“Yet morale ratings at Rockingham General Hospital and King Edward Memorial Hospital eclipse the horrendously poor morale ratings identified by the AMA at BRH, which sparked that investigation.”
Core issues affecting morale were doctors being on fixed-term contracts for less than five years, insights from clinical staff being ignored by hospital executives, and fears of retribution for speaking up about ongoing issues.
Dr Duncan-Smith said this created a toxic workplace environment, where doctors risked “being decapitated” if they raised issues about safety and quality of health care delivered.
He said the AMA was aware of instances where senior doctors hadn’t had their contracts renewed after speaking up.
“I was made to understand a long time ago to keep your head down,” one of the respondents said.
“If a decision doesn’t have an immediate financial impact then it doesn’t get made, and if there is an immediate financial impact (regardless of the long-term outcome) then the answer is no,” another wrote.
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Another doctor said they were thinking about working only in the private sector or retiring early from clinical practice because of culture issues and low morale in the workplace.
“There is chronic understaffing and I worry about the patients on the wards and my nursing colleagues’ mental health,” the doctor said.
The doctor’s comments were echoed by a third respondent, who said the public health system had “lost all its appeal to work in”.
About four in five respondents said permanent employment would encourage more doctors to come and work in WA and lift morale. It would also allow doctors to raise concerns without the fear of being let go at the end of their fixed-term contract.
The AMA has been calling for permanent contracts for public hospital staff for months.
Dr Duncan-Smith said the situation was unlikely to improve based on current budget allocations by the government, which focused on “glossy” brick and mortar solutions instead of funding the day-to-day running of hospitals.
“Next year there will be a $114 million increase in the operational budget, which represents 1.4 per cent, which is less than the CPI,” he said.
“The following year, to our absolute astonishment, there’ll be a $210 million cut in operational budget to less than what the budget is for this year.”
He pointed at ramping levels, the shortage of hospital beds, and the cancellation of elective surgeries in absence of a COVID outbreak as examples of the inadequacy of the current budget.
Dr Duncan-Smith said the government needed to learn from the results, which echoed those of a recent staff engagement survey by Health Minister Roger Cook.
“The morale of our senior doctors can’t wait much longer for a remedy and the health system is well past the point of band-aid solutions,” he said.
