Doctor who led independent review at Joondalup Health Campus close personal friend of Ramsay Australia boss

WA Health has demanded an explanation from Ramsay Health Care after it was not told about an apparent conflict of interest between its chief executive and the specialist emergency doctor appointed to review Joondalup Health Campus’ paediatric emergency services. The multi-billion-dollar operator of the beleaguered hospital did not to notify the department that Christa Bell, a senior emergency physician and paediatrician at the publicly run Gold Coast University Hospital, has a close personal relationship with Ramsay Australia boss Carmel Monaghan. Dr Bell was one of two doctors appointed to the independent review, ordered after the preventable death of toddler Sandipan Dhar from an undiagnosed leukaemia in March 2024 and the shocking misdiagnosis of a snake bite in 10-year-old Olivia Bakranich-Fowler in May 2024. Sandipan was refused a blood test by emergency department doctors on March 22, 2024 despite his parents’ pleas. Two days later, he was dead. The 21-month-old died of sepsis due to an underlying acute lymphoblastic leukaemia, a highly treatable blood cancer. Then in May, doctors told Olivia’s mum, Stephanie Bakranich, her daughter was angling for a day off school by faking being bitten by a deadly tiger snake. The incidents caused public outcry and forced Ramsay bosses to launch an external review. At the time, Ramsay State Manager Shane Kelly said the review panel would not include any doctors who work at Ramsay facilities. Instead, Dr Kelly selected a friend of Ms Monaghan, who heads the multinational company’s Australian operations. Dr Bell and Ms Monaghan have known each other for several years. Their relationship is close enough that they go on holidays abroad together with their families, post birthday well-wishes to each other on social media, and are often at the same social events. While Dr Bell’s expertise in her field and independence in her involvement in the review remains undisputed, it raises questions about a perception of impartiality of the review, and how the potential conflict and unconscious bias were managed. The report was issued six months ago, while the coronial inquest into Sandipan Dhar’s death begins within days. Ramsay Health Care’s code of conduct says: “Where a conflict of interest may or does arise, we must: declare it to our manager, in writing” and withdraw from any related decision-making. “This includes: where a close personal relationship exists between two of us,” the code says. It means Ms Monaghan, who has been at the helm of Ramsay Australia for almost three decades, was potentially required to formally declare her close personal relationship with Dr Bell. “Ramsay Australia CEO Carmel Monaghan is known to Dr Bell. The connection was acknowledged internally at the time,” a Ramsay Health Care spokeswoman said. “Ms Monaghan had no involvement in the panel’s appointment, the scope of the review, the conduct of the review or its findings.” But Ramsay would not confirm how the relationship was “acknowledged internally” or how it was managed. “Panel members were selected for their clinical expertise by Ramsay WA leadership,” the spokeswoman said. “Ramsay Health Care and JHC are confident the panel acted independently and with the utmost integrity,” she said. “During our respective consideration, my connection with Ms Carmel Monaghan was acknowledged and the collective judgement was made that this connection would not impede the ability of the review to be comprehensive and impartial,” Dr Bell said. The paediatric emergency doctor said that independence was “clearly reflected in the content of the review report.” “As such, I have confidence that my personal and professional integrity have been maintained,” she said. But the company left WA Health blindsided. “The Department of Health was not aware of any personal relationships between panel members and Ramsay Health Care executives,” a WA Health spokesman said. Ramsay is not bound by WA Health public policy standards, and therefore not legally required to raise any conflicts. But the department has further questions, particularly given Ramsay’s status as operator of the public hospital. “The Department will meet with Ramsay Health Care to discuss the review, the panel members involved, whether a conflict of interest was identified by Ramsay Health Care, and if so, how it was managed,” the spokesman said. The West Australian can also reveal this is not the first time an issue has been raised about the panel. Ramsay’s original panel did not include a consumer representative, usually someone with lived experience in the healthcare system, until WA Health requested one be included. It wasn’t until that person was appointed that the department supported the panel’s makeup. Sanjoy Dhar, Sandipan’s father, said this latest development was “another reason why we don’t trust them (Ramsay Health Care).“ “If they’d been honest, we’d be more sure about their integrity,” Mr Dhar said. “It just appears that they are looking after themselves again.” Dr Bell said her work at JHC “has been, and continues to be, of vital importance to me and to the review team.” Gold Coast Health, which manages Gold Coast University Hospital, referred questions to Ramsay Health Care and Dr Bell regarding the “external matter.”