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ACT Health’s ‘toxic culture’: what staff told the Independent Review

Ian Bushnell 4 February 2019

Canberra Hospital: a workplace in crisis and in need of its own healing. Photo: Ian Bushnell.

It was described as a difficult and disturbing read that laid bare the toxic workplace culture in what ironically are supposed to be places of healing.

The interim report of the Independent Review into the workplace culture within the ACT public health system released on Friday (1 February) heard from many staff members who had been subjected to bullying and harrassment, some violent and sexual in nature.

A staff survey found that 60 per cent had witnessed bullying in the last 12 months, with most of it coming from immediate supervisors and senior managers. Thirty-five per cent said they had been victims of bullying at work.

It also documents how complaints were not dealt with, not taken seriously or handled in such a heavy-handed manner that the harm was compounded. Almost half of those surveyed said they were not satisfied with the outcome of a complaint process.

“I raised numerous complaints with HR, management and the director which were never actioned,” said one review participant.

While some submissions provided positive experiences and played down the seriousness of some complaints, the great majority of them portrayed a workplace in crisis.

One submission expresses shock and disgust and says they will be getting out of the system in 2019.

“When I think about the culture within ACT Health and what I have experienced in my time here, I feel shocked and disgusted. The culture within the division is the most toxic, dysfunctional and prehistoric that I have ever worked in. In the [xx] years I have worked, I feel that I have been a target for bullying from managers and colleagues. As a result, in 2019 I will be looking to leave the public health system,” it says.

Another submission says ACT Health’s workplace culture is the worst they had ever seen.

“In my years as a registered nurse, employed in both public and private hospitals across the UK and Australia, the workplace culture within the [redacted] is the worst by far that I have seen,” it says.

“The treatment of staff in [redacted], is appalling. I have worked in [redacted] for nearly [xx] years and have never witnessed such a disgraceful approach to work ethics.”

The nurse says that a number of staff have had to leave the area because of the stress caused by how they were treated, with others believing the only way things will change is if they leave ACT Health.

“At ACT Health, we feel there is nowhere to go, no one who will listen, no one who will stand up for us, that shows that Health support the bullying of managers,” says the nurse, who alleges years of bullying and harassment.

“I have reported through every means available to me but not one of the following means of reporting has ever been followed through. No outcome has ever come of me making any reports.”

Citing ‘endless emotional abuse and mind games by management ‘, the nurse says making a complaint can make matters worse.

“There is ZERO consequence for the bully or even at the least feedback about how their behaviour may be contributing. There is no such thing as mediation. So the person who suffers the most is the person who has been bullied. They suffer more if they report it, because it usually changes their workplace, which is a big upheaval. But the biggest psychological insult is that they are invalidated,” the nurse says.

The review found that the use of a software tool called Riskman to log complaints only served to escalate matters quickly rather than supporting early intervention and the managing of issues locally.

“One nurse reported to me that they are too scared to put in RiskMan reports because her friend had been reprimanded and told it was her own time management that led to the incident she had reported,” a submission said.

“While working at another facility where lots of medication errors occurred I placed many incident reports to enable improvement of issues which were rarely acted upon and when I left the manager made a comment to me about the number of incidents I put in [RiskMan] as if to say I was a pain and created work for her.”

The review recommends the adoption of an early intervention strategy based on programs such as the Vanderbilt University Medical Center’s Patient Advocacy Reporting System (PARS) and Co-worker Observation Reporting System (CORS).

It says implementation of CORS has been shown to significantly reduce the number of complaints that require intervention, and in combination with PARS, resulted in an overall reduction in the number of future complaints.

“The program provides an opportunity for a staff member to receive and consider feedback early and ideally, modify their behaviour. The program employs a graduated coaching model to support the individual in reducing complaints by adjusting their behaviour. The individual is supported in that process, through peer-to-peer coaching, joint action planning and referral to peer reviews,” the interim reports says.

Health Minister Meegan Fitzharris said there was a process for the review panel to refer matters on to relevant authorities and organisations, and it had identified a number of clusters across all three health organisations and referred these to the relevant CEO or Director-General. It had also assisted in referring a small number of other cases to other authorities.

Health Minister Meegan Fitzharris announcing the review last September.

“Of course we want to make sure through this process people feel they have been heard, and that they get a resolution to their own personal concerns as soon as possible, but clearly many people also want to see change to a culture the panel found had developed over decades. This will take time,” she said.

“There are independent mechanisms to enable this to occur and I have asked the panel to provide further advice on these matters in the final report.”

She rejected claims from the Canberra Liberals that a Board of Inquiry would have had a different outcome, saying fewer people may have been willing to share their stories.

“The Canberra Liberals have not had anything constructive to say about our health system, and would prefer another inquiry rather than starting the process to fix the issues in front of us,” she said.

“If the Canberra Liberals remain unsatisfied I assume they will then take a Board of Inquiry to the 2020 ACT election.”


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