It came up time and time again in yesterday’s NSW budget estimates hearing: can NSW Health workers safely speak out when they see unsafe practices or staffing levels?
Is there a culture of silence at NSW Health? Can frontline workers speak out when they see unsafe practices or staffing levels? Will they be punished?
These questions were continually put to state health minister Ryan Park at yesterday’s NSW budget estimates hearing, particularly in light of the new social media policy that has been implemented.
The culture of speaking up was first raised by Liberal Member of the New South Wales Legislative Council Susan Carter, who noted that neurosurgeon Dr Raoul Pope was terminated after being critical on social media about the culture at Concord Hospital.
“I obviously can’t and won’t be commenting about individuals’ HR issues,” Mr Park said.
But he said the new social media policy was consistent with the whole of government policy around the use of social media.
“I just don’t want people losing confidence to go to the hospital because someone’s gone out and make claims that may or may not be accurate,” he said.
He acknowledged the staff at Concord Hospital and his recent promise of an investigation into governance at the hospital.
“I made it clear to clinicians that what I’m interested in is engaging with people that want to improve the culture at Concord and want to make sure that that hospital remains a really good part of the health services delivered to that community.
“People who have got that frame of mind are always welcome to speak with the secretary, the chief executive, and myself,” he said.
However, the topic of staff feeling like they couldn’t raise issues continued.
“Are you aware that a number of specialist GP obstetricians have temporarily withdrawn their services at Queanbeyan District Hospital?” Sarah Mitchell, Nationals MLC asked.
“I’m aware of issues at Queanbeyan,” Mr Park responded.
He confirmed that the government had established a taskforce to oversee improvements to that service, including appointing a temporary obstetric consultant as head of department.
“You’ve got four specialist GP obstetricians who are no longer offering their services because they’ve raised concerns about clinical workplace safety at the maternity unit,” Ms Mitchell said.
“This is a bit bigger than a taskforce. With respect, Minister, what are you going to do to restore confidence? Why have these staff effectively been stood aside because they raised safety concerns?” she asked.
“I’m not shutting down staff, and that’s the thing. I’m not saying that I don’t want to hear from them. I’m just trying to make sure that whilst we work through these issues, we’ve got a service maintained that it’s safe and effective,” Mr Park responded.
“I don’t think that ever have an attitude that this is a perfect system, and I don’t ever think that the workforce speaking up is not appropriate. I always think that, but it doesn’t mean that I can resolve an issue straight away,” he continued.
But the lambasting wasn’t finished yet.
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“We’ve had questions this morning about Concord Hospital and Queanbeyan Hospital, but frankly, at this point, it would be easier to count the local health districts from which I haven’t heard directly from staff rather than the ones from which I have,” Chair of the Committee and Greens member, Dr Amanda Cohn, said.
“There are serious concerns among the workforce that when they raise those issues and they’re not heard, that they are subsequently punished for doing that, or they become desperate enough to raise concerns on social media or with members of parliament, which is really going above and beyond their frontline workers as health workers.
“Where do you expect people to raise these issues if they go through the appropriate channel?” she asked.
“There’s not one time where I’ve seen Ms (Susan) Pearce or anyone else try and shut down staff advocating for improvements to services, improvements to funding … I would challenge anyone who meets more staff or more staff representatives through the union movement than I do,” Mr Park responded.
“I want to do better tomorrow than I did today, and that’s the attitude that our executive team have. And if staff have that view and they’re about doing that, then I’m quite happy to engage with them.
“But equally, we’ve also got a bit of responsibility when staff sometimes engage in social media that attacks other staff, or that perhaps is not always accurate.
“I’ve also got a responsibility to make sure people don’t lose confidence in a world-class health system, and so it’s striking the balance,” he said.
However, Dr Cohn questioned that, saying clinicians are trained in open disclosure.
“When you’ve got frontline clinicians saying one thing, and hospital or local health district management saying, ‘actually everything’s fine and there’s nothing to see here’.
“Do you accept that it might actually build more community and staff trust to acknowledge those issues and talk about what you’re doing to fix them, rather than have them swept under the rug?” she asked.
He responded that his government had already instituted a special commission of inquiry into health funding and health resources which was advocated by the Health Services Union. He also said there were opportunities for staff to speak up in inquires such as at Concord.
However, he continued to reiterate that when people speak it, it needs to protect colleagues and the public.
“I would be highly surprised if someone was simply stood down for speaking up about wanting to improve their place of place of work, and it was only and solely based around that,” Mr Park said.
“We don’t have a perfect system, but we’ve got a very very good one. I don’t want a system where people, and the secretary doesn’t want a system, where people don’t feel they can’t speak up,” he said.