Political bullying of senior health system managers won’t work

5 minute read

When organisations and people want to manipulate the media people should wonder why and resist it as far as practical.

Normally, our sister publication, Health Services Daily has a weekly compilation edition that contains the most clicked-on articles from the previous week’s HSD reporting. 

In a recent edition HSD‘s two best-performing articles for the week went missing from the list – not because we didn’t want you to read them, but because someone else didn’t. 

The first article talked about urgent care clinics and how they would not have been a priority for one PHN chief executive had they not been a Commonwealth initiative.  

The other was about how important it will be to be in the room when the national health agreement will be negotiated next year if value-based healthcare is to happen over the term of the next agreement. 

There were a couple of common denominators in those two stories.  

First, they were generated from a session of a certain peak healthcare organisation’s healthcare conference at which there were 200-odd senior Commonwealth, state, public, private, insurance and patient representatives.  

The organisation in question had an agreement, apparently, with speakers at the conference that any media coverage would be vetted by the organisation before publication was allowed. 

HSD didn’t agree to that condition. But we didn’t not agree to it either. We mistakenly overlooked the email saying it was a condition of our attendance. 

HSD, like TMR, is an independent media outlet. We sometimes will attend sessions where we know that Chatham House rules apply and we’re being allowed to attend for background only. Even then, we will often get a story after asking and explaining the reasoning to the right person. 

But this conference wasn’t that sort of deal. This was a conference with more than 200 people in the room from across the spectrum, any of whom could have tweeted (Xed?) away at any point of the proceedings, or just texted their mates about what was said (and probably did). 

Over the two days of the conference the matter of that agreement between speakers and the organisation was not mentioned to the audience nor to our reporter despite face-to-face conversations with the CEO.  

The organisation in question rang us and requested we pull both stories, and not in one go either. First one, then the other a couple of days later.  

We agreed because we didn’t actually answer the email saying the organisation had the right to vet material. 

In seeking to have the articles taken down the organisation mentioned that in at least one article, speakers had been misrepresented. 

That didn’t happen. 

We recorded the sessions and the quotes used in the articles were direct quotes from the transcripts. The stories were simple reports of panel sessions in which the moderator asked a question and the panellists being quoted answered them. 

Ironically, what was said in both sessions wasn’t particularly controversial. That UCCs don’t work to reduce emergency department presentations, has been known for more than 30 years now.  

But someone said it out loud, and most likely, someone else didn’t like that someone said it out loud. 

The most likely scenario here was that someone who didn’t like the political optics has taken issue with the voicing of what everyone else already knows – UCC’s are an expensive, messy and unworkable political smokescreen getting in the way of more meaningful hospital and primary care reform on patient access. 

What happened here is not that uncommon for the Australian healthcare sector.  

It’s a dynamic that is very difficult to pierce because most people who matter in the system are employed by government, and if government wants to persist with something everyone knows is wrong, you’d best not step out of line and say anything to rock the boat. 

So, if you’re high up in a hospital network, a PHN, or some other ultimately government-funded agency, if you step out of line, you might end up worrying what will happen when your contract comes up for renewal. It’s that bad. 

We aren’t blaming the conference hosts, or the someone at the conference who in the end didn’t want their words amplified in the media. 

We’re blaming the system and suggesting that this is a very big problem for a system that needs a lot more transparency in order to move faster and more constructively towards meaningful reform. 

People who run important parts of the system should be able to speak out and be protected to some degree in saying what they think.  

How else are we going to get a conversation going among enough key system administrators and managers to offset politics when it is politics that is clearly warping what is going on? 

As a quick by the way, there was nothing but good news out of the conference – value-based healthcare is a concept that is hard to argue with. 

But implementing it is fraught with complexity and difficulty and we if aren’t going to have honest and transparent conversations in the wider community about those issues, we are going to mess up big time with this important initiative. 

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