Parliamentary Committees

Parliamentary Committee on Occupational Safety, Rehabilitation and Compensation

The Hon. J.S.L. DAWKINS (17:46): I move:

That the third report of the committee on an inquiry into workplace fatigue and bullying in South Australian hospitals and health services be noted.

I am pleased to present the final report of the committee's inquiry into workplace fatigue and bullying in South Australian hospitals and health services, which was established through the committee's own motion on 16 October 2018.

The inquiry terms of reference are outlined in the report and while I will not detail them all here today, the committee was focused on understanding the causes and impacts of workplace fatigue and bullying, and finding practical evidence-based solutions to reduce both the instances and impacts of fatigue and bullying within the South Australian health system.

The committee accepted 66 written submissions from stakeholder organisations, as well as from individuals who shared their own personal experiences of workplace fatigue and bullying. The committee received a further 24 supplementary submissions, the majority of which were responses to a short questionnaire sent to all individual submission authors. In addition to this, the committee met with 48 witnesses, 13 of whom were current or past employees within SA Health and the remaining represented 19 Australian-based organisations.

While the committee sought submissions from a diverse range of stakeholder organisations and the general public more broadly, the majority of the evidence received focused on the South Australian public health system and, as a result, our report does likewise.

Given the scope and complexity of the inquiry, the committee wanted to ensure that it consulted widely and fully understood all the key issues associated with workplace fatigue and bullying. For this reason, we developed a survey to assess the experiences of healthcare professionals with workplace fatigue and bullying. A total of nearly 2,300 valid responses were received, and an overview of the results is available in the report.

The committee also undertook a site visit to a selection of SA Health sites, including the Flinders Medical Centre, the Royal Adelaide Hospital, the South Australian Ambulance Service headquarters and the Lyell McEwin Hospital. The site visit provided a valuable opportunity for committee members to speak directly with SA Health staff about a range of important issues, including rostering practices, human resources procedures, fatigue risk management and incident reporting tools.

In reflecting on the evidence gathered throughout the inquiry, the committee has made 27 recommendations aimed at reducing the impact of workplace fatigue and bullying in South Australian hospitals and health services. The nature of these recommendations was informed by the evidence the committee received, which, as noted previously, focused predominantly on issues within the South Australian public health system. That being said, a number of the recommendations are sufficiently broad so as to apply to the health sector more broadly.

The committee found that the high-pressured nature of the work undertaken in hospitals and health services, coupled with the need to work long hours, shift work, overtime and on-call work, all as part of a 24/7 operation, creates an environment that places health professionals at greater risk of workplace fatigue and bullying. This is exacerbated by a poor workplace culture and lack of contemporary management skills among many clinical leaders. The committee also received evidence of inadequate complaint resolution processes, leading to issues remaining unresolved and discouraging staff from reporting inappropriate behaviour.

Workplace fatigue and bullying can have very detrimental impacts on the health and wellbeing of healthcare professionals. These impacts on both mental and physical health often stem from unsafe working practices, such as working excessive hours, having inadequate breaks and working irregular shift patterns. Further to this, both workplace fatigue and bullying can create a risk of emotional and physical burnout amongst staff.

The committee's recommendations aim to address areas where we see weaknesses in the way that workplace fatigue and bullying are currently being managed. The recommendations broadly fit within four key themes. Firstly, improvement to systems and processes: the report includes a series of recommendations focused on ensuring that SA Health takes a risk-based approach to preventing workplace fatigue and bullying and that it has sufficient high-quality data to allow it to do so.

Secondly, complaint management and resolution: while preventative measures are a key focus of the recommendations in the report, the committee received evidence to suggest that existing South Australian health complaint management and resolution processes have deficiencies which need to be resolved.

Thirdly, having appropriate levels of accountability: the committee sees the advent of new local health network governing boards as an opportune moment to improve accountability for addressing workplace fatigue and bullying. To this end, the committee has included a series of recommendations designed around LHN boards reporting against key performance indicators relating to workplace fatigue and bullying. The committee also sees SafeWork SA as playing a greater and more proactive role in ensuring that hospitals and health services are providing safe working environments for their staff and reducing the impacts of workplace fatigue and bullying.

Finally, accreditation processes: notwithstanding that much of the framework around the accreditation of hospitals and health services is managed outside of the South Australian jurisdiction, the committee considers that there is an opportunity to more effectively address issues of workplace fatigue and bullying through accreditation processes.

Ultimately, workplace fatigue and bullying can lead to serious negative effects on the performance of staff, which can impact on patient safety. For this reason alone, it is important that workplace fatigue and bullying in SA hospitals and health services are addressed as a matter of priority.

Before making some concluding remarks, can I say that this was a complex inquiry and it did attract a range of evidence. Some of that evidence took me back to some work that was done in a previous inquiry by the committee in the previous parliament and one that I was on in relation to suicide prevention and mental health in the workplace.

I think in that inquiry we saw evidence, particularly in country settings but not only, that the willingness of health staff to come forward and admit to their supervisors that they have a mental health issue was frowned upon but also, as I said, in many of the smaller communities was seen to be a very limiting factor in their continued employment or in any advancement in employment. I think these matters are most complex.

The work of the committee also complements the work that the Issues Group on Suicide Prevention has been addressing in the attitude of all government departments, in addition to dealing with their clientele, to the way in which they better deal with their staff. That is something that is very important to me.

I would like to thank everybody who took the time to contribute to the work of the committee during the inquiry, including those who gave up their time to make submissions or appear before the committee hearings. I would particularly like to thank the individuals who provided written submissions and appeared before the committee. Many of these people recounted their own very personal and often traumatic stories of fatigue and bullying. The committee is extremely grateful to them for sharing these experiences. As part of its ongoing commitment to occupational safety-related issues, the committee intends to keep these matters under review and monitor progress with respect to the implementation of the recommendations outlined in the report.

I would also like to thank all the members for their input and deliberations throughout the inquiry. From the other place, my thanks go to the Presiding Member of the committee and member for Morphett, Mr Stephen Patterson; the member for Davenport, Mr Steve Murray; and the member for Taylor, Mr Jon Gee; and my colleagues from this house, the Hon. Tammy Franks and the Hon. Tung Ngo.

As are, I think, any of us who have ever worked on these sorts of inquiries, we are very grateful for the efforts of our staff. In this case, the committee, at the outset of the inquiry, had Ms Anthea Howard as its sole officer. Anthea at the time was also working full-time in the employ of the House of Assembly and in the chamber. I must commend Anthea. I think she has now left the service of the parliament, but she was an excellent officer.

Subsequently, Mr Simon Macdonald came on board as the parliamentary officer of the committee, as I think the officers of the committees that are formed in the other house are called. Not long after that, we had the appointment of the research officer, Mr Eugene Braslavskiy. I commend both those gentlemen for the work they did for the committee. Unfortunately, they have both now departed, as Mr Macdonald has been shifted within the offices of the House of Assembly and I think is now working in that chamber as a parliamentary officer, and Mr Braslavskiy has, only I think last week, returned to his role in the government department he came to us from.

With those remarks, and underlining the very good work of the committee staff in supporting the committee, I commend the report to the house.

Debate adjourned on motion of Hon. I.K. Hunter.

At 18:00 the council adjourned until Thursday 20 February 2020 at 14:15.