A report by ICAC deputy commissioner Paul Alsbury, tabled in parliament yesterday afternoon, found bullying and harassment within the Central Adelaide Local Health Network (CALHN) resulted in employees feeling reluctant to report problem behaviour.

Alsbury stated he was provided with information which suggested that CALHN management “does not consistently encourage the reporting of inappropriate behaviour”, with some employees suggesting reporting is discouraged to avoid reprisals from “those with power”.

“The presence of bullying and harassment underpins a reluctance by employees to report,” he wrote.

“This is perhaps more of an issue for junior employees who must consider the consequences of reporting the very people who make decisions about their future career opportunities.

“This is an unenviable dilemma.”

Alsbury’s evaluation considered the practices and policies of the Central Adelaide Health Network, which alongside the Royal Adelaide and Queen Elizabeth Hospitals also oversees the Hampstead Rehabilitation Centre and mental health services at Glenside.

It involved collecting details about complaints received, investigations conducted, and sanctions imposed by CALHN between October 1, 2019 and March 31, 2022.

According to Alsbury, approximately 51 per cent of the complaints related to “unprofessional conduct”, including disrespectful behaviour, bullying and harassment, and inappropriate use of social media.

The evaluation follows an earlier 2019 investigation by former ICAC commissioner Bruce Lander, which uncovered cultural issues, bullying and conflicts of interest within SA Health.

InDaily reported in August that Australian Medical Association (AMA) SA president Dr Michelle Atchison had written to Alsbury claiming that patient care at CALHN sites was at risk due to a “high level” of workplace bullying, harassment and overwork.

She claimed CALHN had a “mismanaged culture that allows negative behaviour to occur”, with a recent AMA survey finding junior doctors felt least confident about raising issues of bullying and harassment at the Queen Elizabeth and Royal Adelaide Hospitals.

In his report tabled yesterday, Alsbury stated that CALHN’s own submission to his evaluation highlighted results from a 2021 “I Work for SA” survey, which showed that 43 per cent of the network’s respondents had witnessed bullying or harassment at work, while 26 per cent had indicated they had been subjected to problem behaviours.

He said those figures were an improvement on 2018 results.

The report quoted one CALHN worker, who in a response to an ICAC survey said the network had a “toxic culture whereby bullying and harassment are allowed to go unchecked and exist at the highest levels of the organisation and there is a tokenism in the response to this by the organisation”.

Other submissions to the ICAC survey, which garnered 1342 responses representing seven per cent of the CALHN workforce, raised issues about the network failing to address complaints about poor behaviour, reluctance to make a complaint, the network’s culture not encouraging the making of complaints and complaints not being taken seriously.

“Less than one in four survey respondents believed the Network would take action if they reported. This is worrying,” Alsbury wrote.

“The evaluation also identified occasions where the timeliness of the investigation process was wholly unsatisfactory.

“The Commission’s review identified one matter where complete evidence relevant to a misconduct allegation was not obtained and properly considered for over ten months.

“The findings against the employee were eventually withdrawn, but the entire process took nearly 12 months to resolve.”

All up, Alsbury made 25 recommendations to improve CALHN’s complaint management process and its workforce reporting culture.

His first recommendation was to have CALHN’s CEO and governing board chair provide “at least quarterly messaging” aimed at reinforcing the network’s lack of tolerance for bullying and harassment.

SA Health chief executive Dr Robyn Lawrence said the department had accepted all the recommendations and would work with the Office of the Commissioner for the Public Sector and CALHN to address Alsbury’s findings.

“Bullying and harassment has no place in SA Health. Our state’s health workers must be able to feel safe, respected and supported when they’re at work,” she said.

CALHN CEO Lesley Dwyer added that CALHN would “redouble” its efforts to eradicate bullying and harassment.

“We have already introduced a range of reforms aimed at improving our workplace culture and complaints management, including the world-leading Professional Accountability Program where staff address poor behaviour by having an informal conversation with colleagues which prompts reflection and ultimately leads to better patient outcomes and an improved workplace culture,” she said.

“This program has been rolled out to medical staff and will be extended to all staff including executive in 2023.

“CALHN is absolutely determined to continue our work in creating a culture that is safe and respectful, and a workplace where staff can be their best.”

Alsbury noted that both CALHN’s board chair and CEO had stressed that dealing with bullying and harassment was a priority for the network.

“The Network is commended for improvements implemented as a result of and during the course of the evaluation, and its commitment to implement further improvements,” he said.