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Health bureaucracy promises

Martin B Van Der Weyden
Med J Aust 2006; 184 (3): 97.
Published online: 6 February 2006

One unsavoury finding of the Bundaberg Hospital saga is the incompetence and arrogance of some hospital administrators. A recent commentary in Quadrant pulls no punches, noting that:

“It is virtually impossible to describe the ingrained evasiveness, the compulsive buck passing, the deliberately obfuscatory language, the strategic amnesia, and the mechanical reciting of rules to excuse the inexcusable, displayed by the Bundaberg Hospital administrative staff . . .”

However, this insularity and conceit was not peculiar to Bundaberg Hospital — the inquiries triggered by the scandal found Queensland Health sorely wanting in its stewardship.

But now all this has changed!

At a recent meeting in Brisbane, the closing address was given by a high-ranking Queensland Health bureaucrat. Her speech had a mea culpa theme, and sought forgiveness for past bureaucratic inadequacies. We were told that Queensland Health had turned over a new leaf, and would put serving the public and health professionals first! The values of caring for people, leadership, respect, integrity and public service were all codified in a new Queensland Health code of conduct.

However, scepticism pervaded the meeting. Old heads were well aware that reforming a bureaucratic culture will require more than a new code of conduct. Burning questions are: Who will ensure bureaucratic accountability and transparency? Who will ensure that the health bureaucracy will not slip back into the old habit of believing that “they know better what is good for the people than the people know themselves”? Who will ensure that they serve the public rather than their political paymasters?

It remains to be seen whether the Queensland Health promise to listen, care and act for people and health professionals is more than the usual bureaucratic rhetoric.

  • Martin B Van Der Weyden

  • The Medical Journal of Australia

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