Doctors silenced as bureaucrats prioritise metrics over medicine

As the NSW public hospital system reels from a historic doctors’ strike and ongoing staff burnout, a new social media policy issued by the Office of the Public Service Commissioner is being viewed by many clinicians as a thinly veiled attempt to silence dissent.

Communicated to Sydney Local Health District staff by Deputy Secretary of People, Culture and Governance Raoul Pope, the timing of the new social media policy has sparked anger and disapproval among doctors already fed up with a system they say punishes whistle-blowers and protects bureaucracy over patients.

Coinciding with the rollout of the policy, the Australian Salaried Medical Officers’ Federation (ASMOF) released its National Doctors’ Survey – a brutal exposé of dysfunction inside Australia’s public hospitals.

The findings are staggering. Only 25% of doctors said they were treated with respect by hospital administrators and managers. For specialty trainees, the very future of Australia’s public hospital system, the levels of disrespect were even higher.

The report paints what ASMOF calls “a deeply disturbing picture of dysfunction in the working relationships between administrators of Australia’s public hospitals and the doctors who work in them.”

Over two-thirds of doctors surveyed said hospital administrators lacked even a basic understanding of their clinical roles. Worse still, a mere 5% felt hospital budgets were aligned with clinical need.

Doctors say they’re not just unsupported, they’re actively punished for speaking out. Only 25% said they felt safe reporting workplace culture, safety, or other concerns. Many who did report issues described facing retribution, including bullying, intimidation, and even accusations of misconduct or insubordination. Over a quarter saw their performance evaluations downgraded.

Plastic surgeon Dr Anthony Porter, from the Royal Adelaide Hospital and Clinical Senior Lecturer at the Australian Institute for Machine Learning, said on social media “A hospital culture that hunts its whistle-blowers would rather protect its metrics than its patients. Every Australian who walks into a public ward should be alarmed: if doctors fear speaking up, dangerous care stays hidden and the next harm could be theirs.”

Psychiatrist Dr Tejpal Singh highlighted the absurdity of the situation, saying “NSW Health has a budget of $35.1B, which is more than the total GDP of many countries with even bigger populations. I contend that for the same money the NSW public can have a Rolls Royce healthcare service.

“The problem is the potential Rolls Royce is being driven by unfit and unqualified people who should not be behind the steering wheel at all. The politicians feel the managers are easy to control, but they do not understand that if executive and financial authority is given to frontline clinicians who actually see patients, then the broken Barina which has been run into the ground and is sputtering before the engine dies down, will be turned into a Rolls Royce which will fly on the highway and the politicians will be praised.”

The ASMOF survey comes on the heels of the first strike by NSW public hospital doctors in 25 years – a clear indication of just how deep the discontent runs.

Dr Porter issued a warning, saying “Hospitals exist for patients, not spreadsheets. The survey is a distress signal, not a gripe list. Until we replace today’s dysfunctional management model with governance grounded in clinical reality, the truth will keep working on us – and patients will keep paying the price.”

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