Ex-WA Health director-general Neale Fong says St John WA needs more changes after Michelle Fyfe’s departure

St John WA needs “fresh blood throughout the whole organisation”, according to the chair of a panel previously tasked with a forensic review of the ambulance provider. Former WA Health director-general Neale Fong, who now heads the board of the WA Country Health Service, said he worried cultural issues identified in a 2016 probe of St John — including workplace bullying and a disconnect between management and frontline workers — continued to plague the not-for-profit. “St John appears to be a very difficult organisation to manage and lead. You have to ask questions about not just the CEO and management but of the board,” Dr Fong said. His comments come as St John embarks on a “global search” for a new chief executive after Michelle Fyfe on Tuesday announced her resignation, effective July 12. Ms Fyfe’s departure comes after months of scrutiny of St John following the deaths of three West Australians while waiting for paramedics, which came amid deteriorating response times and record ambulance ramping and COVID absenteeism. “I’m not going to call her a scapegoat but she had a very difficult job to do,” Dr Fong said. “I do think there needs to be more accountability all the way through the organisation to the top. One of the interesting things about St John is previous CEOs have come on to the board and so culture change can be quite difficult to bring about.” Dr Fong chaired an independent oversight panel formed to review St John operations in the wake of a spate of paramedic suicides between 2013 and 2015. The panel’s 2016 report detailed a “toxic” work environment for paramedics. That finding was echoed by a recent parliamentary inquiry that said “the evidence suggests cultural issues at St John Ambulance WA extends to serious matters such as harassment and bullying and the current processes do not adequately address these matters”. “We basically had a royal commission — we interviewed so many paramedics and St John staff — so for the latest inquiry to find some of the same issues still haven’t been fully addressed was disappointing,” Dr Fong said. “I think some fresh blood throughout the whole organisation is probably what is required and not to be so resistant all the time to change, that has clearly been a problem over the last 10 to 15 years.” Adelaide Medical School director Alexander McFarlane — who worked alongside Dr Fong on the review panel — said he was disappointed by what he perceived as St John’s response to the 2016 report. “What I personally found troubling was the lack of engagement with the report subsequent to it being produced,” Professor McFarlane said. “It was my impression that they really didn’t want to engage. It didn’t appear there was a desire to reach back to the people who produced the report to get further suggestion or directions about how the matters raised could be resolved.” Dr Fong said he fully supported weakening St John’s grip on non-critical patient transfers between hospitals — a key recommendation of the parliamentary inquiry — in favour of a greater focus on having ambulances available to respond to emergency calls. “This is one of the things St John has resisted because obviously there is an economic benefit to it; they think it is their patch,” he said. “But things change, the world changes, health has changed — competition needs to be brought in.” Dr Fong said he also backed introducing minimum standards in a much broader swath of country WA.