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The Guardian
13-07-2025
- Health
- The Guardian
Indigenous midwife referred to by racist slur on staff whiteboard at Sydney's RPA hospital
A former midwife at one of Sydney's largest public hospitals who was referred to by a racist slur on a workplace whiteboard says the health system needs to do more to create culturally safe workspaces. Renee Bani, a Kaanju and Wagadagam woman, worked at the Royal Prince Alfred (RPA) hospital for seven years, primarily with the Aboriginal midwifery group practice program at the Camperdown campus. The program aims to provide Indigenous women and their babies with culturally safe care before, during and after birth. In August 2022, Bani saw that the Aboriginal midwife on duty had been described using a derogatory term as ''Abo MW' on a whiteboard in the hospital's Women and Babies Ambulatory Care Clinic. The whiteboard was used to record staff movements. Bani said she quit the job in 2024 due to chronic stress, overwork and burnout, but the slur was the last straw. She made a complaint to the hospital's senior management, who began an internal investigation. But Bani said she was left feeling drained by the 12-month inquiry, which concluded without an outcome as the hospital said there was insufficient evidence. 'It just it started to really drag me,' she said. 'I was fighting a battle that I couldn't fight alone and it came down to, basically, racism.' Bani said she wanted the hospital to introduce specific cultural awareness and anti-racism training to improve cultural safety for both staff and patients. 'People don't understand simple cultural awareness and just [the] appropriateness of culture. It just really ticked me off that [they] could drag this whole [process] out and keep me tight lipped, keep pressuring me,' she said. She said one manager didn't realise the use of the slur was an issue and asked 'What is wrong with it?', until another non-Indigenous colleague raised her concerns. Bani said she also felt she was treated differently than her lighter-skinned colleagues. 'There is a lot of colourism too,' she said. 'I mentioned that a lot in our clinical reviews, that I'm really struggling because I'm a darker skinned girl, and I'm not getting the same treatment.' In response to Guardian Australia, a spokesperson for the Sydney Local Health District (SLHD), which includes the RPA, said racism is unacceptable and that the whiteboard incident was thoroughly investigated. They said the hospital had since introduced a number of changes including mandatory cultural training for all staff in partnership with the Redfern Aboriginal medical service; an Aboriginal workforce network and a dedicated manager to promote a culturally safe workplace; and an Elders network to improve culturally appropriate decision-making. This month the RPA announced cuts to the number of midwives it employs, including a plan to merge the Aboriginal midwifery program with the general midwifery program, meaning the midwives will no longer be dedicated to Indigenous patients. The proposal sparked swift condemnation from current and former staff and prompted the hospital to promise a review of the decision. Paige Austin, one of only two current midwives assigned to the Aboriginal midwifery program, said it should have five full-time midwives. She spoke to Guardian Australia in her capacity as a member of the New South Wales Nurses and Midwives' Association, and said many women come to the program with fear or trauma from past negative experiences with healthcare providers and have complex social and health needs. 'There's a real systemic racism in hospitals, and there's history with Indigenous women around healthcare, and there's just mistrust,' Austin said. 'I think you can speak to any Indigenous family and find trauma that they've had with the healthcare system.' Austin said the work done by the program 'isn't just midwifery'. 'We're social workers, we're caseworkers, we're looking out for the women,' she said. 'We work a lot with drugs and alcohol. We have meetings with DcJ, there's extra things that normal MGP doesn't do.' The SLHD said the Aboriginal midwifery program remains available for Aboriginal women, despite staff no longer being dedicated just to that purpose, and they will receive holistic, culturally safe and trauma-informed maternity care at RPA. In a statement, they said the hospital made 'every effort to fill vacancies within maternity services when they arise' and was committed to providing high quality care. Guardian Australia has been investigating alleged racism and discrimination in mainstream maternity services. Prof Catherine Chamberlain is a Palawa woman, the chief midwifery officer for the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, a professor in Indigenous health at the University of Melbourne and a former midwife. She said that culturally safe and supportive workplaces were essential for all Aboriginal and Torres Strait Islander staff, but that when she has asked at conferences if anyone had witnessed a lack of cultural safety in a healthcare setting, 'every single person put their hand up'. 'Unfortunately the reality is I've heard so many anecdotal stories of where people have reported instances of racism and lack of cultural safety in the workplace, and it just hasn't been dealt with,' she said. 'It is really critically important that all people experience care that's safe, otherwise there's a risk that people don't access the care that they need.' Chamberlain said creating a culturally safe workplace can help reduce the high rates of attrition among Aboriginal healthcare workers. 'We've got a huge challenge trying to recruit and retain Aboriginal nurses and midwives and there's a whole lot of reasons for that including institutional racism and structural barriers,' she said.
ABC News
02-06-2025
- General
- ABC News
The families seeing their loved ones abandoned by a mental health system in crisis
Desperate and grieving families say they're living with the consequences of the crisis in New South Wales' public mental health system. Their loved ones are part of a group the system does not adequately care for, known as "the missing middle" — people with complex mental health needs who are too unwell for a GP, but not sick enough to be admitted to hospital. Without proper support in the community, their health can deteriorate to a life-threatening point where they need the acute care of a hospital. Doctors say the crisis is only getting worse, revealing the under-resourcing of mental health in the state has led to them turning people away from care and discharging patients before it's safe. "People might be discharged early, they may have another attempt on their life, which I saw on a number of occasions, and then they'd come back to a hospital," Suzy Goodison, former psychiatrist at Sydney's largest hospital, the Royal Prince Alfred, said. Four Corners was flooded with responses after asking its audience to share their experiences seeking help for serious mental illness in NSW. A clear pattern emerged — people spoke repeatedly about how they, or their loved ones, were discharged too soon or denied care when they needed it most, sometimes with devastating consequences. Warning: This story contains references to suicide and self-harm and may be distressing for some readers. One father told Four Corners his daughter's early discharge from hospital actively triggered her to self-harm. "My daughter has had several admissions to hospital for suicidal ideation or suicide attempts. "In each case, she has simply been discharged after waiting all day (and night, in some cases) in emergency. "In my daughter's most recent admission to a Sydney hospital, she was again discharged without any further direction provided for her care. "As soon as she got home that afternoon, she went to her room and attempted suicide. We later found out that the trigger for this suicide attempt was despair at being sent home again, when she knew that she needed serious care but would never receive it. "Our GP has had to play the role of ad hoc psychiatrist, prescribing and monitoring depression and anxiety medication. "He personally tried to contact psychiatrists in the public and private system on our behalf, but those either did not reply to his calls, were closed to new patients or were prohibitively expensive." It costs more than $1,000 a day to stay in a private mental health clinic and only top gold cover private insurance will help pay for it. After dealing with an overwhelmed hospital system, patients are supposed to be assigned to a mental health team in the community staffed with psychologists, social workers, nurses, and ideally psychiatrists. The NSW government's own data shows it's likely that almost 60,000 people with severe mental illness aren't getting the community care they need, because the teams are so short staffed. "It comes down to loss of staffing in community mental health services, they're running on the sniff of an oily rag," said Dr Goodison, who previously worked in the community teams in the Sydney Local Health District. "These people with really chronic, debilitating mental health issues become unwell in the community, the community team can no longer hold onto them, and so they come to hospital," Dr Goodison said. This mother said her son was repeatedly told by a community mental health team in Sydney tasked with supporting people at crisis point, that no help was available. "In mid 2024 our son was admitted three times to the emergency department. "Then in July, experiencing distress and not wanting to go back to the emergency department, he called the acute community care team and asked for help. "He was informed there was no assistance available as they were understaffed. "He put me on the phone to the member of the acute care team who told me that they did not have anyone available to speak with him or come and see him, and that I should call the police or take him to the ED. "I was later told by a member of this team, that the understaffing and under-resources of this service is the worst it has been for 20 years, and the service is unable to help young people experiencing acute distress or crisis such as my son. "Our son died late last year, aged 19. "He was a beautiful, clever, thoughtful, compassionate, perceptive, loved and loving and profoundly sensitive child and adolescent who had struggled — with courage and resilience." More than 4 million Australians are experiencing a serious mental health challenge and rates of severe symptoms are rising, according to a landmark national survey by Beyond Blue obtained by Four Corners. But more than half of them are not getting the help they need, when they need it. The figures reflect the experience of these families, like Penny Leemhuis', whose brother died by suicide last year. He had presented to a mental health hospital unit three times in three weeks, as well as an emergency department, saying he had thoughts of suicide. "In March last year, my brother Luke took his own life… [and] a serious adverse event investigation was held. "The report was over 200 pages long, finding multiple systemic failures and lack of procedures contributed to Luke ultimately taking his life. They were identified as missed opportunities. "At what point will governments across all levels, recognise and understand that we in Australia have an escalating mental health crisis that is not being adequately addressed? "Luke was a person. Luke had a life. Luke, like so many others, deserved better." The NSW government told Four Corners it invested $2.9 billion into mental health services in the last year, including funding for community support programs which reduces pressure on emergency departments. That includes $102 million for living support programs. "We acknowledge there is more work to do to address the areas of need, and NSW Health is continuing this important work with stakeholders to further investigate and identify services best suited to addressing identified gaps," a spokesperson said. Despite government spending, many families have struggled to access services — like this father whose daughter died by suicide last year after consistently being discharged from psychiatric wards before she was ready. "Alice was a cherished and much-loved daughter and sister. "In the nine months before she died, she had three separate month-long admissions to psychiatric wards under a schedule. "The day before her final discharge from the psych ward she said to me, 'I can't wait to get out of here so I can kill myself.' "I told the doctors exactly what she had said but they discharged her the next day. "In the final three weeks I took her to the emergency department twice. I pleaded with them to admit her, explained how unwell she was and that she talked of little else but suicide. Each time she was discharged after a few hours. Days later she was dead. "I believe very strongly that Alice's suicide was due to a complete failure by the health system, a failure in duty of care. There were a sea of red flags, that were ignored, overlooked or minimised." Testimonies like this along with firsthand experiences from doctors show the current system isn't fit for purpose, according to the NSW chair for the Royal Australian and New Zealand College of Psychiatrists. "This is a shortfall we would not accept anywhere else in our health sector," Pramudie Gunaratne said. "The only thing that we are able to actually uphold in our current public mental health [system] is crisis care, and that doesn't actually provide ongoing, good quality care for our patients. "If all we have is a revolving door where someone comes in under crisis, we are able to kind of keep them in a ward, patch them up, and then send them back out for them only to come back again. "So I don't think we really have a system at all at the moment." NSW Health told Four Corners patients are not discharged "unless clinically appropriate". "We will never turn people away," a state government spokesman said. "We want to make it very clear — if anyone is in need of mental health treatment they should reach out for help. Our system is designed to provide it, and has continued to, throughout this process." Watch Four Corners's full investigation, Emergency: The Long Wait for Help on ABC iview.
News.com.au
28-05-2025
- Health
- News.com.au
Schiller taken to Hospital after pre-race fall at Canterbury
Tyler Schiller has been taken to Royal Prince Alfred (RPA) after parting company with his mount prior to the opening race at Canterbury Park on Wednesday. Schiller was aboard the Gary Portelli -trained Rockabye Roxy when the filly reared going out onto the track, sending Schiller to the turf. Schiller was conscious, moving his limbs and talking when treated by paramedics, but he was complaining of soreness in his back. All races on the Canterbury card were put back a race due to the delay while waiting for a replacement ambulance. The last race will be run at 5pm. Gallo Nero, Superalloy in the Group 1 Queensland Derby and Payline in the Group 1 Kingsford Smith Cup.
