The inquiry’s findings, handed down in May, savaged the behaviour of those bureaucracies, finding doctors and nurses were operating in a “culture of fear” unable speak up about staff shortages and preventable deaths, leading to significantly poorer health outcomes for patients.
The Ombudsman was intended to investigate the cover-ups of medical errors and deaths and the bullying and harassment of whistleblowers by hospital managers. The government argued such a role was unnecessary.
“The NSW Ombudsman has written to the NSW Government indicating these matters already fall within their jurisdiction,” the government said in its response.
“The NSW Ombudsman and the Health Care Complaints Commission (HCCC) are existing bodies with accountability, authority and responsibility to investigate decision making by NSW Health, including clinical and administrative decisions.”
The government noted those bodies were independent of government and overseen by parliamentary committees.
“The NSW Government notes that the report did not describe an analysis or conclusion that the NSW Ombudsman and the HCCC were not adequate, nor did it justify the costs likely to be incurred in duplicating their functions in a third agency.”
The government conceded action was needed to ensure NSW Health Staff had better access to those complaints bodies and said the Ministry would meet with them as an “immediate first step”.
However, the government supported “in principle” a recommendation for an independent review of workplace culture by NSW Health and its local health districts, improved complaints handling and the development of a plan to eliminate bullying and harassment.
Independent MP Helen Dalton, who represents the seat of Murray in NSW’s south-west, said cultural issues state’s regional hospitals needed to be addressed claiming her office received multiple emails and calls each week from health staff who felt unable to speak out.
“I’ve got staff that are crying, people that are just overworked – they are chronically fatigued,” said Dalton, who attended the nurses and midwives’ union strike at Hay on Thursday.
“The culture of fear in the health system is rampant and it needs to stop. That isn’t going to cost the government a cent.”
Taylor also unveiled a new ministerial advisory panel to be chaired by Richard Colbran, the chief executive of the NSW Rural Doctors Network, and said it would work closely alongside her to develop a new regional health plan for release later this year.
“We know that almost all patients who pass through our rural and regional hospitals and health services have a positive outcome,” Taylor said.
“A Bureau of Health Information survey of more than 6,000 patients who received emergency care from small, rural public hospitals found that 94 per cent rated their care as ‘good’ or ‘very good’.
“However, it was important to hear directly from those on the ground, including patients, their families, health staff and communities, about where we need to address issues in our health system and also build on the NSW government’s ongoing commitment to best practice healthcare and reform.”
She noted that since the inquiry commenced, the NSW government had committed $883 million over four years to attract and retain staff in rural and regional NSW.
NSW Labor health spokesperson Ryan Park said the inquiry had shown patients in rural and regional communities have significantly poorer health outcomes than those in the cities.
“I welcome the government response and now want to see them going from supporting the recommendations to implementing them,” he said.
“Because we can’t have a situation where a cook or a cleaner looks after patients in rural and regional hospitals, we can’t have a situation where people choose between paying the mortgage and paying for cancer treatment.
“And we can’t have a situation where people are continually struggling to access basic medical care at their hospital.”
Park said Labor supported a separate inquiry into mental health issues in regional and rural areas: a process recommended by the inquiry but not supported by the government, noting these concerns “came up frequently” during the hearings.
“It was extremely apparent throughout the inquiry that the mental health system is just as, if not even more, dysfunctional as the health system in regional, rural and remote NSW,” agreed Greens MP Cate Faehrmann.
Dalton and Faehrmann both said they supported changes to nursing ratios, the subject of the union’s statewide strike today, which Faerhmann said she recommended be included in the final report.
Dr Michael Clements, rural chair of the Royal Australian College of GPs, said it was good to see a wide-ranging list of recommendations supported by the state government, although some were dependent on federal government cooperation.
“There are a lot of statements in there which sound nice, but we need to see what they mean by that and see action,” he said, adding “we as a college have seen a lot of governments make a lot of promises about rural health over the years”.
The college supports the pilot of Rural Area Community Controlled Health Organisations (RACCHOs) and a single employer model for GP trainees, both of which were recommendations accepted by the government.