The John Curtin School of Medical Research building at the Australian National University. Photo: Lannon Harley, ANU.
It seems the health sector is a misnomer.
The findings from a review into gender and culture at the former ANU College of Health and Medicine, and its constituent schools, the John Curtin School of Medical Research (JCSMR), the School of Medicine and Psychology, and the National Centre for Epidemiology and Population Health, will be familiar to those who have followed the travails of Canberra Health Services, particularly Canberra Hospital.
The report from Professor Christine Nixon found “prevalent” gender bias, sexism and racial discrimination, a “poor and disrespectful” culture, widespread harassment and bullying of staff and students, and appointment and selection systems which facilitated “bias, nepotism and abuse”.
There was a “deeply dysfunctional culture” across the College and broader university, “marked by bureaucracy, territorialism, bullying, entitlement and resistance to change”.
Poor behaviour was “weakly acknowledged” by ANU but attributed to chronic overwork and stress.
One report has been made public. A separate confidential report outlining specific allegations against named persons has been provided to the ANU for further investigation.
None of this will be new to Canberra Hospital staff, or indeed, to hospitals generally across Australia.
The 2019 CHS Culture Review found a disturbing culture of bullying and harassment, including sexual harassment, and a “worrying and pervasive poor culture across the ACT Public Health System”.
It found that the attitude of disengaged doctors, most of whom did not participate in the review, had contributed to the problems.
That resulted in the implementation of wide-ranging reforms that are still working their way through the system, but are generally believed to have made a difference.
In 2023, a report also highlighted a poor workplace culture at Canberra Hospital’s obstetrics and gynaecology department, leading to staff burnout.
That same year, a national survey of doctors-in-training ranked the ACT worst on a wide range of criteria, including supporting staff wellbeing; tolerating bullying, harassment, discrimination and/or racism; and workplace culture.
Last year, a $31.5 million settlement between junior doctors and the ACT Government over unpaid overtime highlighted the fact that junior doctors were working 80 to 90-hour work weeks.
As the government has said many times, the culture issues at Canberra’s hospitals are not isolated to the ACT but reflect endemic problems across the nation.
Hospitals’ pressure-cooker conditions and ridiculously high work expectations contribute to this poor culture, but the ANU review has yielded very similar results.
This points to historical, entrenched patterns of behaviour in our health systems that begin in training, continue in the workplace, and are then perpetuated in a vicious cycle that health professionals find almost impossible to escape.
The implications for health staff and their wellbeing, as well as the people they treat, are enormous, impacting the quality of care and the viability of a competent workforce.
The ANU College of Health and Medicine no longer exists, having morphed under the university’s cost-cutting reorganisation into the ANU College of Science and Medicine. However, a name change and rearranging the chairs won’t mean an end to harmful behaviour.
Like CHS, implementing the review recommendations will be an arduous, long-term, but necessary project.
The review talks about academics without management training, but it’s also time that the sometimes brilliant, big and colourful personalities that medicine can throw up stop being tolerated for their bad social skills.
Physician, heal thyself.
Because why shouldn’t those in the health professions extend Hippocrates’ tenet of ‘do no harm’ to those they work with?
