Building a better future but maybe not a safer one

Cover of ACTU Blueprint 2015The Australian Council of Trade Unions (ACTU) has a strong commitment to safe and healthy workplaces in Australia and would likely assert that nothing is more important than the safety of workers. However the latest submission to government on economic and social reform, “Building a Better Future – a Strong Economy for All” (not yet available online), has missed the chance to bring occupational health and safety (OHS) into the current policy debate on economic and productivity reforms. Continue reading “Building a better future but maybe not a safer one”

Safety change through rape?!

At many occupational health and safety seminars and conferences in Australia there is often an OHS professional in the audience who says that jail time is the only real and effective deterrent for those breaking safety laws, usually in the context of gross negligence, reckless endangerment or industrial manslaughter.  The threat of imprisonment is indeed a deterrent for some people.

But sometimes there is an OHS professional who colours their call for imprisonment by suggesting that, once in prison, offenders should be harmed or even raped.  An example appeared on an OHS discussion forum within the last week.  The comment, on an issue of fall prevention, included this phrase:

“Only need to send a few for a short holiday with “Bubba” and some soap on a rope, to get the message across to the masses.”

This person is suggesting that the deprivation of liberty is insufficient punishment for an OHS offence and that the offender should also be raped.  What does this say about the real values of a person whose profession is based on harm minimisation and the elimination of hazards?

If, as The Guardian newspaper says, the two main principles for jail are “in order to punish wrongdoers, and to remove the danger they would otherwise pose to the wider world”, where is the justification for abuse?

The “Bubba” comment above, and many similar comments I have heard over the years, may be an extension of the cynicism that many OHS professionals seem to acquire over their time in the profession.  But it is also offensive and shows an approach to humanity that I do not share and that I believe has no place in the OHS profession, or anywhere, for that matter.  It is lazy thinking, and these thoughts come from those who advise Australian businesses!  It is a shameful situation.

Kevin Jones

Brothel safety gains new media attention

The occupational health and safety of sex workers is one of the most difficult areas to write about as the industry is politically and ideologically charged with matters of feminist ideology, human rights and sex trafficking, religious morality and NIMBY lobbying.  In such an environment, it is important that the OHS needs of sex workers not be forgotten.

On 13 July 2011, The Age newspaper reported on the threat of legal action by one sex workers on a Victorian licensed brothel, Butterflys of Blackburn.  The article raised many OHS issues for the brothel industry.  In short, the article reports that a sex worker is suing the brothel because the brothel, allegedly, established an expectation that the sex workers would allow unprotected sex, sexual acts without a condom or other protection, an offence under Victorian law.  This particular sex worker’s experience in Butterflys of Blackburn was that, when refusing unprotected sex to a client, the client assaulted her, attempted to rape her and threatened her with a gun.

The Age reports that the woman “has since been diagnosed with post traumatic stress disorder, whiplash in her neck and a torn muscle in her shoulder.”  The worker is already receiving workers’ compensation and is pursuing compensation for permanent impairment.  Her plans for suing the brothel relate to the accusation that the brothel failed to provide a safe workplace. Continue reading “Brothel safety gains new media attention”

Employee Accommodation and Executive Accountability

SafetyAtWorkBlog has been following the aftermath of the rape and assault of a nurse working in a remote area of Australia for well over a year.  The issue has many personal and political aspects to it.  The most recent blog mention was the demotion of the CEO of the Torres Strait District Health Service.

Queensland is in the middle of a close election campaign and the Premier Anna Bligh on 11 March 2009 made an extraordinary move of removing the responsibility for employee housing from the Department of Health to the Department of Public Works.  Bligh was also scathing of her own ministers.  Her statement is below.

What Bligh’s decision seems to affect is a removal of the OHS obligations for a safe and healthy work environment from the organisation that is the employer of the health staff.  This will obviously need some clarification.

It may mean that Queensland Health may have to be the go-between between staff requests for repairs and the agency that undertakes the repairs.  It is doubtful that such an administrative process will be any quicker than what has already occurred – a process that Bligh says “does not meet a reasonable timeframe”. 

The broader political messages for the Premier’s Cabinet colleagues is discussed in an article in today’s Australian newspaper.

The issue of the security of government employees was again in the media when commonwealth government-employed staff were attacked in remote areas of Australia.  

“Statement by Premier – health staff housing

This afternoon I have spoken with both the Health Minister and the Director General of Queensland Health and have been advised as follows:

  • All health staff houses classified as extreme or high risk by the audit in the Torres Strait region have had all required work completed
  • Two of the 101 houses identified are no longer used for staff accommodation and the remaining 99 have all had locks checked and passed inspection or had new locks fitted
  • To date, 45 houses have had all work completed
  • Further work to be completed on the remaining 54 houses includes additional work such as the installation of path lighting

However, even though progress on this work is on-going in regional centres, it has failed to meet a reasonable time frame.

This failure to meet a reasonable time frame highlights that the core business of Queensland Health is running our hospitals and other health facilities and taking care of sick Queenslanders – not the business of maintaining staff accommodation and housing.

Accordingly, today I have directed that responsibility for health staff accommodation maintenance and upgrading be transferred in full to the Department of Public Works.

Further, I have directed that the work on this staff housing be completed by Easter.

It is completely unacceptable that this work has taken such a long period of time to bring to this standard and I’ve made this absolutely clear to both the Minister and the Director General.

From tomorrow, Queensland Health will no longer be responsible for staff accommodation.”

Kevin Jones

CEO loses job over safety failures

Health funding and management is a constant political issue.  The attention increases hugely during election campaigns like the one that is currently occurring in the Australian state of Queensland.

This week the leader of the opposition parties, Lawrence Springborg, called for the release of a government report into the sexual attack on a nurse and security in Torres Strait islands.  SafetyAtWorkBlog has written repeatedly on OHS issues associated with the attack in February 2008.  Springborg has pledged increased safety resources for remote area nurses.

Queensland Health reports on 25 February 2009 that the CEO of the Torres Strait District’s health service CEO has been stood aside as a result of the government’s investigation.  The statement reads

“Director-General Michael Reid said the Crime and Misconduct Commission had reviewed the report by the Ethical Standards Unit and was satisfied with the investigation.
“Some allegations that members of the Torres Strait and Northern Peninsula Health Service District executive did not act appropriately were upheld by this investigation,” he said. “We accept this investigation has found serious faults in the way Queensland Health staff responded to this critical incident and we are taking immediate action.”
The CEO of the Torres Strait-Northern Peninsula District has been stood down, effective immediately, while her role with Queensland Health is under further consideration.”

Many of the issues raised relate to possible corruption and improper behaviour by the Queensland Health and others.  These are the political points that Springborg is likely to chase.  

In terms of occupational health and safety, the focus of this blog, Queensland Health says

“There is substantial evidence that there has been a systemic failure by the Torres Strait and Northern Peninsula Health Service District to acknowledge and address workplace health and safety issues within the District over a long period of time.”

“There is sufficient evidence to conclude, on the balance of probabilities, that members of the Torres Strait and Northern Peninsula Health Service District (TSNPHSD)
Executive responded inappropriately and insensitively when notified of the alleged rape of a Remote Island Nurse on Mabuiag Island on or around 5 February 2008.”

“Further, there is sufficient evidence exists to find, on the balance of probabilities, that the repatriation of the remote area nurse from the outer islands as not managed or coordinated at a level cognisant with the seriousness of the events which had occurred.”

It is no wonder the CEO of the health service has lost her job.  It is a little surprising that more, and more prominent, heads have not rolled.  It is suspected that this may be one of the aims of the opposition politicians during the current election campaign.

To return to our core issue of OHS and accountability, this result clearly indicates that senior executives, particularly in the public sector in this instance, must take a preventative approach to the health, safety and security of their staff, wherever the employee is located.

Kevin Jones

Management failures and a rape of a five-month-old baby

Earlier this year, SafetyAtWorkBlog reported on the attack on a nurse in the Torres Strait Islands north of Australia, the investigation of the issue by Queensland Health and the mechanisms introduced to get the working conditions and accommodation up to a safe level.  In this case there was a clear link between occupational health and safety and the security of a worker.

OHS law in Australia obliges workers and those in control of a workplace to ensure the safety of people on their premises.  Last week the Northern Territory government received a report (081128vol1-f9c6d46d-75d5-4a5e-95e7-7c040ae6600c1) into the security measures at the Royal Darwin Hospital.  This hospital has undertaken fantastic medical work in the past, most noticeably, on a large scale following the bombings in Bali in October 2002.

However it failed to prevent the rape of a five month old female infant on 30th March 2006, while the indigenous baby was an inpatient.

Carolyn Richards, the Health & Community Services Complaints Commissioner, said in her report

As a result of a complaint reported to the Health & Community Services Complaints Commission an investigation was undertaken by the Director of Investigations, Mrs Julie Carlsen, who is employed as the Director of Investigations (DI) Health &  Community Services Complaints Commission.

This report highlights that the Department of Health & Community Services (DHCS) needs to implement effective risk control mechanisms to minimise the risk of an assault on a vulnerable inpatient in the Royal Darwin Hospital (RDH). The investigation has led to the conclusion that DHCS (DHF) and RDH have not complied with the applicable Australian Standard. It has also revealed that crucial information has been withheld from an expert engaged by RDH to review security arrangements and from the DHCS (DHF) Security Manager based at RDH. This report also details inadequacies and failings by those responsible for managing RDH who have failed for over two years to implement and maintain better security for patients in the Paediatric Ward. It is published with the hope that it will cause DHCS (DHF) and RDH to give higher priority to improving its risk management and security procedures.

The Commissioner’s conclusions are worth including here so that OHS professionals and security officers can establish appropriate procedures for their workplaces.pages-from-081128vol1-f9c6d46d-75d5-4a5e-95e7-7c040ae6600c1

1. On 30th March 2006:

  • There were no arrangements in place on the Paediatric Ward to ensure the safety and inviolability of vulnerable patients.
  • No risk assessment had been conducted.
  • The arrangements in place did not comply in any aspect with the Australian Standard which sets the benchmark for proper security.
  • There was no control on access to the Ward or to the patients.
  • The staff had not received adequate training, and possibly none at all, about the risks arising from lack of security arrangements.
  • In 2002 RDH had commissioned and received an expert consultant’s assessment and report on security arrangements at RDH. The Terms of Reference did not require 5B to be assessed. By 30 March 2006 the recommendations in the report had not been implemented in Ward 5B. This failure can only be described as shameful.
  • Following the rape of the infant police were not notified for about 2 hours.

2. Action taken by RDH after the rape to improve security was: (a) slow (b) inadequate, and (c) has not been adequately evaluated or reviewed to determine its effectiveness

3. RDH has a Security Manager on site as well as an NT Police member stationed at the hospital. Neither has been asked to evaluate the security on the Paediatric Ward either before or after the rape of the infant.

4. Staff working on the Paediatric Ward have not been trained at their induction on the elements of security arrangements to reduce the risk to vulnerable patients nor has there been adequate ongoing training of staff before or after the 30th March 2006 incident.

5. In 2007 the same expert safety and security consultant, as in 2002, was engaged to assess security arrangements at RDH. He was not informed of the rape of the infant in March 2006 nor was he asked to report specifically on arrangements in the Paediatric Ward.

6. On 21 November 2007 two investigation officers from the Health and Community Services Complaints Commission visited the Paediatric Ward by prior arrangement. They were able to enter the Ward and wander around, have entry to every part of it and stand at the nurse’s station, for about 25 minutes without anyone asking who they were and why they were there.

7. Management’s lack of commitment to the proactive identification of risks and to taking appropriate action has not created a culture where each member of staff takes responsibility for identifying and reporting risks and developing safe practices.

8. A security review of RDH was carried out by an expert hospital safety and security consultant who issued a report in 2007. The Security Manager of DHCS (DHF) was not given a copy even though he requested it. HCSCC enquired of RDH management why he was not given a copy and RDH have offered no explanation. On 31 October after this report was published to RDH and DHF the CEO of DHF advised this Commission that he had finally been given a copy and that he had seen a draft copy.

9. RDH Maternal and Child Health Clinical Risk Management Committee considered security in the Paediatric Ward following the incident. The Committee met on 16th May 2006, 2.5 months after the rape of the infant. It met a further 4 times. It submitted an action plan to the General Manager of RDH in July 2006. At its last recorded meeting on 5 September 2006 there had been no response from the General Manager on the recommendations, particularly with respect to installing CCTV cameras with recording facilities on the Paediatric Ward. There were still no recording cameras on the Paediatric Ward as at June 2008 although a CCTV system had been installed in the kitchen area to deter the pilfering of food. Dr David Ashbridge on 31 October 2008 advised, when responding to a draft of this report, that CCTV cameras were installed in Paediatrics on 25 August 2008.

10. The surveyors from the Australian Council of Health Standards which accredits RDH probably did not receive all relevant information about the incident of 30 March 2006 and what action RDH were taking. Those surveyors on 13 October 2006 were informed by RDH that the patient information pamphlet and admission interview are being reworded to reflect the changes to ward access. There was no verification throughout the investigation that any action had been taken by RDH to implement the recommendations of the review. Neither the report of ACHS nor records of information given to ACHS have been provided to the HCSCC. DHCS (DHF) was invited to provide me with those relevant documents in response to this draft. No response was received on this issue from DHF or RDH. According to the published information of ACHS the accreditation survey commences with a self assessment by the hospital concerned. This Commission specifically requested details and copies of the information provided to the ACHS surveyors but no response was received from either the CEO of the Department or the General Manager of RDH.

11. The governance arrangements at RDH do not promote adequate transparent accountability of the General Manager and the Department of Health and Families for the operation of the hospital. Control of all aspects of the day to day management of RDH rests in the hands of three individuals. This includes staff recruiting, training, security, nursing and medical services, procurement, record keeping, financial accountability and risk management. Such specialist management groups as exist are subordinate to the General Manager’s authority. The General Manager reports to the Director of Acute Services who reports to the CEO of the Department. I have been unable to find out what role the Royal Darwin Hospital Board has since its last annual report to 30 June 2006. 

It is well worth obtaining the complete report to understand how such an individual tragedy occurred.  As one media commentator has posited

“One wonders what the reaction would have been if a non-indigenous infant was raped.”

New work accommodation for Torres Strait nurses

In February 2008, a nurse was raped in her remote house on Mabuiag Island.  The accommodation was provided as part of her occupation and risk assessments have identified that the house was not secure, poorly maintained and, in my opinion, unsafe. Previous SafetyAtWorkBlog posts on this issue are available HERE.

Stephen Robertson, Minister for Health
Stephen Robertson, Minister for Health

On 19 August 2008, the Queensland Minister for Health, Stephen Robertson, officially opened primary health centres on both Warraber and Erub Islands.

The Warraber Island facility cost $A4.45 million and includes:

  • two, two-bedroom staff accommodation units
  • expanded clinical areas
  • a dental chair
  • a conference room.

The $6.84 million Erub Island facility includes:

  • a three-bedroom doctor’s residence
  • two, two-bedroom staff accommodation units
  • expanded clinical areas, including a dental chair, a morgue, and a conference room for video conferencing.

The media release emphasizes a feature rarely mentioned:

“Both centres have secure accommodation units to ensure the safety of local health staff.”

Theses costs are for upgraded clinics with very good facilities and housing is only part of the projects.

Beth Mohle, Assistant Secretary with the Queensland Nurses Union, told me today that the official opening of these facilities had been delayed for several months due to the difficult of providing a reliable electricity supply to the clinics.  These facilities had been planned for a considerable time, well before the February 2008 attack.  In fact the previous facilities on Erub Island had been so bad that the facility was condemned.

Beth said that the new clinics had been assessed by the union’s OHS officer in March 2008 and found to be very suitable.  There were several minor security issues but the union was generally happy with the clinics.

A formal maintenance schedule for the facilities has been committed to be the government.

Beth said that the remaining outstanding issue for negotiation with Queensland Health is the operation of duress buttons for its members. However a trial of a satellite-based system through Skynet Mobile Communications is under way where the community police will be informed immediately of any problems.  

The underlying challenge for all OHS issues in Torres Strait seems to be the remoteness.  Many of the islands have no mobile phone communication coverage and nursing staff have only recently received automobiles.  Previously wheelbarrows were used for transporting equipment on the islands.

To update readers about the circumstances of the nurse who was attacked on Mabuig Island, the case against the attackers is still before the Courts.  The nurse is no longer working in that profession and she has a WorkCover claim relating specifically to the effects of the attack.  

Beth Mohle spoke optimistically about the progress made on the campaign to improve housing and facilities in these remote communities but we must remember the unnecessarily unsafe conditions that workers were expected to operate in.  The future may be hopeful but much of this hope is built on pain and trauma.

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