Parliamentary Committees

Parliamentary Committee on Occupational Safety, Rehabilitation and Compensation: Annual Report 2018-19

Mr PATTERSON (Morphett) (11:25): I move:

That the second report of the committee, entitled 2018-19 Annual Report, be noted.

This is important business that we are now speaking about. I rise to speak on the second report of the Parliamentary Committee on Occupational Safety, Rehabilitation and Compensation, entitled 2018-19 Annual Report.

I should say from the outset that this report will provide an overview of the activities that have been undertaken by the Parliamentary Committee on Occupational Safety, Rehabilitation and Compensation (the committee), activities that occurred between 1 July 2018 and 30 June 2019, and also provide a brief update on the committee's ongoing activities in the latter half of 2019.

In accordance with its legislative obligations, the committee continued to monitor existing relevant South Australian legislation, as well as monitoring the recommendations from and the implications associated with several externally conducted inquiries and reviews. Specifically, the committee reviewed the reports associated with the evaluation of SafeWork SA conducted by the South Australian Independent Commissioner against Corruption, the ICAC commissioner, who is quite topical at the moment.

There was also the independent review into the workplace culture within the ACT public health services and additionally the Your Voice Survey undertaken by the South Australian Office of the Commissioner for Public Sector Employment. Another investigation undertaken by the ICAC commissioner was the Public Integrity Survey. A lot of the findings in that survey led to his further investigations, which are now quite topical.

A lot of work has been done looking into activities in the Public Service in general. Some of the reading in that survey regarding SA Health and the findings of the ICAC commissioner which led to his further investigation were quite interesting, as was his most recent report into the governance in SA Health. We can touch on that a bit later in my contribution. The committee also looked into the South Australian Coroner's inquest into the death of Mr Castillo-Riffo on the new Royal Adelaide Hospital construction site.

In October 2018, the committee undertook an inquiry into workplace fatigue and bullying in South Australian hospitals and health services. This inquiry has been the major focus of the committee's activities during that report period. I will touch on some of the reasons behind that. The ICAC commissioner has been investigating attitudes in the Public Service, along with Office of the Commissioner for Public Sector Employment. Over many years, one of the issues that has been highlighted through those reports has been bullying.

It has been found that bullying is occurring across all parts of the Public Sector at unacceptable levels, but SA Health was more prone to bullying and fatigue. That was certainly one of the prompters for our committee, which does have oversight of these key workplace health and safety concerns. Bullying has been going on for years, and we heard evidence that it has been reported for years, but there has been no action.

The committee, very early on in the Marshall Liberal government's time in government—in October—to supplement the work that the health minister was doing in SA Health, resolved to look into bullying and fatigue in the South Australian health system in general, not just the public health system. We wanted to look at what was going on in private health as well because there is that crossover with some of the medical professions working in public and/or private hospitals.

I just want to touch on the definitions used by this inquiry, which were based on those that Safe Work Australia has come up with. Workplace bullying is defined as repeated and unreasonable behaviour directed towards a worker or group of workers that creates a risk to health and safety. Fatigue is defined in a work context as mental and/or physical exhaustion which reduces your ability to perform your work safely and effectively.

In terms of the inquiry's terms of reference, I think it is worth highlighting what we were looking at. Some of the terms of reference were the factors contributing to workplace fatigue and bullying in South Australian hospitals and health services, the impact of workplace fatigue and bullying on the health and wellbeing of healthcare professionals, the impact of workplace fatigue and bullying on the quality, safety and effective health services and measures to improve the management and monitoring of workplace fatigue and bullying. There are other recommendations, but that gives a bit of the flavour of the key investigations we looked into.

The inquiry received written submissions up to 31 May 2019. During that time, it received more than 60 written submissions, along with more than 20 supplementary submissions, which took the form of responses to a short questionnaire following up on their written submissions. From the launch of this inquiry, the committee has been keen to ensure that it consults as broadly as possible. As part of this consultation process, the committee developed a survey which included a range of questions relating to the experience of individuals with both workplace fatigue and/or bullying. The survey was open from 3 April 2019 to 31 May 2019.

In order to ensure that the information relating to this survey could be collected from as many stakeholders as possible, the committee asked a range of relevant agencies and organisations to assist in notifying their members about this survey. These ranged from SA Health, the College for Emergency Medicine, SASMOA, the Health Services Union and the Australian Nursing and Midwifery Federation. They certainly assisted with the distribution of the survey, and I acknowledge that and thank them for assisting us in getting a fuller understanding the state of play in SA Health. As I said, we greatly appreciate the assistance that the committee received in this regard.

I should note that all responses to these surveys were anonymous and confidential. A total of 2,299 valid responses were received. Of those responses, a high-level overview of the survey results was made available on the committee's web page. The survey itself was a voluntary, self-selecting survey, so was more likely to attract respondents who had been affected either by workplace fatigue and/or bullying. This should be taken into account when interpreting the results.

In terms of some of the overall trends and rates of bullying and fatigue, they were found to be reasonably consistent across all the constituent parts of SA Health. The committee did hear evidence that it seemed to be centred around CALHN more so than others but, in fact, the survey found it to be quite consistent across all local health networks and the Ambulance Service, as well. This is also consistent with the findings conducted by the ICAC commissioner's survey and the public sector workforce, as well.

If I could also touch on a few more of the themes, not only did we have some standard, quantitative responses but we also had qualitative responses that allowed for free-form explanations of some of the responses by survey respondents. Some of the themes that were identified around that survey that were quite prominent were around workplace culture and the complaints resolution process around bullying, especially in terms of a dissatisfaction with how the complaints around bullying and fatigue were resolved.

Before going into more detail, I will touch on some of the submissions. In terms of using surveys as a tool to engage with stakeholders as part of an inquiry process, they have been used in other Australian jurisdictions, but they have not been used previously here in South Australia. The committee sees them as a really effective tool and an important part of running the inquiry to help engage with as many stakeholders as possible. We certainly encourage other South Australian parliamentary committees to consider using this mechanism into the future.

During the reporting period, the committee met on a total of 16 occasions and heard from 20 witnesses, who were all in connection with the inquiry on workplace fatigue and bullying. Of those 20 witnesses the committee heard from, two where individuals whose submissions focused on instances of fatigue and/or bullying they had previously experienced or witnessed. The remaining witnesses were individuals appearing as representatives of nine separate organisations. These stakeholder organisations certainly provided valuable information about the impact of fatigue and bullying, as well as information about potential ways in which these matters could be addressed into the future.

Given the scope and the complexity of the inquiry, the committee is taking care to ensure that it consults widely and fully understands the key issues. It has been quite a substantive inquiry. As I said, it has been going for all of 2019 and the last part of 2018. When we started the inquiry and looked into it in depth, we realised from the early stages that a final report was not likely to be finalised for at least 12 months. At the time of tabling the report here in the parliament, the committee is aiming to complete its information collection by November (we are hearing our last witnesses tomorrow), and then from that hopefully come up with some draft recommendations. That is why we are still meeting in December.

An honourable member interjecting:

Mr PATTERSON: That's right—it is one of the last times we will meet. Another key aspect of this inquiry was to make some site visits to some of the primary tertiary hospitals in South Australia. The committee resolved to visit the Flinders Medical Centre, the new Royal Adelaide Hospital, the South Australian Ambulance Service headquarters at Parkside and also the Lyell McEwin Hospital to look at a range of initiatives they are undertaking, and I will touch on those briefly.

We went to the Flinders Medical Centre because the committee received a number of submissions and heard from a number of witnesses regarding the importance of rostering with respect to the management of fatigue, and this was really important. The member for Davenport and I went to the Flinders Medical Centre and found really interesting some of the initiatives they are taking and saw the stresses the emergency department is under.

So funding for the upgrading of the emergency department, adding an extra 30 beds, was a really welcome announcement this morning from the health minister. This will be really vital in providing an upgraded emergency system in the south and will be welcomed by the member for Davenport, who has been pushing strongly for it. He has seen the stresses the department is under, and the staff who took us on the tour of the Flinders Medical Centre will certainly see it as welcome announcement, too.

The member for Davenport and I then went to the Royal Adelaide Hospital, where we were met by a member from the upper house, the Hon. Tung Ngo, and we looked at how bullying complaints are handled. Some of the evidence we heard was around the hierarchical nature of health and how that made it hard for bullying complaints to be resolved adequately. There was a lot of influence by having these hierarchies in place, and how this culture can be broken and how complaints are handled we see as key requirements the committee we will have to address.

We then went to the South Australian Ambulance headquarters at Parkside in regard to fatigue management and the great work they are doing in recognising fatigue and elevating it to be a core part of their rostering decision-making so that at all times fatigue is looked at. Their fatigue management, while quite simple, seems to be very effective. I am certain that is something that the committee will look at going forward.

Finally, the member for Davenport and I then went to the Lyell McEwin Hospital, where we looked at the safety learning system that is used to report incidents that are occurring in SA Health. They are also starting to roll out a program about speaking up for safety, which aims to promote professional accountability. This is all really important to provide for the health and wellbeing of not only medical professionals in the South Australian health system but also, ultimately, patients, in that the medical professionals who are treating them are not subject to bullying and fatigue.

I thank the committee for their efforts. I thank parliamentary officers Mr Eugene Braslavskiy and Mr Simon Macdonald for their hard work and, previously, Ms Anthea Howard.

Motion carried.