3 August 2023

Accreditation lost from another Canberra Hospital program as the obstetrics and gynaecology's training comes under fire

| Claire Fenwicke
Join the conversation
Centenary Hospital for Women and Children entrance

A RANZCOG draft report has identified repeated failures by the Centenary Women and Children’s Hospital for trainee doctors in the obstetrics and gynaecology unit. Photo: Claire Fenwicke.

Canberra Hospital’s failure to provide a safe and educational environment for trainee doctors in one of its departments has raised concerns about whether patient care for expectant parents is also up to scratch.

Meanwhile, it’s been revealed yet another unit has had its training accreditation pulled – the term in plastic surgery.

A draft report from the Royal Australian and New Zealand College of Obstetrics and Gynaecologists (RANZCOG) identified multiple concerns around the training, education and responsibilities of trainees in the obstetrics and gynaecology department.

This included a “blame culture” of bullying within mortality and morbidity meetings, placing an “inappropriate burden” on trainees or unaccredited registrars, and not giving trainees time to pursue their education. It also said opportunities for operating were “severely limited”.

“The workplace culture has deteriorated to the point where it did not appear to be one which prioritised training,” the report stated.

Concerns were raised that, due to staffing pressures and burnout, there were instances in antenatal clinics where junior trainees were supervising senior resident medical officers (SRMOs).

“As a consequence, there were concerns that patients are not well managed given time and staffing pressures,” it stated.

Overall, the report appeared to express disappointment in the training opportunities within the department, stating the hospital had been “repeatedly made aware” of areas that were lacking.

The report suggested this was due to a combination of staffing shortages, minimal workforce planning and poor communication.

“The culture was described as toxic on several occasions, with the pressure of increased workloads leading to frustration being expressed in ways that made others feel unsafe,” it stated.

“Decreasing consultant numbers have severely impacted the workplace culture, with those who remain overworked and in some cases burnt out.

“This has allowed poor behaviour and attitudes to fester, and acts as a barrier to further recruitment which would otherwise help in addressing some of the issues.”

READ ALSO Golden staph trend ‘going in the wrong direction’, ACT Health Minister admits

Specialist Colleges such as RANZCOG accredit registrar training programs that teach doctors who wish to qualify in a specific subspeciality.

In the wake of the draft report, and the hospital previously requesting the training accreditation of its Fetal Medicine Unit to be suspended, Region asked if any other departments had had the same thing occur.

A Canberra Health Services (CHS) spokesperson confirmed this was the case.

“Canberra Region Medical Education Council (CRMEC) accredits terms which junior doctors undertake after finishing university, in order to achieve their general medical registration,” they said.

“The accreditation for the term in Plastic Surgery has been revoked and work is underway to address workforce concerns.

“No junior doctor has been or will be disadvantaged by this as they have been reallocated to other terms.”

Meanwhile, the hospital has also been notified a “mid-cycle review” will take place into the accreditation of the training in its Child at Risk Unit.

READ ALSO ‘Horror story after horror story’: ANU students protest sexual violence on campus for sixth consecutive year

Canberra Liberals leader Elizabeth Lee said the RANZCOG draft report showed the unit was at “breaking point”, and accused the government of trying to rebrand “serious failures” as mere “challenges”.

“In 2010 and 2014, RANZCOG made similar scathing comments about the Obstetrics and Gynaecology Unit, yet almost 13 years later it would seem the Canberra Hospital has been handed a worse report, despite the government saying it would fix the issues,” she said.

“If the challenges have been known, then why are serious management, cultural and governance issues continuously noted in these reports?”

Ms Lee questioned if the college couldn’t trust the ACT Health system with trainees, then how could expectant parents do the same.

“This is a tertiary hospital that is in danger of not being accredited – that speaks volumes, not only about the standard of care that patients are receiving but also about the health and wellbeing of the trainees themselves, consultants and trainers,” she said.

“It also raises alarm bells about the long-term future, because if Canberra Hospital is unable to train these trainees … [how can we] retain them?”

READ ALSO ANU prepares to launch world-first registry to monitor impacts of psychedelics prescriptions

Both Health Minister Rachel Stephen-Smith and CHS acknowledged more work needed to be done to better support trainees and to create a more positive and collaborative team environment.

It was also stressed that people looking to give birth at the hospital would receive appropriate care.

“We are confident the review into training accreditation does not impact on the safety and quality of patient care, thanks to the ongoing hard work of our obstetrics and gynaecology team,” a CHS spokesperson said.

“The busy clinical workload of our clinicians has meant that there is less time to dedicate to ongoing training of our obstetrics and gynaecology trainees. As a teaching and learning hospital, we know this is not acceptable.”

While Ms Stephen-Smith said the workforce shortages and culture challenges being faced by the hospital weren’t unique to the Territory.

“A number of obstetrics and gynaecology units across the country have faced challenges around their training environments and accreditation over the last year or so,” she said.

“[However] we’ve certainly heard the message that what we’ve done to date hasn’t been enough, and CHS is recommitting itself to ensuring that the voices of those staff are heard and those issues are addressed.”

RANZCOG has granted the Obstetrics and Gynaecology Unit provisional accreditation for six months. The hospital has to provide evidence of workforce planning by September and a progress report by December.

Ms Stephen-Smith said she didn’t expect the unit would lose its training accreditation.

RANZCOG hasn’t released the final report.

Join the conversation

All Comments
  • All Comments
  • Website Comments
optimusmaximus7:07 pm 07 Aug 23

This does not surprise me one little bit. In 2021 my contract as a professional scientist at the Canberra Hospital was terminated for my speaking out about (1) the Hospital’s longstanding toxic culture of bullying and intimidation, (2) unsafe work practises and lack of proper escalation procedures which have led to preventable patient deaths, (2) its history of being unable to provide a proper and safe environment for its registrars, including a consistent lack of professional guidance, training and adequate resources, (3) deliberately cutting corners on vital quality assurance procedures, (4) allowing clinical directors and managers to usurp and waste public funds by ignoring policies that govern probity and transparency during procurement processes. I firmly believe my dismissal was an unlawful and unjust act to silence my voice of conscience. Although there are laws that afford whistle-blowers protections including anonymity, immunity/protection from liability, and protection against retaliation or victimisation by an employer, in the ACT they are limited in coverage and power, which has prevented any legal challenge that would otherwise have allowed me to seek redress. Becoming a whistleblower cost me everything – my job, my career, my source of income, my home. It is regrettable the Act Health Minister refused to give my termination closer scrutiny when presented with all the facts as it would have given her and her government a golden opportunity to show the public that they understand the problems at the Hospital and are committed to rectifying them. Instead, in apostolic succession to her predecessors, she just keeps sweeping things under the carpet and using plausible deniability to absolve themselves of any responsibility.

My criticisms of the Hospital are not confined to my occupational area within allied health. The Canberra Hospital has been plagued by a litany of problems for as long as Labor has been in government in the ACT. This is why federal intervention is required and why we need an inquiry. The Barr Labor government has long viewed the ACT more as a principality than a Commonwealth territory and this has to stop. To that end I join the growing call for a Royal Commission and will gladly make myself available to be called by the Solicitors and Counsel Assisting the Commission to appear as a witness. I deem it as a matter of utmost public importance and the only way to address the persistent problems it has. The (unlawful) acquisition of Calvary Public Hospital is intended to make Canberra’s healthcare system more efficient but it will not make these problems go away. To say that the government is working to improve things is all well and good but things never seem to change.

The Canberra Hospital’s own record of failed accreditation and medical standards in the last five years will serve to illustrate the point. Building a new hospital will not fix problems that originate from bad governance, bad leadership or bad culture which had led to the state of affairs within CHS and which still continue to attract criticism from a growing community of concerned citizens.

All credit to the minister. She can make any adverse outcome seem normal, and on its way to being fixed. The fixer. Top job.

Yesterday and today we have seen Elizabeth Lee, who has recently returned from extended maternity leave, fronting the media as the party’s spokesperson for health. Again, Leanne Castley, the party’s supposed shadow health spokesperson is nowhere to be seen. First Jeremy and now Elizabeth hijacking her portfolio. Just who is the party’s health spokesperson and where is Leanne Castley?
Now we have the unauthorised release of the Sofronoff report. I would have expected the party’s shadow Attorney-General Peter Cain to be all over this but he is nowhere to be seen. Elizabeth Lee is now fronting the media as the party’s spokesperson for the portfolio, all bluster demanding that the government release the report.
Has there been a reshuffle in the Canberra Liberals and just who is responsible for what?

@Jack D another swing and miss by you. They mentioned on radio yesterday morning that Leanne is on leave at the moment which would explain why Elizabeth Lee is speaking on this. Secondly where is the Attorney- General and why has he not said anything regarding the Sofronoff report? Seems strange you would only mention the shadow but clearly both leaders Barr and Lee are the ones commenting. best of luck next time on your rant.

I think you may be a bit of a hit and miss alter ego of the chewy type Tom Philips. Good luck with that!!

Jack D,
Swinging at shadows again I see and not even remotely close to connecting also as usual.

Surprised you didn’t actually know the details outlined by Tom seeing as you claim to know everything else about the workings of the Liberals and Legislative Assembly.

And only someone as partisan as yourself could somehow make the Sofronoff report an issue for the opposition. When it clearly shows once again the inability of the ALP and Greens Government (remember them?) to manage the areas that they’re responsible for.

Daily Digest

Want the best Canberra news delivered daily? Every day we package the most popular Riotact stories and send them straight to your inbox. Sign-up now for trusted local news that will never be behind a paywall.

By submitting your email address you are agreeing to Region Group's terms and conditions and privacy policy.