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AMA Vice President, Dr Chris Moy - Bullying in the workplace

Being bullied at work can extinguish hope and be soul destroying.

You might even end up blaming yourself or putting it down to some misunderstanding on your part. All you know is you’re the one who ends up suffering. Maybe so severely that you don’t want to turn up for work.

In South Australia we came together last year to work out exactly how to put our finger on the problem. It wasn’t easy.

In 2019, working conditions for doctors – and particularly junior doctors – were the subject of discussion around Australia. The concerns regarding poor culture and bullying highlighted by state-based Hospital Health Checks (HHC) in recent years had reached a point that no one could ignore. 

In South Australia, the issue had generated front-page headlines in September 2019, after I told the Parliamentary Inquiry into Workplace Fatigue and Bullying in South Australian Hospitals and Health Services of the ‘toxic’ culture in the State’s hospitals.

These were work environments in which doctors and other health practitioners were subjected to bullying and harassment that led to stress, anxiety and fatigue. It was not only doctors and other health care workers who suffered the consequences; tired, stressed doctors make mistakes that can lead to poor care and even serious harm to patients. 

So I announced that in early 2020, the AMA in South Australia would bring together doctors, academics, administrators and politicians at a ‘Culture and Bullying Summit’, to identify causes and solutions for poor workplace culture and bullying and to say unequivocally that ‘bullying must stop’.

On 29 February, more than 100 of the State’s leading health and medical minds and leaders attended the Summit.

They heard Dr Hannah Szewczyk, chair of the AMA (SA) Doctors in Training Committee, report that South Australia’s HHC results mirrored those of other states in relation to workforce factors such as the lack of access to leave and professional development opportunities, rostering and failure to pay overtime, and bullying and harassment. 

An 'aha moment' at the Summit led to a ground-breaking recognition of the role of Local Health Network (LHN) boards in demanding staff wellbeing as a non-negotiable ‘performance indicator’ in the South Australian health system. 

As a result, an unequivocal statement that LHN Boards are ultimately responsible for the welfare of their staff has been adopted. An amendment has been passed which was proposed and developed by AMA(SA) for the SA Health Care Governance Amendment Bill 2020 which defined the roles and responsibilities of LHN Boards.

In a letter to Health and Wellbeing Minister Stephen Wade, I wrote it was important to “be explicit in setting out of the responsibility of LHN Boards to promote and ensure psychosocial health and wellbeing in the workplaces for which the Boards are responsible”. 

“The amendments bring LHN Boards into line with their corporate counterparts by bringing clarity and balance to their imperatives – not only the need to provide good quality health care and to maintain budgets, but also to care for their greatest asset: their workforce,” the letter continued.

Clarifying this key responsibility of Local Health Boards is a key to providing a firm foundation upon which a wide array of initiatives in this area can be utilised, including those of the Federal AMA:

1) The 2019 Medical training survey results launched in February 2020 also highlighted bullying and harassment as serious concerns for doctors in training (https://ama.com.au/e-dit/issue-171/articles/medical-training-survey-delivers-many-positives-long-hours-bullying-and) with the 2020 results due out soon.

2) In October last year the AMA was instrumental in developing and launching the ‘Every doctor Every setting’ national framework to support the wellbeing of doctors. It includes a specific section on how to address bullying and harassment in the workplace and the AMA encourages every jurisdiction and medical setting to implement recommended processes and report on their findings.

3) The online resource www.drs4drs.com.au/resource-hub was developed and based on research conducted by Everymind, a national Institute dedicated to the prevention of mental ill-health and suicide, underlying the seriousness of these issues and potential consequences.

The South Australian experience shows that it takes more than just a helping hand to address the issue. We needed to identify where responsibility lies and then pressure Governments to enshrine this in legislation.

Poor culture and bullying are cancers in our workplaces which can break the hearts and minds of doctors. As AMA Vice President I feel strongly that the profession needs to say “enough is enough”- and to work toward genuine change.

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