Health bureaucracies and their public affairs units, ministerial staffers and health service managers make a powerful effort to stop people who work within the public health system from engaging in public debate.
On one hand, this is understandable – if everyone was hitting the headlines, complaining about the lack of resourcing to their particular area, then this could quickly lead to distortions in how funds are spent (as does indeed happen from time to time). Not to mention the political embarrassment this might cause.
On the other hand, this suppression of debate – enforced through endless protocols, employment contracts and other tactics, including bullying – is not healthy. It inhibits open discussion about the complexities of issues and challenges facing the system, and keeps the general public in the dark about what is, after all, meant to be a public service.
Those are just a few of the reasons why I’m delighted that a surgeon with a long commitment to the public sector, Professor Guy Maddern from Adelaide, has begun a new feature in the Crikey bulletin – Diary of a Surgeon. It records the life of a clinical director at St Anywhere. St Anywhere may be fictitious but the events and issues are real.
It will run every few weeks, if all things go according to plan, and will also be archived here in a single document.
Next step – anyone interested in writing a warts-and-all diary of a hospital boss or a public health manager? Or about life inside a health minister’s office? I can’t make any promises on behalf of Crikey, but Croakey would be very happy to publish such accounts…