1 REPORT OF CASE STUDY NO. 27 The response of health care service providers and regulators in New South Wales and Victoria to allegations of child sexual abuse MARCH 2016 2 ISBN: 978-1-925289-50-3 © Commonwealth of Australia 2015 All material presented in this publication is provided under a Creative Commons Attribution 3.0 Australia licence (www.creativecommons.org/licenses). For the avoidance of doubt, this means this licence only applies to material as set out in this document. The details of the relevant licence conditions are available on the Creative Commons website as is the full legal code for the CC BY 3.0 AU licence (www.creativecommons.org/licenses). Contact us Enquiries regarding the licence and any use of this document are welcome at: Royal Commission into Institutional Responses to Child Sexual Abuse GPO Box 5283 Sydney, NSW, 2001 Email: 3 Report of Case Study No. 27 The response of health care service providers and regulators in New South Wales and Victoria to allegations of child sexual abuse March 2016 CHAIR The Hon. Justice Peter McClellan AM COMMISSIONERS Professor Helen Milroy 2 .oN ydutS esaC fo tropeR 7 4 Royal Commission into Institutional Responses to Child Sexual Abuse childabuseroyalcommission.gov.au 5 Table of contents Preface 1 Executve summary 4 1 Child sexual abuse by medical practtoner Dr John Rolleston 11 1.1 New South Wales health care regulators 11 1.2 Experiences of former patents of Dr Rolleston 15 1.3 Dr Rolleston’s professional history 28 1.4 Communicatons between NSW Police and the HCCC 32 1.5 Complaints to the Medical Board: 1992 33 1.6 AWC’s complaint to the HCCC: 1998 34 1.7 AWH’s complaint to the HCCC: 2003 45 1.8 AWH resumes his complaint to the HCCC: 2006 48 1.9 The HCCC’s current systems, policies and procedures 54 1.10 AWB’s disclosure to the RNSH: 2005 55 1.11 Current RNSH practces and policies on internal reportng 56 1.12 Reportng obligatons of health practtoners, including medical practtoners 58 2 Allegatons of child sexual abuse at the Royal North Shore Hospital by a psychologist 60 2.1 The Royal North Shore Hospital 60 2.2 Experience of Mr Terence Kirkpatrick 60 2.3 Mr Kirkpatrick discloses his abuse 61 2.4 Impact of the abuse on Mr Kirkpatrick 62 2.5 RNSH policies for child safe practces: 1968–1985 63 2.6 Current RNSH policies for child safe practces 63 3 Allegatons of child sexual abuse at The Royal Children’s Hospital, Melbourne, by volunteers 67 3.1 The Royal Children’s Hospital 67 3.2 Experience of AWI 69 3.3 AWI reports her abuse to the RCHM 70 3.4 RCHM’s handling of AWI’s complaint 70 3.5 Overview of RCHM’s current policies, practces and guidelines 76 4 Systemic issues 81 Appendix A: Terms of Reference 82 Appendix B: Public hearing 89 Endnotes 93 2 .oN ydutS esaC fo tropeR 7 6 Royal Commission into Institutional Responses to Child Sexual Abuse childabuseroyalcommission.gov.au 1 Preface The Royal Commission The Leters Patent provided to the Royal Commission require that it ‘inquire into insttutonal responses to allegatons and incidents of child sexual abuse and related maters’. In carrying out this task, we are directed to focus on systemic issues but be informed by an understanding of individual cases. The Royal Commission must make fndings and recommendatons to beter protect children against sexual abuse and alleviate the impact of abuse on children when it occurs. For a copy of the Leters Patent, see Appendix A. Public hearings A Royal Commission commonly does its work through public hearings. A public hearing follows intensive investgaton, research and preparaton by Royal Commission staf and Counsel Assistng the Royal Commission. Although it may only occupy a limited number of days of hearing tme, the preparatory work required by Royal Commission staf and by partes with an interest in the public hearing can be very signifcant. The Royal Commission is aware that sexual abuse of children has occurred in many insttutons, all of which could be investgated in a public hearing. However, if the Royal Commission were to atempt that task, a great many resources would need to be applied over an indeterminate, but lengthy, period of tme. For this reason the Commissioners have accepted criteria by which Senior Counsel Assistng will identfy appropriate maters for a public hearing and bring them forward as individual ‘case studies’. The decision to conduct a case study will be informed by whether or not the hearing will advance an understanding of systemic issues and provide an opportunity to learn from previous mistakes, so that any fndings and recommendatons for future change which the Royal Commission makes will have a secure foundaton. In some cases the relevance of the lessons to be learned will be confned to the insttuton the subject of the hearing. In other cases they will have relevance to many similar insttutons in diferent parts of Australia. Public hearings will also be held to assist in understanding the extent of abuse which may have occurred in partcular insttutons or types of insttutons. This will enable the Royal Commission to understand the way in which various insttutons were managed and how they responded to allegatons of child sexual abuse. Where our investgatons identfy a signifcant concentraton of abuse in one insttuton, it is likely that the mater will be brought forward to a public hearing. Public hearings will also be held to tell the story of some individuals which will assist in a public understanding of the nature of sexual abuse, the circumstances in which it may occur and, most importantly, the devastatng impact which it can have on some people’s lives. 2 .oN ydutS esaC fo tropeR 7 2 A detailed explanaton of the rules and conduct of public hearings is available in the Practce Notes published on the Royal Commission’s website at: www.childabuseroyalcommission.gov.au Public hearings are streamed live over the internet. In reaching fndings, the Royal Commission will apply the civil standard of proof which requires its ‘reasonable satsfacton’ as to the partcular fact in queston in accordance with the principles discussed by Dixon J in Briginshaw v Briginshaw (1938) 60 CLR 336: ... it is enough that the afrmatve of an allegaton is made out to the reasonable satsfacton of the tribunal. But reasonable satsfacton is not a state of mind that is atained or established independently of the nature and consequence of the fact or facts to be proved. The seriousness of an allegaton made, the inherent unlikelihood of an occurrence of a given descripton, or the gravity of the consequences fowing from a partcular fnding are consideratons which must afect the answer to the queston whether the issue has been proved to the reasonable satsfacton of the tribunal ... the nature of the issue necessarily afects the process by which reasonable satsfacton is atained. In other words, the more serious the allegaton, the higher the degree of probability that is required before the Royal Commission can be reasonably satsfed as to the truth of that allegaton. Private sessions When the Royal Commission was appointed, it was apparent to the Australian Government that many people (possibly thousands) would wish to tell us about their personal history of child sexual abuse in an insttutonal setng. As a result, the Commonwealth Parliament amended the Royal Commissions Act 1902 to create a process called a ‘private session’. A private session is conducted by one or two Commissioners and is an opportunity for a person to tell their story of abuse in a protected and supportve environment. As at 26 February 2016, the Royal Commission has held 4,874 private sessions and more than 1,485 people were waitng to atend one. Many accounts from these sessions will be recounted in later Royal Commission reports in a de-identfed form. Research program The Royal Commission also has an extensive research program. Apart from the informaton we gain in public hearings and private sessions, the program will draw on research by consultants and the original work of our own staf. Signifcant issues will be considered in issues papers and discussed at roundtables. Royal Commission into Institutional Responses to Child Sexual Abuse childabuseroyalcommission.gov.au 3 This case study In Case Study 27, the Royal Commission into Insttutonal Responses to Child Sexual Abuse examined the experiences of a number of patents in health care services in New South Wales and Victoria. The public hearing was held from 6 May 2015 untl 15 May 2015 in Sydney. The scope and purpose of the public hearing was to inquire into: 1. T he experience of a number of patents of health care services in New South Wales who were sexually abused as children in: a. private medical practces b. public hospitals. 2. T he experiences of a number of complainants who made complaints against a medical practtoner to the New South Wales Health Care Complaints Commission and the then Medical Board of New South Wales. 3. T he systems, policies, practces and procedures for receiving, investgatng and responding to complaints against medical practtoners of child sexual abuse of: a. the New South Wales Health Care Complaints Commission b. the Medical Council of New South Wales c. the Royal North Shore Hospital, Northern Sydney. 4. T he experience of an outpatent who alleges child sexual abuse by a psychologist at the Royal North Shore Hospital, Northern Sydney, in the late 1960s. 5. T he systems, policies and procedures of the Northern Sydney Local Health District and New South Wales Ministry of Health for preventng, detectng and responding to child sexual abuse. 6. T he experience of an inpatent who alleged child sexual abuse by a volunteer at The Royal Children’s Hospital, Melbourne, Victoria, in the early 1980s. 7. T he response of The Royal Children’s Hospital, Melbourne, Victoria, to an allegaton of child sexual abuse made against a hospital volunteer. 8. T he systems, policies and procedures of The Royal Children’s Hospital, Melbourne, Victoria, for preventng, detectng and responding to child sexual abuse. 9. Any related maters. 2 .oN ydutS esaC fo tropeR 7 4 Executve summary In Case Study 27, the Royal Commission considered child sexual abuse set in the context of medical consultatons, in both private practce and public hospitals, by health professionals and hospital volunteers. Medical practtoners, health professionals and hospitals are responsible for improving and maintaining the health of their patents. Patents, who are in a vulnerable state of illness, place their trust in health care providers. Patents, and the parents of child patents, place such trust in medical practtoners that they permit those medical practtoners to view and touch intmate parts of the patent’s anatomy. Patents permit these acts because of the close nature of the health practtoner – patent relatonship and because they believe that a health practtoner is actng in pursuit of a higher purpose of assistng the patent with his or her illness or injury and not out of personal sexual gratfcaton. Children ofen follow instructons from health care providers without queston and the private one- on-one nature of therapy places children in a vulnerable positon. The public hearing was divided into three parts. The frst part examined the experiences of seven patents who were abused by a medical practtoner, Dr John Rolleston, in private medical practces or at the Royal North Shore Hospital (RNSH). The second part of the case study heard the experience of an outpatent, Mr Terence Kirkpatrick, who alleged child sexual abuse by a psychologist at the RNSH in the late 1960s. The third part heard the experience of an inpatent who alleged sexual abuse as a child by a volunteer at The Royal Children’s Hospital, Melbourne (RCHM), in the early 1980s. The Royal Commission examined the responses of the relevant regulatory agencies, hospitals and health practtoners to the allegatons of child sexual abuse. Child sexual abuse by medical practtoner Dr Rolleston in New South Wales Health care regulators The New South Wales Health Care Complaints Commission (HCCC) is a state statutory authority responsible for receiving and assessing complaints about health care services and facilites. It acts to protect public health and safety by resolving, investgatng and prosecutng complaints. The HCCC operates in a complex co-regulatory relatonship with health professional councils for the relevant health professionals. The Medical Council of New South Wales is the relevant health professional council responsible for any complaints or notfcatons received against registered medical practtoners. The HCCC and the Medical Council (health care regulators) together investgate complaints against registered medical practtoners. Royal Commission into Institutional Responses to Child Sexual Abuse childabuseroyalcommission.gov.au