It might be hoped that a factor in the prime minister's decision on who to appoint the next health department secretary will be a commitment to creating and maintaining an agency with the best possible culture, including the highest standards on stakeholder engagement.
Last week, health minister Mark Butler announced the planned retirement of Professor Brendan Murphy AC. Mr Butler said a 'recruitment process' for a successor is underway.
The Commonwealth does not appoint agency heads based on the normal understanding of that term.
It is hard to imagine that the prime minister, the secretary of his department and even Mr Butler, who presumably will be consulted on the appointment, do not already have a well-developed view of who should lead the agency responsible for delivering much of the Government's policy agenda.
It is fair to assume that a new secretary will lead to change, but what change?
Since its election last year, the Albanese Government has publicly highlighted the importance of proper conduct from its ministers, their personal staff and the officials delivering its policy program.
In an interview with the Australian Financial Review late last year, the secretary of the Department of the Prime Minister and Cabinet, Professor Glyn Davis AC, emphasised the point and said the new National Anti-Corruption Commission (commission) would fundamentally change public service behaviour.
“It will encourage public servants to reflect on what they’re doing and to contemplate how it sits against the Code of Conduct,” he said.
The commission's enabling legislation defines corruption as conduct that directly or indirectly adversely impacts the honest exercise of an official's powers, breaches public trust, involves the misuse of information or documents acquired in the person’s capacity, or represents an abuse of office.
The Australian Public Service Code of Conduct requires officials to act and administer programs according to certain principles, including integrity and respect for stakeholders and the public.
It creates a framework that guides government officials and aims to protect individuals and organisations engaging with the government.
The Code of Conduct's protections are important for every stakeholder, including large multinational companies fortunate to maintain an institutionalised relationship with the Government and its officials.
Yet they are particularly important for organisations whose day-to-day existence can depend on decisions taken by the officials who wield extraordinary power often delegated by the health minister.
Nobody should doubt that the respectful treatment of stakeholders is integral to good public health outcomes. In the end, the government's officials are just another vested interest, and their version of a positive outcome does not necessarily align with the community's.
It is naive to think officials happily implement the elected Government's policy agenda without consideration of their agendas.
These agendas are currently in play with the bureaucratic-led 'backsliding' on some of the Albanese Government's key election commitments, including Patient Pathways, funding for NPS MedicineWise and reform of Australia's utterly hopeless newborn bloodspot screening programs.
A few seasoned senior officials on Mr Butler's personal staff would quickly address these issues. Experienced personal staff would enable the minister to identify and manage when the bureaucracy is not providing advice free of its own agenda.
Advocacy and engagement are critical to good outcomes. Tension is a natural consequence of the relationship. However, Mr Butler, every Australian politician and the new health department secretary should be concerned that the cultural issues in the health bureaucracy dominate discussion across the life sciences sector, and the fear of retribution for speaking out is genuine.
Yes, in Australia, in 2023, individuals and organisations fear the consequences of speaking out against government officials.
Surely the treatment and 'gaslighting' of Kate Holliday at the Centre for Community-Driven Research is the best possible evidence of why stakeholder groups fear speaking out?
The Department of Health and Aged Care recently engaged external legal advisers, using taxpayer dollars, to investigate allegations against some of its officials.
Some allegations relate to bullying, threats and coercive behaviour. The officials deserve the presumption of innocence.
What about one official suggesting to the leader of an external organisation that they should treat them 'as if they are God'?
What about officials accepting the late input of a competitor company to a Medical Services Advisory Committee process and not informing the applicant? What about concealing the existence of this input, including in official outcome statements, until compelled in response to a Freedom of Information request?
Readers might also remember the performance of one senior health department official at the 2020 BioPharmaDispatch conference. They thought it appropriate to admonish the audience for having the temerity to suggest the need for change.
To what extent do these examples reflect the questionable conduct of certain officials or a wider issue with the culture of an agency? Are any examples of corruption as the new commission defines that term?
More importantly, have they contributed to negative outcomes?
It is always possible to highlight specific examples of questionable conduct, but the new secretary might contemplate whether they indicate the existence of a deeper issue.
Correspondence seen by BioPharmaDispatch confirms that Professor Murphy and Professor Davis are aware of the detail of at least some of the allegations against health department officials that are currently the subject of investigation.
The correspondence shows that both endorsed a direction to a complainant (Kate Holliday) that they must continue day-to-day engagement with an alleged perpetrator of bullying while an investigation of the conduct is ongoing.
The official was named in the complaint. The health department decided to exclude them.
In Professor Davis' own words, do they believe that any official, reflecting on how their actions sit against the Code of Conduct, would effectively dismiss the complaint's substance and direct a bullying victim to continue engaging with the alleged perpetrator?
What would they do if one of their junior officials lodged a bullying complaint against their manager? It is hard to imagine they would investigate the complaint but exclude the named alleged perpetrator and direct the junior official to continue as if nothing had happened. Yet that was the effect of the direction given to one small organisation.
The advice officials gave the complainant in response to their expression of distress over this direction made the situation far worse. Ms Holliday was told to contact LifeLine. Even if we presume it was well-intentioned, the suggestion makes for very jarring reading.
What does it say about 'culture' that a discussion about the response to a bullying complaint ends with the endorsement of words to the effect that 'we are sorry you are distressed but keep working with the alleged perpetrator because we have decided to exclude them from the investigation and call a non-government helpline if that might assist'?
