One of Australia’s most experienced geriatric specialists has told a Sydney court there was a “highly irregular” power imbalance between a GP and his wealthy patient who left him tens of millions of dollars.
Raymond McClure, who died aged 84 in 2017, left his GP, Dr Peter Alexakis, 90% of his estate worth more than $30m.
McClure altered his will twice in the five months before he died. Previous wills – the first of which was made in 1986 – made the Salvation Army and other individuals the beneficiaries of McClure’s estate.
The Salvation Army’s legal secretary, Gary Masters, is challenging the final will in the New South Wales supreme court, arguing that it was executed in suspicious circumstances and that Alexakis had undue influence over his patient. The will is also subject to multiple cross-claims.
On Monday, Dr Melanie Wroth, the senior staff specialist in geriatric medicine at the Royal Prince Alfred (RPA) hospital, gave evidence about her involvement in McClure’s case.
Wroth, who is also the chief clinical adviser for the federal Aged Care Quality and Safety Commission, met with McClure and two other doctors in June 2017.
McClure was a patient at RPA, and the meeting had been called after one of the doctors overheard McClure discussing his will with solicitor Angelo Andresakis in his hospital room earlier that month, the court heard.
The court has previously heard that Andresakis was recommended to McClure by Alexakis. Alexakis told the court in an earlier hearing that he had not struck a deal with McClure to get him out of hospital if he was “looked after” in the will, and he did not know McClure planned to leave any of his estate to him when he recommended Andresakis as a solicitor.
Wroth, who the court heard had extensive experience in elder abuse and was a senior member of the guardianship division of the NSW Civil and Administrative Tribunal, said she believed McClure was vulnerable to exploitation when he was in hospital. However, she said the type of exploitation would have to be more clearly defined.
She said the fact McClure was physically weak and frail would affect his energy levels and the robustness of thought required to perceive any risks of exploitation.
McClure was taking multiple doses of hydromorphine per day, which could have clouded his judgement, Wroth said, but added that that may be less likely, given he had been on the medication for some time.
While there was an acknowledged power imbalance between all patients and their doctors, the “highly irregular” nature of the relationship between Alexakis and McClure meant this was greater than normal, she said.
McClure hated hospitals, had tried to leave RPA without being discharged, and was suspicious of doctors, the court has previously heard, but was dependent on medical care because of several serious medical problems.
Not only would much of this dependence fall on Alexakis after he left hospital, but Alexakis was one of the only people who visited him, the court heard.
“The power imbalance would be on the basis of both the respect Mr McClure had for Dr Alexakis’s position as a general practitioner,” Wroth said. “And it would also be on a basis of his reliance … on Dr Alexakis for all of his social interactions.
“There was such a great respect for his position as a medical practitioner, and there was a belief that the extra attention that he was getting in relation to what would be a normal doctor-patient interaction, he was flattered by that, and he valued that he had someone he could sit down and talk to when there was nobody else in his life with who that could occur.”
Wroth said she was only aware of one other GP visiting a patient in hospital during her career, and that it was also unusual that Alexakis recommended a solicitor to McClure.
Once Andresakis visited in hospital, McClure also had less opportunity to change his mind, she said.
Wroth acknowledged that McClure had passed a test that proved he was of sound mind when he made the will, and that much of her comments about his vulnerability went to concerns about his physical state and social interactions.
Wroth said McClure endorsed the care provided by Alexakis during the meeting, but appeared concerned that the decision he made on his will had got Alexakis “into trouble”.
The hearing will continue on Wednesday.
