The prestigious cardiothoracic surgery department at Sydney's Royal Prince Alfred Hospital is to be barred from training doctors next year amid allegations of bullying and dysfunction.
The Royal Australasian College of Surgeons (RACS) has withheld training accreditation for RPA's cardiothoracic surgery department in 2019.
No trainees will return to the cardiothoracic surgery department at the Royal Prince Alfred Hospital until 2020. Credit: Michele Mossop
College representatives uncovered alleged bullying and dysfunction during the department's recent accreditation review, deeming it an inappropriate environment to train Australia’s next generation of surgeons.
RACS considered immediately revoking its accreditation in August, issuing the hospital's executive a draft report stipulating it would remove its trainees.
But the college decided against the extreme measure, concluding it would compromise patient care and penalise trainees.
"The bottom line is bullying is a big problem in that department. It's been going on for a long time and the College of Surgeons has taken a strong stance against it," a College fellow said.
"This is ultimately about patient safety and the welfare of the trainees."
Last week The Herald revealed Westmead Hospital’s ICU was stripped of its accreditation by the College of Intensive Care Medicine in an extraordinary indictment of bullying and harassment within the unit.
On Wednesday doctors warned a toxic bullying culture among NSW public health workers was threatening the welfare of patients.
The Herald has since been deluged by calls and emails from healthcare professionals concerned about RPA’s cardiothoracic department and the degradation these allegations would have on its world-class reputation.
The hospital boasts the first open heart surgery performed in NSW and is the principal teaching hospital for the University of Sydney.
Two of the department’s six cardiothoracic surgeons resigned in dismay at the unit’s upheaval.
In a statement, chief executive of the Sydney Local Health District Dr Teresa Anderson said the district was of the understanding the decision to remove accreditation may be reconsidered before the end of 2018.
But RACS executive director of surgical affairs Dr John Quinn said the hospital and college are working together to maintain accreditation next year, but he was clear no trainees will return to the department until 2020.
"We are hopeful that will happen," Dr Quinn said.
Head of cardiothoracic surgery Professor Paul Bannon said the department did not have an endemic bullying problem.
He said the college accreditation review was based on a single bullying allegation and a separate external review found the incident did not meet the criteria for bullying, "but they certainly felt there was room for improvement".
The department has since developed an action plan and formed a taskforce that has taken a whole-of-culture approach to improving communication skills, interactions and teamwork within the training setting, Professor Bannon said.
"The data we have [shows] the patients have always been safe. That has never been an issue," he said.
Health Minister Brad Hazzard has launched an external investigation of the department.
Mr Hazzard said he was not aware the department would not be re-accredited in 2019 until he was contacted by The Herald.
But he had been informed of "alleged bullying and possible practice issues within the cardiothoracic unit".
The minister had "expressed a high level of concern" to the secretary of NSW Health after he was alerted to a separate investigation triggered by complaints from within the department this year.
"More recent information that has come to me through medical sources caused me to direct the secretary to implement a further external investigation of what occurred after the review that was undertaken," Mr Hazzard said.
"My primary concern was and is that patients are well cared for and I have been given those assurances."
In her statement, Dr Anderson said the cardiothoracic department would be fully staffed next year and would continue to provide the full range of world-class cardiothoracic services.
"This means that surgeries at the hospital will continue without interruption," the statement read.