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SA Health executive roles "impossible"

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The SA head of the Australian Medical Association has suggested SA Health's senior roles should be carved up after the under-fire department's boss admitted the high turnover rate of executives was damaging morale and leading to staff ignoring executive directions.

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Interim Central Adelaide Local Health Network CEO Len Richards resigned yesterday after just two months in the role – the latest in a long series of resignations from top positions in Health in recent years. He replaced Julia Squire, who was sacked in January.

Speaking on ABC Radio Adelaide this morning, SA Health boss Vicki Kaminski said that the high turnover rate among executives at the department was affecting staff morale, and part of the problem was that the department was recruiting “the wrong people”.

She said some lower-level staff had stopped following executive directions because they did not expect the same individuals to be in their roles for long enough to make a difference.

“It does affect I think the morale of the people in the system [who are] thinking … ‘When do we get a leader that we actually have to listen to cause they’re going to stick around?’” said Kaminski.

“So the new leader comes in and says ‘we’re going to look at new models of care, we’re going to invigorate the system’ and they say ‘well, you know, we’ll just keep our head down, you’ll be gone before it impacts me, I don’t have to do anything’.

“Sometimes we have recruited the wrong people [but] I’d rather see turnover than stay with someone in the job who’s not able to do it.”

But she insisted Richards was not the “wrong” person for the job and that he told her he needed to spend more time with his family.

AMA SA President Dr Janice Fletcher told InDaily this morning: “I’m a bit sympathetic with people who have jobs that are impossible.”

She suggested that some executives within SA Health, particularly the CEO of the Central Adelaide Local Health Network (CALHN), had responsibilities that were too vast and complicated for “any one person” to undertake successfully.

She said she would “not in a million years” want the role of CALHN CEO because it was “too unwieldy; too overwhelming”.

Respected bureaucrat and former SA Health deputy chief executive Jenny Richter has stepped out of retirement to act as CEO until a new chief is found.

Fletcher said whoever was found to fill that role would have to oversee the current Royal Adelaide Hospital, the transition to the New Royal Adelaide Hospital, the Queen Elizabeth Hospital, Hampstead Rehabilitation Centre, the implementation of the troubled EPAS electronic health records system and much more.

“I can’t see how any one person could do all that,” she said.

“You’ve got an unrealistic budget – you can’t stick to it.

“At the same time you can’t cut costs, and you can’t cut services – it’s a really difficult job.”

South Australian Salaried Medical Officers’ Association senior industrial officer Bernadette Mulholland agreed that many SA Health executives bore untenable levels of responsibility.

“The position that they are put into isn’t a tolerable one,” she said.

“It’s far too big a job.”

She said new executives were set up to fail in their roles because too much “enormous change” – including hospital reform program Transforming Health and the implementation of e-health records system EPAS – was happening at once.

She said SA Health had not been willing to give enough resources to Local Health Networks during a period of historic change.

“This gets recognised by the [executives] of the LHNs and they move on,” she said.

Mulholland added that medical staff felt frustrated and disempowered by the constant churn of new management.

“Many times I have presented on matters [to executive SA Health staff] where I believe there was agreement reached … only to find that there’s a new administration … who don’t support that decision and you have to start again,” she said.

No South Australians “at the helm”

Kaminski also told the radio program this morning that SA Health had “zero” South Australians in CEO positions.

“That’s why I believe one of the things we need to do is develop our talent,” said Kaminski.

“We’re taking it by the horns, we’re going to have a leadership program, we’re going to have SA talent at the helm.”

But Fletcher told InDaily: “It’s astonishing that there’s no locals.”

“[Former SA Health CEO] David Swan was the last local boy, and he sort of came up through the ranks [of] the Health Commission [now named SA Health],” she said.

“Is there [still] a career path in SA for local candidates? If there’s not, there needs to be.”

She speculated that a lack of good South Australian candidates for high-level roles in Health may be because “no-one wants the job” here.

“You have to ask the question whether there are no local applicants because the locals all read the paper and they know it’s really hard,” she said.

“It’s a massive job.”

In December last year, SA Health accepted the recommendations of a devastating assessment of CAHLN, which described safety and management problems so extensive that few medical staff would allow their family members to be treated in the system.

It found that a constant turnover of management positions has encouraged lower-level staff to “‘keep their heads down and get on with the job’ rather than engage in meaningful discussion about the organisation’s strategy and … improving the quality of care”.

Then-CEO Julia Squire told InDaily at the time that since starting in the role in October 2015, “I have found there are times when CALHN’s functions, processes, leadership and culture have been called into question”.

“The review confirmed that, while our staff are dedicated to providing the best care for their patients, the support systems, functions and leadership required are inadequate for our needs now and into the future.”

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