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Psychiatrists at public mental health service declare "no confidence" in management


Psychiatrists at an under-pressure public mental health service in Adelaide’s south declared no confidence in their clinical director earlier this year and told the head of SA Health about their decision, according to correspondence obtained by InDaily.

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In the latest evidence of turmoil in mental health services in the Southern Adelaide Local Health Network, InDaily can reveal that psychiatrists based at Noarlunga have repeatedly raised concerns with SA Health about management, staffing and clinical issues in the service.

InDaily has obtained two letters from the group of eight psychiatrists based at the Outer South Mental Health Services in Noarlunga Centre, sent to their management and others in December 2017 and January 2018.

In the January letter, addressed to Vickie Kaminski, then CEO of SA Health, the group declares no confidence in their clinical director.

“The ongoing management, staffing, and clinical issues we highlighted in our letter from 12-12-2017 have continued to compound over the last two years, and have been particularly worse over the last twelve months,” the letter says. “This is in spite of us continually raising concerns, both as individuals and as a group, over this same time period.

“As a result, as a Consultant group, we have no confidence in our current Clinical Director, Professor Malcolm Battersby, in regards to being able to work with us to resolve these issues. We feel an ongoing productive and professional relationship between our Noarlunga Psychiatrist group and Professor Malcolm Battersby is no longer possible.”

The letter says the group believed the only way to quickly resolve the issues at Noarlunga would be to reinstate a clinical director for the Noarlunga/Outer South region “from within our own ranks”.

SA Health won’t comment on the psychiatrists’ letter nor Battersby’s position, citing privacy legislation.

The letters highlight similar concerns raised last week in emails leaked to InDaily in relation to staff shortfalls in SALHN’s mental health services. As also revealed by InDaily last week, Chief Psychiatrist John Brayley is reviewing SALHN’s mental health services after concerns were raised with him and Health Minister Stephen Wade.

The December letter raised issues of ongoing shortfalls in medical staffing and risks regarding accreditation from the Royal Australian and New Zealand College of Psychiatry in relation to training positions.

The letter says the RANZCP had “declared the whole of the Outer South Mental Health Service as an area of high risk”.

“We understand the RANZCP has put the Service on notice, with the possible outcome that they will declare the site unsafe for trainees, and withdraw all trainees from the Service,” the letter says.

The RANZCP told InDaily it did not have concerns about trainees undergoing placement in the service.

“We are aware that the Chief Psychiatrist is investigating the service and we do hope the review will help improve services for the community,” a spokesperson said.

In response to InDaily’s queries to SA Health, SALHN provided a statement, saying that “under privacy laws within the Health Care Act, we are unable to comment on any individual cases”.

“It is our responsibility to look into any issues raised by staff and to make every attempt to resolve matters that may arise between individuals or teams,” the statement said.

“We continue to engage with our mental health teams as we implement important reforms to Community Mental Health services across the south, to ensure we always provide safe and high-level care to our patients.”

InDaily attempted to contact Battersby directly – on his office phone number and via email – to get his response to the letters.

Former SA Health CEO Vickie Kaminski was told of the doctors’ concerns in January. Photo: Tony Lewis/InDaily

An automated email response said that he was on long-service leave and would return to work in October.

It’s unclear whether there has been any change to the psychiatrists’ stance since January.

The Public Service Association and the nurses’ union have both expressed concern – as late as July this year – about staff shortages in SALHN mental health services.

The December letter is addressed to the then interim CEO of SALHN, Chris Baggoley, and the then chair of the SA Branch of the RANZCP, Michelle Atchison, while the January letter is addressed to the then CEO of SA Health, Vickie Kaminski, Baggoley, Atchison, Acting Chief Psychiatrist Brian McKenny, and Bernadette Mulholland from SASMOA – the union representing doctors.

Many of the people who received the letters are no longer in those positions, including Kaminski who was replaced by Chris McGowan in May. Baggoley has moved to the private healthcare sector, and Brayley is now Chief Psychiatrist. Atchison has finished her term as chair of RANZCP.

InDaily understands that Battersby remains clinical director of southern mental health services.

The December letter contains a detailed list of concerns about recruitment and staffing models. The December letter also raises issues about an alleged lack of transparency about performance reviews of staff.

The correspondence indicates that Kaminski met with the psychiatrists after sending the December letter, but they remained unsatisfied with SA Health’s response to their concerns.

SASMOA would not comment on the letters.

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