Queensland Health Minister Yvette D’Ath should be congratulated for having the courage to admit the Department of Health in Queensland has “cultural issues” and needs to change.
Admitting there is a problem is the first step needed to rectify what has become a dysfunctional, bureaucratic colossus with an unwieldy management structure.
Critical failures in clinical performance and in-house arguments and increased bullying suggest Queensland Health’s 99,032 FTE staff lack direction and are unable to work collaboratively to enable the system to deliver quality services that are safe and responsive for Queenslanders. Only about 40,000 of those staff are nurses by the way.
“It is very concerning that not only are staff not willing to speak up, but staff are scared to speak up in some areas of Queensland Health,” Ms D’Ath told the Courier-Mail.
Minister D’Ath is now acknowledging the fact that bullying and nepotistic behaviour is rife. What needs to be added to this list is the management ‘culture of cover-up’.
As a nurse of over 40 years, I know this firsthand. I became involved in a controversy and was threatened with dismissal simply for pointing to failures in nurse training as a NPAQ executive member. That matter is still before the Queensland Industrial Relations Commission.
Reports in the Courier-Mail point to a culture of bullying in Queensland Health.
Minister D’Ath has been in parliament since 2014 and in the Health portfolio for over two years. She knows only too well what is going on. But nobody is fixing it.
We shall see whether she has the courage to do anything about it but let’s give her a chance.
She is not the first minister to acknowledge failure in the health system. Peter Beattie to his credit acknowledged difficulties as the Minister for Health in the Goss government and later as Premier saw failures that allowed rogue surgeon Jayant Patel to perform procedures at Bundaberg hospital that harmed patients.
Today's problems are no less serious with botched surgeries, ambulance ramping, elective surgery delays and other failures swept under the carpet.
We have just been shocked at Townsville University Hospital where an elderly Vietnam veteran died after being assaulted by another Vietnam veteran patient who had a history of violent behaviour and assault against other patients and nurses. Yet not only was nothing done to isolate this patient under security, when the seemingly inevitable happened and he killed someone the first management response was to cover it all up.
The matter is under police investigation we are told and hospital management refuses to comment. What rubbish.
The police aren’t going to, and nor should they, investigate why in the face of innumerable formal warnings from the nurses about the potentially dangerous situation, Townsville hospital did nothing. Management cover up rather than solve what are now on-going systemic management problems that result in occupational violence and death.
Due to hospital management inaction, the NPAQ have called for Queensland’s Workplace Health and Safety regulator to investigate the death because we believe under Workplace Health and Safety law the CEO is personally liable.
Let’s be clear though, it is not just this incident in isolation that should be investigated, there are hundreds of incidents of violence against hospital staff that are swept under the carpet by management and risk management reports are ignored. This is systemic mismanagement of work health and safety that impacts patient and staff safety.
If the local hospital board was elected and answerable to the local community and not politically appointed, then not only would the CEO have been stood down and the matter thoroughly investigated by now, more than likely the whole sorry saga would never have been allowed to happen in the first place.
Minister D’Ath has confessed to a big problem. What do we do? Our view is that the solution isn’t to replace the Minister, certainly not the first since Peter Beattie to acknowledge the problem.
The problem is the system itself, not so much the people in it. Because nothing has been done to address the problem, the large number of bullies certainly doesn’t help.
Here is a solution. Like all bureaucratic management systems, unless there is a system of independent performance review with ‘teeth’ and commitment from management then the bullies will just keep bullying and covering up their mess.
The NPAQ believes the first step is to replace the current system of politically appointed regional hospital boards with locally elected hospital boards. These boards need the power of hire and fire over the hospital senior staff but the boards themselves have to be answerable with their jobs to the local community not the bureaucracy.
Furthermore we believe every local board should have at least two nurse board members elected by the nurses at each facility. The way forward is to have nurses not bureaucrats running our health system. This is a good mechanism to achieve that.
Let’s give Minister D’Ath the opportunity to promptly do something about reforming Queensland Health. Let us support her call to improve the culture and for locally elected and accountable hospital boards. Queensland Health should be a workplace where people want to work and feel safe. She will be judged by what happens next.