A 60-day appointment took 549 days: Townsville’s urology report finds the board knew in 2022

A Townsville patient referred to the hospital’s urology clinic in 2022 was classed as category 2, meaning they should have been seen within 60 days. They waited 549 days for a first specialist appointment and 782 days for a biopsy. That patient now has advanced cancer that has spread and is receiving palliative care.

It is one of the cases set out in Queensland Health’s investigation into the Townsville Hospital and Health Service’s urology service, released on Wednesday by Director-General Dr David Rosengren. The report, more than 200 pages long, covers 1 January 2022 to 31 July 2025.

It found 576 urology patients had gaps in their care. Six of those gaps were severe. One patient, diagnosed with bladder cancer in 2023, was not referred to an oncologist despite urgently needing treatment; the report found the referral delays contributed to their death. Other patients with high-grade prostate cancer were not recalled for results, had follow-ups cancelled, or were lost to follow-up after a biopsy confirmed their cancer.

Health Minister Tim Nicholls said 85 per cent of the 576 patients experienced no or minimal harm. “It was unacceptable and it should not have happened,” he said.

Who knew, and when?

The report found the Townsville health service’s board was aware of gaps in urology care as early as 2022, but did not appreciate how serious the emerging patient safety risks were until 2025. It described the board’s oversight as inadequate and found it did not escalate its concerns to Queensland Health in a timely manner.

The report found former chief executive Kieran Keyes was among executives who departed from good practice. Mr Keyes resigned before the report’s release, citing personal reasons. Mr Nicholls said there had been a change in executive leadership at the health service.

A separate cultural review by consultancy Hoffman Reed, released alongside the investigation, found a fractured relationship between staff and the board, and widespread fear of speaking up about problems, including patient safety.

How do patients get lost in a hospital?

Through paperwork, mostly. Investigators blamed workforce shortages and vacant specialist positions, human error, paper-based administration, poorly formed policies and staff not following them. Follow-up appointments were not booked, test results were not passed on, and patients sat on waiting lists without anyone tracking whether their cancer was progressing.

The investigators said Townsville needs two more full-time urologists. The service covers an area of more than 148,000 square kilometres, larger than England.

What changes now?

The report makes 27 recommendations, including urgent urology recruitment, stronger rules for outpatient care and closer oversight of whether staff meet professional standards. Queensland Health has accepted the recommendations and key findings in principle. Dr Rosengren said there were clear lessons for every hospital and health service in the state, not just Townsville.

Investigators also recommended that the health service notify the Coroner, the Office of the Health Ombudsman and the Australian Council on Healthcare Standards.

Is this just a Townsville problem?

Doctors’ groups say no. AMA Queensland president Dr Nick Yim repeated calls for a workforce plan, pointing to the government’s own estimate that Queensland will be 6,000 doctors short by 2032. Townsville GP Dr Michael Clements, rural chair of the Royal Australian College of General Practitioners, said GPs had been spending time chasing up their patients’ results.

The figure that matters most for current patients is the most recent one: in August this year, 44 per cent of category 1 urology patients in Townsville, the most urgent, were not seen within the recommended time.

What should patients do?

Anyone in north Queensland waiting for a urology appointment or result who is worried about delays should contact the Townsville Hospital and Health Service and their GP, and seek urgent care if symptoms worsen.