Ambulance Victoria Review Volume One – Safety, Respect and Trust

On 30 November 2021, the Victorian Equal Opportunity and Human Rights Commission (VEOHRC) released a new report (the Report) that should serve as a wake-up call for all organisations, and a model for those with the courage to identify and begin to address cultural issues in their workplace.

VEOHRC’s Review into Workplace Equality in Ambulance Victoria was commissioned following public reports of discrimination, sexual harassment, bullying and victimisation at Ambulance Victoria. Those who came forward spoke of a workplace culture that demeaned, excluded and discriminated against women in particular.

Volume one of the Report details the results of consultations with current and former Ambulance Victoria employees and volunteers, and sets out findings about the nature, extent, impact and drivers of discrimination, sexual harassment, bullying and victimisation. The aim of the Report is to allow Ambulance Victoria to take steps to address ongoing and immediate risks in these areas. The second volume of the Report, to be released in March 2022, will focus on other changes required in the areas of equality, fairness and inclusion.

The Reviewers utilised surveys, focus groups and interviews, accepted written submissions and conducted on-site visits. Input was received from a broad range of stakeholders, including employees, subject matter experts, unions and professional associations. As is often the case in workplace reviews, the stories people tell of their experiences (both what is and is not working well) in an organisation are the most powerful resource for any Reviewer. Combined with external research, data and literature review, the experiences shared throughout the Review led to a number of key findings. These included:

The extent of the issues:

  • 47.2% of survey respondents reported experiencing discrimination; 17.4%, sexual harassment; 52.4% bullying; and 34.5% victimisation
  • Less than 2 in 7 respondents said that felt ‘very safe’ or ‘completely safe’ from unlawful conduct at AV, with almost a quarter saying the did not feel safe at all
  • Over on-third of survey respondents said they felt ‘only slightly’ or ‘not at all’ respected at work

“it is clear that disrespect has been normalised and tolerated within the organisation.”

The nature of the issues:

  • Women were at heightened risk of experiencing sexual harassment and sex/gender discrimination and discrimination on the basis of pregnancy and parental status; however other forms of discrimination and bullying were widely reported
  • High percentages of respondents reported being bystanders to unlawful conduct (discrimination, sexual harassment or bullying)

“The experiences reported to the Commission by participants suggest that bullying and incivility, in particular, are defining features of the organisation’s culture.”

The impacts:

  • Mental ill-health, stress, undermining confidence and self-esteem, suicidal ideation and suicide attempts were all reported impacts
  • Poor organisational responses in some cases compounded the original impact
  • Combined, these factors impact adversely on workforce morale and trust in the organisation, and can undermine the basics role of the organisation itself in terms of clinical judgement, professionalism and ultimately patient experience

The drivers:

  • Power imbalance
  • Organisational tolerance of harmful conduct and a culture of silence based on belief that perpetrators will not be held to account
  • Disproportionate focus on meeting operational KPIs
  • Leadership and management gaps in identifying and responding to inappropriate conduct, a failure to model good behaviour and to hold perpetrators to account
  • Structural drivers, such as those that limit access to promotion for individuals who work flexibly
  • Work-related risk factors, including the high stress and isolated nature of some of the work

Many of the recommendations contained in the Report relate, unsurprisingly, to enabling people in the workplace to speak up; and listening and responding when they do.

Ambulance Victoria’s Chair, Ken Lay AO APM described the findings of the Report as “both painful and confronting”, setting out a breadth and depth of issues that are deeply disturbing. The Chair acknowledged that too many of the stories relayed to VEOHRC as part of the Review “hide in plain sight – accepted, tolerated, or ignored”. In short, the values espoused by the organisation were not reflected in practice and behaviour within the organisation.

As an organisation founded to provide care to people in time of need, it is easy to assume that the positive aim would drive a positive culture. This Report demonstrates the danger of such assumptions and the pervasiveness of issues such as sexual harassment and victimisation in workplaces regardless of their function. In this case, the issues persisted despite previous attempts to address concerns, the existence of policies, delivery of training and changes to complaint systems.

The challenge now for Ambulance Victoria and for other organisations who have the courage to shine a light on their own cultures, is what they need to do next to create a better, safer and more equal workplace. Identifying the gaps, as this Report has done is the key first step. Implementation of the Review’s recommendations is the second phase of this Review, guided and supported by VEOHRC. The third phase is an audit that will assess the extent to which AV has implemented the recommendations and make any further recommendations as required.

In our experience, the ongoing attention to culture, post-Review is key to reinforcing and embedding change.

As the VEOHR Commissioner states in his introduction, the Report “should be a wake-up call to all Board directors and CEOs. No matter the industry, no one is above the law”. The time for proactive approach to identifying and addressing issues of workplace culture has well and truly arrived. A Review does, as the Report describes, require hard work, commitment and courage over the long term to embed change and improve outcomes. This three-step approach undertaken by VEOHRC and AV provides a comprehensive model for this work and a template for other organisations with the courage for introspection.

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