WA Health Misconduct Handling Procedures - Corruption and Crime ...

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… I think it’s very difficult for a paedophile to get into the PMHsystem, but if they did, I don’t think any of us would even know …… [staff] think “that’d never happen here” …[76] The consistent view expressed by managers was that they would find outif misconduct was occurring in their work area because others wouldinform them, by “knowing” when and what to report:… I rely on supervisors and managers to look out for behaviour– they are my eyes and ears …[77] Many staff indicated that there was a “silo mentality” in the hospitalenvironment, and that the medical area was particularly insular whenconfronting and dealing with misconduct:… staff close ranks …… medicine is an old boys’ club … there’s a culture of “don’tdob in your mates” …… there is a culture in medicine not to tell the truth … you’dmanage someone until they become someone else’s problem …2.2.9 Management Discretion[78] Management discretion influenced whether misconduct was reported tothe next tier of management or was dealt with at a local level. It wasevident that when hospital management became aware of importantinformation relating to an employee’s behaviour, there was a reluctance topass that information on to others with management responsibility for theindividual concerned.[79] The following list details the most commonly expressed influences onmanagers and directors in the exercise of their misconduct managementresponsibilities.(1) Devolved management style: the expectation that managersshould deal with issues at their operational level and not refermatters (including misconduct matters) or seek advice unless it isessential.… problems may occur if they [managers] think they haveto sort everything out at their level … they might see it asa failure if they fail to keep something under control or inhouse...(2) Compromise/conflict: operational and clinical impacts wereconsidered in deciding how to respond to a misconduct issue andwhat action to take, particularly with regard to discipline and howseriously to treat a matter.… with it being so hard to find and hold onto staff, it [asituation involving misconduct] may not be managed as20
impartially as it should be if I [had] a formal process [touse] …(3) Inexperience: personal experience in dealing with misconductmatters specifically, or of management generally, shaped howmanagers would act in future.… I use my experience, rather than a set process … Iwould be better able to handle the situation [involvingmisconduct] if it arose again, purely because I have had tomanage it before …(4) Limited understanding of misconduct: there was a generallyacknowledged lack of awareness of the nature of misconduct inthe hospital setting.… we know the difference between what we should andshouldn’t do clinically, but behaviourally, not so much …the level of misconduct awareness is low …(5) Lack of management skills: several managers stated that theywere not managers but clinicians – “one day you’re a doctor or anurse, the next day you’re a manager” – and as such they werenot properly equipped to deal with management-related tasks,misconduct management being one of those.… there is no manual, nothing to show me what to do …(6) Peer views: advice about what action to take was often soughtfrom those that have had misconduct management experience.… you rely on peer support and advice … you hope it’sone good doctor talking to another …(7) Perceptions: how serious an issue was perceived to beinfluenced how managers reacted to it.… nothing is written to say “here’s the bar” and below it isa management issue and above it it’s something else …it’s based on a manager’s assessment …(8) Values: an individual’s own “sense of right and wrong”, and theirown ethical standards, influenced how a situation was defined(being misconduct or not) and consequently how it was managed.… clearly my own standards guide me …… people have different moral compasses …(9) Management associations: with an effective workingrelationship, managers were more likely to report to and engagewith senior management when dealing with misconduct. If therewas a tenuous working arrangement, managers were more likelyto “manage in” and not report misconduct.21
Page 2 and 3: ISBN: 978-0-9805051-8-4© 2010 Copy
Page 6 and 7: RPHRoyal Perth HospitalSchedule 4 D
Page 8 and 9: 2.3.5 Identifying Misconduct ......
Page 11 and 12: EXECUTIVE SUMMARY[1] This report pr
Page 13: [11] The Commission examined the Se
Page 16 and 17: (b)(c)a public officer corruptly ta
Page 18 and 19: were three fundamental issues raise
Page 20 and 21: (3) Notwithstanding the work undert
Page 22 and 23: [25] The review shows these workpla
Page 24 and 25: subsequent review at WACHS-Kimberle
Page 26 and 27: Central to this is the need to comm
Page 29 and 30: CHAPTER TWOCOMMISSION REVIEW2.1 Sco
Page 31 and 32: … there is no specific training o
Page 33: identified misconduct, which it cat
Page 37 and 38: (3) Training and education programs
Page 39 and 40: example, nurses or doctors) their e
Page 41 and 42: misconduct was occurring or not. Pr
Page 43 and 44: compliance, or that they had any gr
Page 45 and 46: • the framework of policies relat
Page 47 and 48: [125] The review focused on actual
Page 49 and 50: … we started counting [Panadeine
Page 51 and 52: checks on the clinical aspect of ad
Page 53 and 54: (2) regional to district hospitals
Page 55 and 56: medication chart … sometimes it d
Page 57 and 58: Pharmacist plus support staff). The
Page 59 and 60: … I’ve checked our policy and p
Page 61 and 62: ... there probably is scope for abu
Page 63 and 64: … I have a heightened awareness [
Page 65 and 66: (b)The notion that the misconduct r
Page 67 and 68: (2) endeavoured to improve communic
Page 69 and 70: The available policies, guidelines
Page 71 and 72: 2.5.4.1 Risk Register Review[233] T
Page 73 and 74: approach is not adopted by SMAHS”
Page 75 and 76: emails each day … we’re busy cl
Page 77 and 78: temazepam … I asked the staff mem
Page 79 and 80: they were entitled to “take” fr
Page 81 and 82: … the hospital has got rid of the
Page 83 and 84: [287] Executives had varying views
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CHAPTER THREEISSUES RELEVANT TO THE
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issues raised and recommendations m
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[310] Several SHEF members raised t
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… sure, budget always plays a par
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… I don’t know that it’s [Cor
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• The Schedule 8 cupboard in whic
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esuscitation room. There had been t
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[363] Local level inquiries were ma
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[373] The Commission is not critica
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… a doctor was raiding the ED [em
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• 78.4% of respondents were from
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[384] Question 2: As an employee wi
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• 81% of respondents indicated th
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Management has demonstrated to me a
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The Department of Health is serious
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[408] Question 15: To whom within W
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[414] Scenario 5: A junior doctor i
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Criminal Code; there is also a risk
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constitute misconduct and the syste
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[438] The Commission also conducted
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APPENDIX113
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MISCONDUCT MANAGEMENT IN WA HEALTH:
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YEAR MONTH MISCONDUCT-RELATED ACTIO
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Page 137 and 138:
Page 139 and 140:
Page 141:
WA Health Organisational Integrity
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Corporate Governance and Public Hea
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Misconduct Resistance: Framework Ov
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Progress: Completed InitiativesMisc
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ENDNOTES1 In its response the Depar
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34 Note in this section some totals
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