In the early hours August 15, 2021, a 14 year old boy Joshua Gill was burned alive in a car not far from his home on Sydney’s Northern Beaches.
A preliminary Coroner’s Report found that Josh had tried to escape from the car as it burned but the child locks were activated and he was trapped inside. The Coroner has yet to advise the Gill family whether an Inquest will be held.
The Serious Adverse Event schedule for the Northern Beaches Hospital records the tragedy:
“On August 16 2021 at 0900 hours, Facility E was notified by the mother that the Young Person had died unexpectedly by suspected misadventure, with his body found in the backseat of an incinerated car a few hundred metres away from their residence on August 15 2021.
“Incident analysis – “Substance abuse culminated in death.”
A few days earlier, in the early hours of August 10, Josh had been admitted to the Northern Beaches Hospital’s emergency department by ambulance in police custody. He had earlier breached bail by breaking his curfew and drug and alcohol related incidents.
“On presentation, Josh was heavily intoxicated, in handcuffs, had a face-mask and plastic face shield on (to prevent him from spitting), and was covered in his own dried blood,” his father Andrew Gill told Michael West Media. ‘Unbeknown to us until after his death, Josh had lost consciousness in a police cell for 10 to 15 minutes earlier that morning after he had allegedly bashed his head against the cell wall, resulting in a nosebleed.”
Private criminal prosecution
Since the tragic loss of their son, Josh’s parents Andrew and Di Gill have been dedicated to seek justice for their son, and other young people and their families; and successfully at that, if anything could possibly be deemed “successful” in the wake of such a terrible loss of life. They brought a criminal prosecution against the hospital operators and have been the principal movers behind changes to NSW liquor laws.
The hospital had failed to ring the Gills to tell them their son had been admitted. Had they known the full circumstances of Josh’s presentation to the emergency department on August 10, they say they may have prevented the ensuing chain of events which led to their son’s death.
“Josh died horribly,” says Andrew. “I took my own criminal action against the Northern Beaches Hospital because we could not let what happed to us happen to another family.
“He was brought to that hospital by police only days before he died. The NBH did not even call us to say Josh had entered the emergency ward despite him being 14 years of age, covered in blood and despite him being taken to that hospital 7 times prior in that year alone (and when on each of those other times we his parents attended the hospital).
“I knew the coronial process could take years (and even then, only ends up in “recommendations” which may or may not be followed by the government of the day) and the law of negligence is stifled in NSW because our law caps compensation sums to pitiful amounts which would not act as a sufficient deterrent (or indeed any) to the conduct I had seen.”
The law, he says, is meant to protect children.
The Caymans connection
The Northern Beaches Hospital is unlike any others. It is both a public and private hospital controlled in the tax haven of the Cayman Islands. It was sold in a sharemarket takeover to a foreign private equity group Brookfield along with another 42 private hospitals across the country owned by the Healthscope group.
It was due to investigations by MWM into the financial transactions which led to these publicly subsidised assets falling to tax haven control, that we came into contact with Andrew Gill.
Incredibly, Gill discovered something we had missed for years, the terms of the deal under which the government leased the Hospital to Brookfield: effectively zero dollars.
The state of NSW had spent $1.2bn in public money building the hospital and surrounding roadworks. Land titles documents show they leased the hospital – with all its operating theatres, private clinics, public wards and retail venues – to the foreign financial players for 20 years for the token sum of $1 a year. The carpark is leased for $1 a year for 40 years.
From the Northern Beaches of Sydney to the Northern Beaches of George Town, Cayman Islands
“This is a disgrace,” says Andrew Gill. “The hospital is owned by a Cayman Island listed entity and is not accountable to our local, state or federal democratic system.
“There is no way of knowing how much the government pays the private company that operates the public portion of the hospital. When you request such information from it or the government, they both claim that it is commercial in confidence!
“This is our money being paid to a company whose sole motive is to make profit in the context of caring for sick people. Surely this information is front and centre public.”
The privatisation of care
There has been no response to questions put to the Northern Beaches Hospital. In coming instalments of this story to be rolled out over the next few days we will explore Australia’s youth mental health epidemic, its underfunding, the secretive financial structure behind the Hospital, the conflicts of interest of state health regulators and the reckless operation of the major liquor retailing chains.
Based on interactions between the Gill family and Josh with the hospital prior to Josh’s death (and the family’s interactions with the hospital after Josh’s death) it is evident that the lack of capabilities at the NBH to care for vulnerable young people with mental health issues is an urgent public health matter.
‘”How dare our politicians allow a public hospital to be run by an offshore company and worse for no adequate and proper youth and adolescent mental health capabilities despite there being approximately 40,000 kids on the Northern Beaches.”
The state also delivered up a public health monopoly by closing the other two hospitals on the Northern Beaches – Manly and Mona Vale – thereby funnelling all traffic to one privately operated facility.
Gill had “nothing to gain personally in taking criminal action against the NBH”: he says. “I stepped into the role of the police and alleged that the NBH had failed to provide adequate and proper medical care to Josh.
“If we won, several legal commentators questioned whether the NBH could continue to function as a hospital. Indeed, people may have been jailed.
“If we lost in our action, the financial fall out for us would have been crippling. If we lost, we would have been hit with an adverse costs order, possibly for millions of dollars (the NBH hired one of the largest and most expensive law firms in the world to defend it).
Conflicts of interest
Andrew Gill says he could “not stand back and let what happen to us happen to anyone else”. Yes, we complained to the NSW Health Care Complaints Commission – but the catch is they are part of NSW Health, and our complaint ultimately was meet with the response that the NBH had not done anything wrong.”
He brought the criminal case in around February 2022. It was settled within a few weeks of it commencing with no money going to the Gill family.
“Several months after the case was settled, the NSW government announced a $11.4 million to boost Northern Beaches youth mental health services. This was to include “four dedicated acute paediatric specialist mental health beds at Northern Beaches Hospital, which will provide for the establishment and operation of the beds.”
“My understanding is that not one of these beds is now up and running. Young people in desperate states continue to be managed or detained in the general emergency ward for long periods.
“Given the urgent public health issue at stake, I felt we had no choice but to take the drastic step of a commencing criminal proceedings. Under the Children and Young Persons (Care and Protection) Act 1998 (NSW) the criminal case needed to be commenced within six months of the alleged child neglect and/or abuse. That is why we needed to act quickly.”
Put public hospitals in public hands
As the hospital is owned by a private company, it is not subject to government freedom of information laws. The Gills had to subpoena NSW Health for information relating to the money the private operator makes from each patient as, the them, this would inform as to what was “adequate and proper” when considering what medical care was provided to Josh.
“I believe the public portion of the NBH which is being run by a private company should be put back into public hands. I also believe there should be a public Inquiry into the circumstances of the initial government funding of the hospital and its ongoing funding.”
Healthscope do not pay any rent to the taxpayer for the use of the hospital (or the carpark) and the NSW government of the day paid almost $1bn to Healthscope to build the hospital, and it is difficult to know for sure, but Healthscope is probably paid around $300 million per year by the public (the government) for the services it provides in the public portion of the hospital.
“It is my understanding that there is still not one dedicated acute mental health care bed for youth and adolescents at the hospital. If I am wrong, then I invite the NBH to allow myself and other interested persons in the community to inspect these facilities – remember this is meant to be “our” public hospital,” says Andrew Gill.
A sick healthcare model
The Northern Beaches public/private partnership is a unique class – typically the private operator owns the land, and the state (the government) operates the hospital and rents the building from the private operator. That way, incentives are aligned. The government is focused on caring for the sick. The private company gets paid rent which has no relationship to the care provided to patients. There is no conflict of interest. Interests are broadly aligned.
The funding relationship of this hospital is the only model of its kind in Australia. The last time this was attempted was with the Macquarie Base Hospital in the NSW coastal town of Port Macquarie – and the standard of care was that bad that the government bought back the hospital from its then private operator. There is precedent for the government acquiring a “public” hospital back from its private-company operator.
“If we do not learn from the mistakes of past,” says Andrew Gill, “We are doomed. More children will die.
“Josh was a great little man. Like many super sensitive kids, he needed some more help during his dark times. Helping kids through their dark times so they may reach their full potential is a goal worth having.
It is time, he says, that we as an informed people took back control of critical social and civil infrastructure to protect those in need rather than protecting the profits, in this case, of offshore investors.
“Even Adam Smith warned that capitalism would be at its worst when the government was captured by corporate elites. Here, on our doorstep, we have a hospital that earns a “toll” when a patient enters the emergency department (the more serious the patient’s health circumstances, the higher the “toll”) even though the hospital may lack the capability to successfully treat that patient – and if it does treat them, it is incentivised to treat them at the lowest possible cost.
“Why? Because that is how you make money, and lots of it. This is not capitalism. It is large corporates dictating what is right and wrong.
“How dare our politicians allow a public hospital to be run by a Cayman Island offshore private company and worse for no youth and adolescent mental health care capabilities despite there being approximately 40,000 kids on the Northern Beaches.”
Editor’s Note: since the privatisation and foreign sale of the Northern Beaches Hospital and 41 other hospitals to the Cayman Islands, the government has also approved the sale of retirement village and nursing home empire Aveo to Bermuda. The same buyers, Brookfield, bought electricity giant AusNet in a takeover last year and are now close to buying Origin Energy in another takeover.
Michael West established Michael West Media in 2016 to focus on journalism of high public interest, particularly the rising power of corporations over democracy. West was formerly a journalist and editor with Fairfax newspapers, a columnist for News Corp and even, once, a stockbroker.