THE PUBLIC SERVICE COMMISSIONER:
With reference to the Under Secretary’s memorandum to you and our proposed discussion tomorrow, I feel it may be advantageous if I outlined my point of view.
Whether, as the Under Secretary suggests, it is my temperament that makes it impossible for me to reconcile myself to the existing Departmental establishment it is for you to determine. This, however, is a matter of minor importance as I am now in a position to put into effect my decision stated to the Hon. Minister for Health before accepting appointment that I would not continue in the Public Service of Western Australia under these condition and no doubt a Commissioner of more amenable disposition may be carefully selected to succeed me.
Whilst we are on the personal aspect you will recall that I asked Mr. Panton for an assurance, before I accepted appointment, that I would be in effect the head of the Department. This assurance was given unequivocally. On my arrival here, I found that this assurance was not to be honoured and I tendered my resignation to Mr. Nulsen. From that time forward there has been succession of disputes and palliative re-adjustments and re-assurances under which I have endeavoured to continue in office with increasing discontent.
To be quite honest and definite I should not have made the attempt had an alternative employment have open to me at any earlier stage, and I should not have sought alternative employment had the discontent not existed.
In a memorandum to you dated 23rd August the Under Secretary states that the present basis of Departmental administration was decided by the Government two years ago, which is well within the period of my service here. I have no knowledge of any such decision which has never been conveyed to me officially or otherwise.
From the impersonal aspect I must state as my conviction that in common with all the Health Departments in the States of Australia, that of Western Australia has fallen into a rut of routine administration which is archaic and under which expansion at a higher level of efficiency into new and profitable fields of health endeavour cannot be expected. On the contrary this routine is determined by the application of outmoded formulae devised and applied by untrained persons in conformity with precepts and principles designed for general application in a large number of Departments whose functions and activities bear no relation to those of this Department.
A progressive Health Department must have as its ideational centre and administrator, an Officer trained and experienced in public health and medical practice. In modern times this officer must have available to him the advice and practical assistance of specialists in the various branches of medicine. This State cannot afford to pay such officers in the number and for the time they are required, but it is possible to obtain their co-operation in an honorary capacity in exchange for an assurance that the head of the Department is a medical practitioner.
The major cause of friction from my point of view has been the sense of insecurity occasioned by the fact that under the Minister I cannot be assured of the continuity and stability of medical policy. Nor can I be confident that those multifarious problems arising from time to time in a service so closely involved in the emotional crises of humanity, shall be resolved upon a sound medical basis rather than by the application of some lay devised prescriptive formula, which seems to meet the case.
The Under Secretary makes light of the incident which has provoked this new dispute. This well discloses the gulf which severs the professional from the lay administrators in the Department because I, as Principal Medical Officer, regard it as of fundamental importance.
Quite unnecessarily an epidemic of Poliomyelitis threw the State and its Government into a condition bordering on panic last year. The medical organisation of the State, as successfully conducted over the years by a lay administration was revealed to be quite unprepared to meet it. All manner of expedients were necessary and for the devising of these the professional officers of the Department were given the responsibility.
Considerable difficulty was experienced in obtaining physio-therapists, absolutely essential for the care of the patients. I, not in my capacity as Principal Medical Officer, but personally was responsible for obtaining three; one a close friend of my eldest son, and two who were friends of hers who agreed to join her here.
The conditions of employment stated by me to these girls were given me by the Assistant Under Secretary, Medical. After the arrival of the first of them it was found that the actual conditions of employment did not come up to the promise made and some mutually acceptable adjustment, the details of which I am not aware, became necessary.
This appears to have created an anomaly in the conditions of employment of other physio-therapists which has occasioned discontent amongst them and threatened to influence some against receiving their appointments.
The maintenance of adequate physio-therapy staff is essentially a matter affect the practice of medicine insofar as it is concerned with Poliomyelitis.
The Committee of medical practitioners set up by the Government to advise the Minister, was gravely concerned at the existence of this discontent and it was a matter frequently discussed between them and with the Principal Medical Officer who, as the professional administrator of the Department was held to be responsible.
It cannot be disputed that these gentlemen were at all times at perfect liberty to raise this question with me and to expect action from me or at least an answer. In effect I am denied an opportunity of receiving their correspondence, of deciding the action to be taken arising from it or of being informed which action has been taken in my name or otherwise.
If this is good administration in public health in the view of the West Australian Public Service, Western Australia is welcome to it, but I personally will have no part of it.
C E Cook
COMMISSIONER OF PUBLIC HEALTH
CEC/PB
25th August, 1949