The gaps in urology care at Townsville Hospital and Health Service led to at least one patient death.
An investigation has exposed how Townsville Hospital and Health Service (THHS) failed to tell its patients they had aggressive cancers needing urgent treatment.
Doctors who have reviewed the more than 200-page report, released this week, say warning signs about poor hospital resourcing had been evident for years.
Queensland Health has accepted, in principle, 27 recommendations made by investigators.
Some patients with aggressive and high-risk cancers were not notified of their diagnosis or booked in for urgent specialist care at North Queensland's largest public hospital.
The Townsville Hospital and Health Service (THHS) became aware of its failings when GPs referred patients back to the hospital for forgotten biopsy results.
In a more than 200-page report on THHS, released by Queensland Health this week, investigators detailed the four incidents they said illustrated the most serious safety breaches suffered by patients.
A report on THHS urology care was released on Wednesday. ( ABC North Qld: Chloe Chomicki )
In these four cases, THHS did not follow up with patients who had suspected or confirmed cancer.
"One patient had a planned follow-up that was not booked; he subsequently re-presented via GP referral and was found to have high-grade prostate cancer," the report said.
Another patient received an MRI-guided prostate biopsy that indicated he had cancer that was moderately likely to spread.
"He was not recalled for results, leaving both the patient and GP unaware of a positive diagnosis until a new referral," investigators said.
The third patient, with a history of fast-growing cancer among the highest-risk category, had their follow-up appointment cancelled, and they remained on a waitlist without a new booking.
"A fourth patient was lost to follow-up after an MRI-guided biopsy confirmed high-grade prostate cancer," the report said.
Kieran Keyes (right) was THHS CEO at the time of the urology failings but has since resigned. ( ABC North Qld: Rachael Merritt )
The investigation confirmed one patient died in 2023 before they could receive reasonable treatment due to the health service failings.
The report explained the patient was diagnosed with bladder cancer in 2023 and did not receive a referral to an oncologist, though an appointment was urgently needed.
"Despite urgent need for oncology intervention, referral delays occurred, contributing to deterioration and death," the report said.
The experience of another patient, who remains in palliative care, was detailed in the report.
"The patient was referred in 2022 for urinary tract symptoms as a category 2 for an appointment within 60 days," investigators wrote.
"The patient waited 549 days for their first specialist appointment and 782 days for their biopsy.
"A diagnosis of high-grade cancer with metastases was made."
Paper systems were blamed for some of the THHS patients being lost. ( ABC News: Keane Bourke )
The report made note of the death of a second patient in 2025 who also experienced gaps in their care, but the report did not directly attribute their death to hospital delays.
The report identified workforce shortages as a key contributor to urology care gaps, as well as human error, paper-based admin, ill-formed policies and policy non-compliance.
Townsville GP and rural chair of the Royal Australian College of General Practitioners Michael Clements said he had advocated for patients caught up in the urology bungle.
"We had noticed some of our urology patients waiting what seemed like exceedingly long times; we were worried that people were being lost," he said.
"We were spending time … chasing up results [and] care wasn't being delivered as expected."
The doctor said he had hoped the THHS investigation would highlight a need for greater hospital funding, but it did not.
"We're seeing that the hospital and health system isn't meeting all community need; waiting lists are blowing out across all departments," Dr Clements said.
Queensland Health has accepted all recommendations made by the independent investigation. ( ABC News: Chris Gillette )
Investigators highlighted that the hospital needed another two full-time-equivalent urologists to provide for its service area of more than 148,000km2.
Australian Medical Association Queensland president Nick Yim highlighted the need for an additional two urologists in Townsville as part of a broader regional workforce shortage.
"This is the reason why, over the past 12 months, AMA continues to call for a workforce plan," he said.
"The Queensland government continues to say that we are 6,000 doctors short by 2032."
Queensland Health Minister Tim Nicholls visited Townsville this week and said the failings should not have happened.
He said there had been a change in executive leadership at THHS.
Queensland Health said it accepted all 27 recommendations made by the investigators.
