell me. My prescription for cataract lenses is: RE +3D, LE - 9D. What lenses would Prof Morgan propose to use for me? If he has managed to solve the lens problem for keratoconus then why has he not published a research paper on this subject and become world famous? Because it is not possible to carry out a cataract operation on my eyes, this means that it is not possible to carry out glaucoma surgery on my eyes as well. This means that I am currently solely reliant on eye drops in order to control the glaucoma. Once they cease to work, then all that is left for me is to undergo end stage glaucoma. This involves a painful process in which the pressure of the eye increases day by day. Would you regard this as an emergency situation and what would you do for me if I presented myself at the ED of RPH in this condition? Would you insist that a person treat themselves for such a condition and how would such a person deal with such a condition on their own? Currently, I have no eye specialist as my previous eye specialisit, a Dr Hock Meng Lim of Murdoch Ophthalmology, allegedly told me to find someone else and allegedly refused to treat me because I suffer from keratoconus.

I attended on 13 and 15 September 2017. Yet the appointment was to be on 10 November 2017. What was I supposed to do in the meantime?

I disagree that this was the correct action to take. Out of control glaucoma is an emergency situation

and requires immediate action and not action in several months time.

Emma Jasper and Dr Stafford have admitted that I was in acute pain and in need of urgent medical treatment. Yet my condition was not adequately diagnosed or treated. Before I attended at the ED at RPH , I attended at RPH A Block Floor 7. At that time there were patients being treated in the Ophthalmology Department. I could have been sent there and received diagnosis and treatment as well. If this was after hours, then an on call ophthalmologist could have been called out and he could have made an assessment of the situation and could have provided proper diagnosis and treatment. Dr Stafford cannot use the excuse that she did not have access to proper equipment because the Ophthalmology Department at RPH has adequate equipment. What is lacking is properly trained staff. I understand that Prof Morgan is in charge of the Ophthalmology Department at RPH.

For the information of Emma Jasper, Dr Stafford did not provide me with any advice. She only showed me to the door. Is Emma Jasper saying that Dr Stafford did not make an appointment for a cataract operation for me? Prof Morgan was scheduled to carry out cataract operations on that day. If cataract operations were not scheduled for that day, then what was I meant to do on that day? Was I merely meant to have the glaucoma checked? That should have been carried out on 13 and 15 September 2017 and not months later.

This is only another admission that I was forcibly turned away from the ED at RPH without any diagnosis or treatment. What was I expected to do? Apparently, I was expected to treat the acute pain due to the out of control glaucoma by myself. If that is the case, then why isn't everyone else expected to treat their own conditions?

Dr Stafford has admitted to using 3 security men to forcibly remove me from the ED at RPH. RPH should be ashamed of themselves and so should the State Government.

I am not happy with the outcome of this investigation and revert back to my letter dated 19 December 2017.

On 26 January 2018, HaDSCO wrote to me:

Complaint relating to RPH

I acknowledge receipt of your letter dated 2 January 2018 to HaDSCO. It is understood that you received a letter of response from CEU and that you were dissatisfied with this response.

Regarding the issue relating to the time taken for RPH to respond to your complaint, I refer to our letter to you dated 29 December 2017, detailing the relevant time frames and clarifying that the response was provided in accordance with the WA Health Complaints Management Policy.

With reference to your complaint relating to your experience in the ED at RPH, I note that you understood that your appointment at RPH on 10 November 2017 was for a cataract operation. RPH has informed HaDSCO that the appointment was for a referral for you to consult with an ophthalmologist.

As there is a conflict in fact and differing understanding of what the appointment was for, there is no further action that HaDSCO can take on your behalf and therefore your file has been closed.

Erica John

As can be seen, numerous letters were passed back and forth. Dr Stafford was given every opportunity to present her case. She chose not to do so and instead chose to hide behind a bunch of lawyers in the form of HaDSCO and the CEU.

In the end the case boiled down to her word against mine.

It didn't really matter anyway , because that was all irrelevant, because she had admitted to turning away a seriously ill elderly person from a public hospital with the threat of the use of force.

Prof Morgan - Head of the Department of Ophthalmology at the Royal Perth Hospital

The same arguments that were used against Dr Stafford can be applied to Prof Morgan.

As head of the Department of Ophthalmology at the Royal Perth Hospital , he would have been aware that an investigation was being carried out in relation to Dr Stafford, or if he wasn't, then he should have been aware of what was going on. He could have presented his version of events as well. He chose to remain silent. So, in the end it was not possible for me to present his side of the story.

Dr Hock Meng Lim of Murdoch Ophthalmology

On 14 November 2017, I received the following letter, thought to be a banning notice, by registered mail from Dr Hock Meng Lim:

Except for referral or requesting your records, I ask that you kindly refrain from any further contact with my staff or me by correspondence. I will not be monitoring any further correspondence from you.

Under the circumstances of a threat of legal action on the part of Dr Hock Meng Lim if I were to even approach him or a member of his staff, it was not possible for me to obtain and publish a response from Dr Hock Meng Lim.

However, he did give reasons for some of his actions in a letter dated 26 October 2017, again received by me by registered mail :

I first saw you on 20 July 2017 on referral for a second opinion regarding your glaucoma and cataracts . You were on Ganfort and Alphagan at the time of consult and your prior ophthalmologists had recommended surgery for you.

Additionally, because of the severity of your keratoconus, I felt you would benefit from a corneal specialist. I explained that keratoconus is an abnormality of the cornea, and calculating accurate intraocular lenses for cataract surgery would be difficult and would be better done by such a specialist. You then agreed to have investigations with me to at least ascertain the extent of the keratoconus I asked you to return in approximately 4 weeks for this.

You saw Dr Wiffen on 22 September 2017. He commented that you refused any testing and that you left without completing the consultation. He explained to you that he could not assess your eyes in a satisfactory manner for cataract surgery without the appropriate measurement.

On 26 September 2017, you attended my practice without appointment and I accommodated you. You felt your eyes were rock hard and you were concerned that the pressure could be sky high

I understand that you are also being followed up in Royal Perth Hospital and have an appointment on 10 November 2017 for your eyes. I encouraged you to keep this appointment as perhaps they can help with appropriate lens selection for you. I explained I would see you in 2 months to monitor your intraocular pressure and ensure they were controlled.

You returned to my practice on 5 October 2017 without appointment. I reiterated again that your cataracts should be performed and that this should be done by a corneal specialist as you may have refractive errors with which they can best assist. Given your experience with Dr Wiffen was perhaps not pleasing, I referred you to a different corneal specialist, Dr Andrea Ang. I have not treated you since this time and it is not apparent that you have been seen by Dr Ang.

Most startling to me, you allege in your correspondence that I told you to get out and pointed to the door at the conclusion of the consult on 8 September 2017. I have never told any patient to get out. I consider such dialogue very rude. I strive to ensure my patients are treated professionally at all times, with courtesy and kindness.

I am uncertain of what you mean by your allegation of leaving you to fend for yourself with a dangerous condition like glaucoma. I am a glaucoma specialist and I am passionate about treatment of this condition. I have never refused to see you. On the contrary, when you turned up at my clinic on 2 occasions without an appointment, I saw you that same day. I have always in good faith made follow up appointments to ensure your glaucoma is controlled.

On the surface, all of these arguments seem to be quite plausible until one analyses them a bit more closely.

Paragraph 1

On 20 July 2017, the anti glaucoma eye drops that I was using were Ganfort and Alphagan. The previous ophthalmologist told me that they were not working anymore as the pressure readings that he had obtained were 25 mm of Hg and that I required glaucoma surgery. As he was not qualified to carry out glaucoma surgery he advised me to find a suitably qualified glaucoma surgeon which I proceeded to do. Incidentally, my optometrist measured my eye pressure and also obtained readings of 25 mm of Hg. When it came to Dr Hock Meng Lim measuring my eye pressure, all of his measurements were less than 18 mm of Hg which I thought was rather unusual at the time. Consequently, he kept me on Ganfort and Alphagan. The reason that I thought it was rather unusual was that both parties could not possibly be right. Either Dr Hock Meng Lim was right, and my previous ophthalmologist and my optometrist were both wrong or vice versa. For instance, on one occasion Dr Hock Meng Lim obtained a reading of 11 and 12 mm Hg. I had never ever obtained such low readings in my whole life and to this day, I have never managed to work out how Dr Hock Meng Lim could obtain such low results.

Paragraph 2

Dr Hock Meng Lim refers to the severity of my keratoconus. I disagree with him on this score. Severe keratoconus occurs when the cornea keeps expanding and eventually bursts requiring a corneal transplant. My corneas have been stable for many years now and not in need of any corneal transplant. Dr Hock Meng Lim felt that I could benefit from seeing a corneal specialist but did not give any good reaons for my seeing a corneal specialist. Any corneal specialist would be faced with exactly the same problems as Dr Hock Meng Lim encountered. At first I could see some logic in Dr Hock Meng Lim’s reasoning. Maybe during a cataract operation the cornea may develop a tear or split and a corneal specialist could quickly salvage the situation by carrying out a corneal transplant. But this is just ludicrous speculation. What is required is a highly competent cataract surgeon not a corneal specialist. I do agree with Dr Hock Meng Lim that keratoconus is an abnormality of the cornea. I agree that calculating accurate intraocular lenses for keratoconus would be difficult. What makes the situation difficult is the degree of irregular astigmatism that is present. The main problem is the anisometropia present due to the asymmetry of the two eyes. I disagree with Dr Hock Meng Lim that calculations involving intraocular lenses for keratoconus would be better done by a corneal specialist. This is a ridiculous statement to make. A corneal specialist and a cataract specialist use exactly the same equipment and software in their calculations. There is always some error in these calculations due to the

fact that the artificial lens tends to shift after the eye has had a chance to heal. A cataract specialist is in a better position to make allowances for factors such as these.

As stated before, a corneal specialist and a cataract specialist use exactly the same equipment and software in their calculations when it comes to doing a cataract operation. There may be some variation between surgeons due to the fact that they may use a different formula or different constants best suited to their techniques. Whatever the case may be, they would all be measuring the same eye when it comes to carrying out a cataract operation on my eyes. Dr Hock Meng Lim obtained the following results: RE + 3D, LE - 9 D. What results was he expecting Dr Wiffen or Dr Ang to obtain? If he was expecting them to obtain vastly different results from his , then he was just fooling himself because my previous ophthalmologists all obtained similar results to his. There may have been some variation, but it was only slight. So, whoever carried out the operation, every one would have been faced with exactly same problem of what lenses to use. So that using a corneal specialist would be of no advantage to me whatsoever. In fact it would have been a distinct disadvantage for me because I required someone who was skilled in cataract and glaucoma surgery, not someone who was skilled in corneal transplant surgery.

I refer to clause 4.3 of the Medical Code of Conduct of Australia:

Referral involves a doctor sending a patient to obtain an opinion or treatment from another doctor. Referral usually involves the transfer of responsibility for the patient's care for a defined time and for a particular purpose such as care that is outside the doctor's area of expertise.

Clause 4.3.1: The doctor who refers a patient must take steps to ensure that the patient is referred to someone who has the qualifications, experience, knowledge, and skills to provide the care required.

Dr Hock Meng Lim referred me to Dr Wiffen and Dr Ang. He referred me to them for the purposes of having a cataract operation. He was a cataract and glaucoma specialist himself and more highly qualified than they were in that area of surgery. Yet the Code clearly states that a doctor may only transfer a patient for care that is outside the doctors area of expertise.

I refer to a letter from Dr Hock Meng Lim to Prof Morgan dated 26 September 2017:

I understand he is due to see yourself Bill on 10 November 2017 and in fact I have asked him to keep this appointment because perhaps he will be more open to seeing one of the corneal specialists at Royal Perth Hospital for his keratoconus. I have tried to offer this to him but he tells me that he will not attend this appointment with you on 10 November 2017. Nonetheless I think it is important that I keep you in the loop and if anything new crops up ...................... understands that I have been recommending to him the importance of seeing other specialists to enable optimal care of his ophthalmology issues

Dr Hock Meng Lim was in effect referring me to Prof Morgan. He was referring me to him for the purposes of having a cataract operation. He was a cataract and glaucoma specialist himself and more highly qualified than Prof Morgan in that area of surgery and I was his patient. Yet the Code clearly states that a doctor may only transfer a patient for care that is outside the doctors area of expertise.

I did not make this appointment for a cataract operation with Prof Morgan. Dr Stafford arranged this appointment for me, an appointment that I did not ask for. I only attended at RPH for treatment for out of control glaucoma.

So, who is responsible for enforcing the Medical Code of Conduct of Australia?

Paragraph 3

It is true that I did see a Dr Wiffen on 22 September 2017. No useful purpose could be served in my seeing Dr Wiffen because no funding had been allocated by the Lions Eye Institute for me and besides the Lions Eye Institute does not do that kind of research. Dr Wiffen does not specialise in cataract surgery or cataract surgery involving hard cataracts. There would not be any advantage to me whatsoever in seeing Dr Wiffen. Despite all of this, I attended at that appointment and met Dr Wiffen for the first time. He seemed to be in an agitated state of mind and he became even more agitated when I asked him what is keratoconus? In answer to the question he handed me a 10 page print out from a stack which he had conveniently located on his desk. I assumed that he kept this stack on his desk in case any of his other patients asked the same question. I then proceeded to show him Dr Hock Meng Lims results and asked him what lenses he would have used for an operation on my eyes. He replied that he did not know and sent me over to have some tests done.

The Lions Eye Institute is a private medical practice so that every patient receives an account following a consultation and treatment. There are usually a number of tests that have to be carried out which will be charged for and there will be no reimbursement from Medicare. Payment on the day of treatment will be required.

I asked the girl responsible for carrying out the tests how much they would cost. She replied $500. As I could not afford the fee I left the Lions Eye Institute. Dr Hock Meng Lim of Murdoch Ophthalmology had charged me the same amount for the same tests only a matter of several weeks before. Other eye specialists that I had been to see in Perth did exactly the same thing. I cannot keep going around to every eye specialist in Perth and pay $500 for tests that are never used. The eyes specialists in Perth should arrange for one eye specialist to carry out all of the tests and they should all be able to use his results. This money gouging on the part of the eye specialists in Perth has to stop.

Anyhow, I concluded that Dr Wiffen would not be of any assistance to me . Dr Wiffen does not specialise in cataract surgery. He certainly would not have had much experience in the removal of hard cataracts . His main job is involved in the teaching of medical students. His main job at the Lions Eye Institute involves corneal transplant surgery. To make matters worse he does not specialise in the treatment of glaucoma.

Paragraph 5

Dr Hock Meng Lim noted that I was also being followed up in Royal Perth Hospital and that I had an appointment on 10 November 2017. I would like to know who provided him with this information? It certainly was not me. He encourages me to keep this appointment as they can help with appropriate lens selection for me. He was certainly in no doubt that the appointment was for a cataract operation. Royal Perth Hospital would not be an appropriate venue for someone with a rare eye condition such as mine for the reasons outlined in my other websites.

Paragraph 6

The same arguments that were used against Dr Wiffen apply to Dr Ang.

Paragraph 7

Dr Hock Meng Lim denies using the words get out. This is largely irrelevant because the net effect of his actions amounts to the same thing.

Paragraph 8

Dr Hock Meng Lim claims that he never refused to see me. Well he certainly did after 14 November 2017.

SOURCES

https://sites.google.com/view/keratoconus

https://sites.google.com/view/markmcgowan

https://sites.google.com/view/royalperthhospital

https://sites.google.com/view/haigis

https://sites.google.com/view/dryeye