PROFESSOR SABE SABESAN Senior Medical Oncologist, Townsville, North Queensland
DR MICHAEL KIRK Medical Administration specialist, Rockhapton, Central Queensland
Health systems run differently: flatten the pyramid and try something new Autocratic systems in a democratic society bound to inflict moral injury on workforce and consumers The public health system remains the engine room of our country, providing universal health care to all Australians. The system’s operation is driven by multiple purposes; underpinned by contextual core
but apply to interprofessional behaviours, processes, actions, and decisions (such as clinician and patientfriendly processes). In the ideal system, activities and performance metrics of every layer align with the said purposes, while actions, processes, and decisions are guided by organisational values in a values-and-purpose aligned health system.
these purposes and values through strategic plans.
The pyramid structure of hierarchy within health systems
To name a few, these purposes may be addressing
Despite the rhetoric of teams and that “everyone
values. Most health services aspire to transform
equity of and timeliness of access, patient-centred care, workforce engagement and wellbeing, sustainability, team-based functioning, or high value care pathways. Commonly chosen values include compassion, equality, accountability, integrity, excellence, innovation, respect, engagement, and collaboration, and are usually associated with clever acronyms. These values are not merely related to human courtesy (such as asking, “Are you ok?”) 22
The Health Advocate • NOVEMBER 2022
is an incomplete leader and in need of complete teams”, management and clinical layers of public health system are structured as hierarchical pyramids where the ‘captain’, usually as the sole decision maker, sits at the pointy end. This autocracy within our workplaces is in direct contrast to our democratic values we venerate as Australians.
