GP-turned-MP Dr Amanda Cohn said she did not make the call for the removal of Albury Wodonga Health leadership lightly.
NSW Greens member Dr Amanda Cohn, a former Albury-Wodonga GP, took the somewhat extraordinary step last week of calling for the CEO and board chair of her local public hospital service to be sacked over allegations of toxic workplace culture.
Speaking under parliamentary privilege in the NSW Legislative Council on Thursday, Dr Cohn said it had been “distressing” to see the supportive and inclusive reputation of Albury Wodonga Health go backward.
“The blame for that lies squarely with CEO Bill Appleby, board chair Jonathan Green and both state governments failing to act,” Dr Cohn said.
“In October the Albury Wodonga Health Senior Medical Staff Association resoundingly passed motions of no confidence in the CEO and board chair.
“Nurses have said, ‘I wish I was more proud to say where I work’ and ‘It scares me to think myself or my family will need medical help at Albury Wodonga Health’.”
The region is a special case within Australia in that it straddles the NSW-Victoria border, making Albury Wodonga Health the only cross-border public health service in the country.
Even though it serves both the NSW town of Albury and the Victorian town of Wodonga and receives funding from both states, AWH technically operates under the authority of the Victorian Department of Health.
Speaking to The Medical Republic, Dr Cohn said she hoped that making the public call for Mr Green and Mr Appleby to be removed would trigger more scrutiny from the NSW and Victorian state governments.
“I’ve taken the really extraordinary step of calling for the board chair and CEO to be removed, which isn’t a call that I made lightly, but [was] in keeping with the votes of no confidence from senior clinicians that passed resoundingly,” she said.
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“And it’s not just senior doctors sounding the alarm.
“There have been really alarming statements and surveys from the local branch of the nurses’ union and from other unions representing other employee groups within the hospital.
“… I’d really like to see greater attention paid to this issue from both state governments, because it’s very clear that business as usual is having a negative impact on the community, and something needs to change.”
Residents of the region have lobbied for years for a combined hospital to be built from scratch at a new location; all parties initially appeared to commit to this plan.
But by late 2023, Mr Appleby and Mr Green had written to the Victorian and NSW health ministers explicitly stating that the $588 million in funding earmarked for the project would not be enough to deliver the single-site hospital.
Instead, the money would be used to “redevelop” existing sites.
Since that time, relations between AWH leadership and staff have frayed, culminating in a no-confidence motion in Mr Appleby and Mr Green last month. It passed with 76 votes to seven.
“As a former clinician myself, I know that doctors largely want to be able to just get on with their clinical work,” Dr Cohn told TMR.
“They don’t take this kind of action lightly. This vote of up to more than 90% of senior doctors passing a motion of no confidence in the board chair and CEO is really extraordinary.
“I don’t know how it’s possible to continue running a health service with that level of non-support from clinical staff.”
According to a survey conducted by the Border Medical Association earlier this year, which collected responses from 138 clinicians in the region, roughly two in three people agreed or strongly agreed that they had felt discouraged or silenced when raising concerns about the redevelopment.
More than 80% of respondents, 65% of whom were doctors, said they had seen peers discouraged or silenced when considering raising concerns about the hospital redevelopment.
Three in four agreed or strongly agreed that they held significant concern regarding negative consequences for their career or reputation if they raised sincerely held concerns about the hospital redevelopment.
“I feel that good clinicians, who genuinely care about their patients and raise these concerns are considered ‘troublemakers’ by the executive, which can result in punishment, which makes people stay silent for fear of their jobs/reputations,” one respondent said.
“I feel that often there is a ‘everything is fine’ message put out there by the executive, which is clearly not the case, when clinicians and resources are under significant strain, and patient care is impacted on a daily basis.”
Other respondents said they had “personally been gaslighted and excluded” for voicing concern with the redevelopment, and that it had been a “shameful” process.
When contacted for comment, AWH said it was “committed to a safe, inclusive, and respectful work environment where people are supported, valued, and empowered to deliver high quality, safe, person-centred care”.
All staff members, it said, have a shared responsibility to contribute to a safe, inclusive, and positive working environment.
The health service has also noted that the motion of no confidence does not have any legal standing or governance authority within AWH.
