Health district CEO in code of conduct stoush over inquiry 'gag'

The former chair of a New South Wales local health district thinks its current CEO overstepped his remit in bluntly directing members of his executive not to attend the local hearing of a Senate Select Committee looking at federal health funding.

Both have now accused the other of breaching the NSW Health code of conduct.

Dr Steve Flecknoe-Brown, a pathologist who was chair of the Far West Local Health District board until December 2012 and is now contracted to the LHD as a visiting medical officer, chose to send an email from the office of CEO Stuart Riley to the committee. It read:

“If you have been notified of the Senate Select Committee on Health public hearing in Broken Hill on 10 June (attached), Stuart has directed that members of the executive are not to attend the public hearing or the round table discussions.”

“I was under the impression that you couldn’t do that,” Flecknoe-Brown told The Mandarin. “I was under the impression that that was contempt of parliament.”

As one might expect, the Opposition and minor party members of the select committee were unimpressed with Riley’s email, and chair Senator Deborah O’Neill fired off a letter to New South Wales Health Minister Jillian Skinner demanding an explanation. Skinner has not responded yet.

Riley then wrote to Flecknoe-Brown on June 12, accusing him of breaching the code of conduct, which applies to him as a VMO. In his reply, five days later, the pathologist said he believed Riley had breached the code of conduct with his original missive to the executive, and that the letter was an attempt to “intimidate” him.

In his June 12 letter, Riley suggests to Flecknoe-Brown that in giving the email — which Senator O’Neill has described as “tantamount to an official gag” — to the committee, he may have breached the following clauses:

4.3.10 avoid conduct that could bring NSW Health or any of its staff, patients or clients into disrepute, including when using social media;

4.3.11 act in a way which protects and promotes the interests of NSW Health and the particular NSW Health agency where they work;

4.3.12 only provide official comment on matters related to NSW Health if authorised to do so.

Riley’s letter goes on to say:

“On this occasion I am prepared to accept that your actions were not intended to bring NSW Health or the NSW Government into disrepute, or to negatively affect the interests of NSW Health, despite this being the case.”

Flecknoe-Brown thinks Riley’s actions breached the code of conduct’s core values: collaboration, openness, respect and empowerment. “And there is a specific comment at the beginning of the code of conduct saying [NSW Health] will welcome and encourage people to speak freely and openly,” he added. “We’ll see what happens from here.”

The code of conduct expands on the value of “openness” with the following points, with emphasis added to the specific points that Flecknoe-Brown believes the CEO has violated:

• We want our community to have confidence in their local health services.
• We foster greater confidence and cooperation through open communication.
• Our performance is open to public scrutiny through patient and employee surveys.
• We welcome and use feedback as a tool to do better.
• We encourage those around us to speak up and voice their ideas as well as their concerns by making it clear that speaking up is worthwhile and valued.
• We communicate clearly and with integrity.

Flecknoe-Brown said in his letter:

In his letter, Riley also says:

“I appreciate that you are dissatisfied with my approach to managing the LHD after the events of 4 June.”

The Mandarin understands the LHD chief executive was referring to a meeting which resulted in the resignation of Flecknoe-Brown’s wife, Jane Corcoran, as general manager of the Broken Hill Health Service. He said Riley “demanded and received” Corcoran’s resignation and that both are relieved she no longer works for the organisation, but that his actions in sending the email to the Senate committee were unrelated and were commenced before June 4.

The doctor’s reply to Riley ends:

Flecknoe-Brown also lectures at Broken Hill University’s health school and is currently chair of the NSW Health Pathology board.

“What offended me was not the thought that the local health district wasn’t putting in a submission; that’s their business, I agree entirely,” he said. “What bothered me was the blunt ‘You will not attend’ — as if a person in a free democracy is not allowed to attend a [parliamentary] hearing in a private capacity.”

The doctor actually thinks few, if any, of the executives would have attended the hearing or the round table as private citizens in any case. But he says some were “highly offended by the tone of the instruction” as he was, while others weren’t particularly bothered and saw the directive as a “lawful instruction” from the CEO.

The row highlights how complex codes of conduct can be.

The Senate inquiry is looking at various aspects of federal health funding, policy and expenditure, in particular the impact of a reduction in federal funding.

But if the directive not to attend the hearing or round table came from the department or even higher up the chain, it hasn’t reached Flecknoe-Brown in his capacity as chair of the NSW Health Pathology board. “I certainly don’t see anything in my organisation that suggests that there’s an embargo on talking to the press [or the Senate inquiry],” he said.

In his own submission to the inquiry he does not blame the federal Coalition government:

“The reduction in Commonwealth funding for hospitals started far before the election of the current government.

“Cost-shifting is due to the failure over the decades for Commonwealth and states to agree upon the proper apportionment of costs for hospitals and primary health care activities. Until consensus is reached, cost-shifting activities will continue, with ever-increasing complexity and resultant waste.

“A larger proportion of primary care activities in the Far West Local Health District (LHD) are provided by the NSW public health system than in other NSW LHDs. This is a result of workforce issues, poor financial viability of private medical services and the vast areas the Far West LHD covers. As a result, much of the Far West LHD’s budget is consumed by activities which would normally be underwritten by the Commonwealth through Medicare.”

He says NSW Health Pathology is a little worried about the impact of current federal policy but “making the appropriate adjustments to make sure that the impact is minimised”.

A spokesperson for the Far West Local Health District told The Mandarin the CEO, Stuart Riley, is seeking legal advice and would not provide any comment.

Read more at The Mandarin: John Menadue: fixing health cooperation in the Federation