A top doctor says a review of Canberra's health system linking patient safety to workplace culture validates concerns that make her afraid for her children's future.
Australian Medical Association ACT branch president Betty Ge said the comprehensive review, chaired by Michael Walsh and commissioned by the government after pressure from the Canberra Liberals and ACT Greens, endorsed "concerns our local doctors have been raising for many years".
Health Minister Rachel Stephen-Smith tabled the report to the ACT Legislative Assembly on Wednesday.
Dr Ge said doctors are sick of constantly raising concerns that are ignored by the government and health bosses.
The Walsh report puts those issues "in black and white on paper," but progress can only be made when problems are acknowledged.
"We just sit around and whinge for years, but nothing really happens, and I think that's where sometimes people feel they're unheard, they feel demoralised," Dr Ge said.
"If we deny there is a problem, then there will be no solution and there will be no practical changes on the ground, and I think that's a real danger to our public."
The doctor said it concerns her not just as a health professional, but as a parent and Canberran.
"As a member of the public and as a mother of young kids, I worry about our future. If my kids get sick, we need to go to the doctor or go to the hospital, who's going to look after them and what system are we dealing with," she said.
"I even tell my children, there are good times to get sick and there are bad times to get sick because we know that the public hospital is under pressure for years and certain departments really struggle."
Mr Walsh and his team reviewed dozens of previous reviews, audits and policy and consulted with 259 people for the review. They received 29 written submissions.
"It's not a lot that people are asking, is what I would say," Mr Walsh said.
Three core themes - better engagement with staff and patients, a spirit of collaboration including at the most senior levels and transparency - underpin 49 recommendations.
Rather than comment on the current state of the ACT health system or concern the public, he hoped it would contribute to a culture of constant improvement. The most important recommendations relate to how safety issues are addressed.
"Quality and safety, that's at the core of healthcare," Mr Walsh said.
The ACT currently over relies on quality assurance committees.
"They are cumbersome, and they provide significant restrictions on what clinicians can tell other people, what they can tell patients [and] what information can be provided to the coroner," Mr Walsh said.
"When clinicians enter into this process ... it's not clear that it's actually a no blame culture, it's not clear what's going to happen, what their legal responsibilities are, what's going to happen to what they contribute, what's going to happen to the report."
The report recommends a transparent and clear framework that engages everyone in the hospital, from wardspeople and nurses to security guards and executives, in improving patient safety.
Despite a number of measures to improve issues since a damming review in 2018 "persistent cultural challenges within the ACT health system" remain, the report found.
"While efforts have been made to uplift workforce culture, there continues to be challenges affecting recruitment, retention and workforce morale," it said.
"Many stakeholders identified workplace and cultural concerns stemming from poor change management driven by past administrative or managerial leadership.
"Stakeholders highlighted the importance of feeling confident that their psychosocial safety will be protected by managers and that there will be no consequences."
Health staff did not know how to raise and escalate concerns for patient safety.
"There have been clinicians who have left the ACT health system as result of their belief in the need to improve clinical quality and safety arrangements, including the escalation processes," the report said.
"Stakeholders identified that excellent quality and safety systems are based on openness with the absence of a culture of blame ... [they] raised the need to improve the confidence of clinicians to escalate safety concerns."
Mr Walsh said practically addressing issues within the system, openly and collaboratively, would help fix workplace culture issues.
"[Canberra Health Services] have done specific initiatives on culture, but actually, the thing you've got to do about culture is focus on quality and safety improvement, focus on the [digital health record] improvement, focus on data and governance improvement," he said.
"[Do it] openly, collaboratively and transparently, and that will change the culture."
On Wednesday, Ms Stephen-Smith told the ACT Legislative Assembly that the government accepted the report at this stage.
"A lot of work is already underway ... towards improving our health system. Much of the current work program aligns with the direction of the inquiry recommendations," the minister said.
