10 September 2018

Government caves in to calls for independent review of ACT Health’s bullying culture

| Glynis Quinlan
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The AMA ACT says that Canberra Hospital (above) and Calvary Public Hospital are the two most expensive public hospitals in the country but the ACT health system stumbles from crisis to crisis. File photo.

The ACT Government has caved in to demands for an independent review of the culture within ACT Health following a call from the Australian Medical Association which said the healthcare system has been stumbling from crisis to crisis with no real end in sight.

AMA ACT president, Dr Antonio Di Dio, yesterday called for an independent inquiry into workplace culture and bullying in ACT Health, saying that in the last 12 months alone there has been “a litany of missteps, maladministration, bullying complaints and sheer failure to respond to serious workplace issues”.

Today, ACT Health Minister Meegan Fitzharris announced a six-month independent review of ACT Health which will be tasked with investigating and reporting on culture and behavioural issues.

Ms Fitzharris said the review will be chaired by an external eminent person and provide a final report and recommendations to government.

“Terms of reference are currently being developed for this inquiry and stakeholders will be included in their development,” she said.

Ms Fitzharris said she would also put in place a Clinical Leadership Forum which would report to her.

“The Clinical Leadership Forum will include a range of representatives from across the Canberra Hospital, Calvary Public Hospital and broader ACT health services sector,” Ms Fitzharris said.

“The Forum will also provide an important mechanism for clinical leaders to advise on health services planning and infrastructure, clinical culture, and training and education.

“Both mechanisms will align with, and maintain progress towards the separation of ACT Health on 1 October. The Director-General has already advanced significant work on the culture of both organisations.

“Both of these important mechanisms will support staff to raise issues and have them addressed, and will ensure that privacy and confidentiality of individuals is upheld.

“More detail including terms of reference on these two important processes will be finalised in the coming days. I look forward to updating the community.”

Dr Di Dio yesterday said it was time for an independent inquiry into ACT Health which should focus on workplace culture, but be specifically tasked with looking at bullying.

“Last week’s regrettable announcement that Janet Anderson had resigned as CEO of ACT Health’s clinical operations was just the latest blow to the confidence Canberra’s doctors have in the administration of health care in the ACT,” he said.

Dr Di Dio said that Canberra Hospital and Calvary Public Hospital are the two most expensive public hospitals in the country but the health system is beset by a range of serious issues which the AMA (ACT) cannot keep quiet about.

These extend from ACT Health’s failure to take effective action on the bullying culture in many parts of the ACT healthcare system to the “failed preliminary accreditation report for ACT Health from March this year that saw 33 failures including eight high or extreme risks”.

Dr Di Dio also named other issues which have occurred in the recent past and largely continue today as including:

  • the downgrading of training accreditation in Radiology that saw the department’s rating fall from the A rating it had held for 25 years to a D rating, as well as the ongoing chaos and workplace disputation in Radiology including complaints of bullying and multiple public interest disclosures
  • the blow out in waiting times for public outpatient clinics (for example, the Gastroenterology and Hepatology Unit has gone from virtually zero to 3,500 in the last 2.5 years for non-endoscopy cases)
  • multiple workplace disputes and allegations of maladministration and bullying including in neurology and geriatrics
  • failure to deal with commonplace workplace issues, such as enterprise bargaining for junior doctors – with 27 meetings and no resolution
  • the sudden departures of the previous Director-General in March 2018 and clean out at senior levels that in itself followed the departed Director-General removing several senior and long-term executives.

ACT Opposition spokesperson for Health, Vicki Dunne, said that the AMA’s call for an inquiry into the health system was an unprecedented demand which made it clear that “Canberra’s doctors have had enough”.

ACT Health Minister Meegan Fitzharris announcing the appointment of new CEO Janet Anderson last week. Ms Anderson has since quit the post. They are pictured with the new director-general, Michael De’Ath and Minister Shane Rattenbury. Photo supplied.

Today Ms Fitzharris said that she is establishing the independent review and the Clinical Leadership Forum after discussion with a number of important stakeholders.

“As leaders in delivering public healthcare to our community we are all totally committed to delivering healthcare to the Canberra community,” Ms Fitzharris said.

“Let me be clear, any behaviour that is not aligned with the values of ACT Health cannot continue.

“There must be a mechanism for people to share their stories safely and privately and for ACT Health to learn from these. And there must be a mechanism to look forward, set the new standard and lead.

“People in our community want to know they can see a doctor when they need to, get the treatment they need and ongoing care and rehabilitation as required.

“I know the thousands of people who work in ACT Health want this to be their focus as well, and we need to look after them too.”

Ms Fitzharris said that, as she said in March this year, over time it had become clear to her that the leadership and governance of ACT Health had let staff down.

“Governance structures and processes to deal with inappropriate workplace behaviour were unclear, and people were not given the opportunity to lead. The initial Australian Council on Healthcare Standards (ACHS) accreditation report made this clear earlier this year,” Ms Fitzharris said.

“However the final ACHS accreditation report handed down in August showed a marked improvement in the culture within ACT Health, and in particular at Canberra Hospital.

“The ACHS final report was an independent evaluation of ACT Health services and should be acknowledged as a clear indicator of how our health system is tracking.”

Ms Fitzharris said that ACT Health has turned a corner and the independent review and the Clinical Leadership Forum would build on the achievements noted by the ACHS accreditation process.

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HiddenDragon6:14 pm 11 Sep 18

“Dr Di Dio said that Canberra Hospital and Calvary Public Hospital are the two most expensive public hospitals in the country but the health system is beset by a range of serious issues which the AMA (ACT) cannot keep quiet about.”

That, and the other points made by Dr Di Dio including serious problems with accreditation ratings and waiting times etc., surely raises fundamental questions about the capacity of a very small jurisdiction like the ACT to manage and maintain a quality, fiscally sustainable public health system. A review should be looking at ALL options to deal with the chronic problems in this critical area of government responsibility.

My observations are that a number of ACT Directorates operate using a culture of fear and oppression rather that good leadership, integrity and sound governance. The general approach seems to be to appoint an independent person to conduct an investigation or review and suggest some improvements at the margins. The only way to turn the trend around is to have an inquiry with judicial powers to put the spotlight on bad behaviours, identify the weak spots and develop a road map for resolution. What the Minister has announced is what she could not avoid. What has not been announced is an inquiry the Minister cannot control.

I’m a big believer of going with your gut instinct.
If you have a look at Janet Anderson there should have been alarm bells ringing letting them know that there’s something wrong here and it’s not going to end well.

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