OPINION: Frank Daly’s changes to NT Health raise concerns about consultation, communication

A report from Perth has some important reminders for NT Health boss Frank Daly as he embarks on a journey to overhaul our hospitals, writes Thomas Morgan.

WHEN the Royal Darwin Hospital’s (RDH) clinical reshuffle was blown into the public sphere this week, some within the hospital privately circulated a report dating back to 2017.

The document found “the majority of nursing staff who were interviewed were generally unhappy”.

It went on to say “a common thread from all staff was that it was not so much about the decisions being made but the lack of consultation and the inability to provide input into decisions or to provide critical feedback”.

“Staff spoke of a general feeling of ‘chaos’ with ‘lots of things happening all at once and quickly’ with no visible overarching plan or documented step-wise approach.

“A focus on process and speed of task has perhaps negatively impacted on staff safety and wellness.”

Senior leadership roles at the Royal Darwin Hospital will undergo a ‘position spill’ in coming days. Picture: Che Chorley

You’d be forgiven for thinking this report was about the RDH.

But it’s not.

Rather, the report was a criticism of the general working environment within the Princess Margaret and Perth Children’s hospitals in Perth five years ago.

Among its findings was a “legitimate disparity” between health executives and staff.

And who was the head of the executive at that time?

Frank Daly, who is now the chief executive of NT Health. His hiring by the Territory government last year raised eyebrows and opposition.

The report into the Perth Children’s Hospital even refers to him directly.

“Many staff related the changes in leadership style and tone to the current (chief executive) and his new executive structure; however others report that there has been a history of poor communication and transparency in style that has been in place for many years and is not attributable to this,” it found.

NT Health chief executive Frank Daly, pictured in 2016 at the newly constructed Perth Children's Hospital. Picture: Sunday Times.

This column is not insinuating Dr Daly’s performance as NT Health chief executive is responsible for the issues within the Territory’s hospitals.

But given Dr Daly’s experience with this earlier inquiry, surely he must be mindful of the impact large changes to an organisation can have on healthcare outcomes.

There is reason to worry that senior doctors and unions within the RDH found out about the sackings via media reports.

A perceived lack of consultation has been raised in relation to the restructure at the RDH.

A sense of chaos enveloped the department after the Australian Medical Association’s Robert Parker, himself one of the people likely to need to reapply for his job, went public on Tuesday morning.

At first doctors in Alice Springs thought they were going to get the same ‘treatment’ as their colleagues in the Top End.

Following Dr Parker’s bombshell, it took five hours for the Acting Health Minister and the Department to issue statements, explaining the change was limited to the Royal Darwin and Palmerston hospitals.

Chief Minister and Health Minister Natasha Fyles was on leave when the news of changes at the RDH erupted. Picture: NCA NewsWire / Martin Ollman

Some clinicians still believe the changes will apply to Alice Springs.

The cherry on top of this fiasco sundae was that the responsible Minister, Natasha Fyles, wasn’t even around.

Given she’s been in the portfolio for years and should have a good grasp of the ins and outs of the department, it would’ve been better if she had been on hand to answer questions.

It’s likely Ms Fyles’ office would’ve been aware the changes were coming.

What’s even worse again, is that these changes don’t really go to any lengths to restore the hospitals.

The Health Department has talked a lot about ‘efficiency’ and ‘new talent’ – it has failed to prosecute the argument what these changes actually mean for patient outcomes.

Last we heard, a third of the beds at the Palmerston Regional Hospital’s emergency department were still mothballed after a Code Yellow last year.

Last we heard, frontline health staff were still overworked.

Last we heard, a pay freeze was still being negotiated for doctors and nurses, which is likely to make working in the Territory’s hospitals even less competitive than interstate.

Again and again in the Perth hospitals report, it pointed to staff frustration with a lack of consultation and poor communication.

Dr Daly would be wise to keep this in mind moving forward with changes to the Territory’s hospitals.

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