THE crisis that has shrouded Portland District Health has exploded out into the open, with chief executive Christine Giles, former chairman Andrew Levings and the Health Department in a war of words over what has happened at the health service.

Ms Giles has spoken publicly for the first time on the circumstances that led her to take leave from her role in July last year after eight years in the job, just as she should have been riding a wave of public support for her much-praised local handling of the coronavirus pandemic.

Instead she told the Observer she was bullied by several government officials over many unrelated matters until her position became untenable for her own health.

The Health Department rejects her claims and launched its own attack, also speaking for the first time publicly on the changes to the board that have led to the present situation.

It has taken aim at both Ms Giles and former board chairman Andrew Levings, who resigned not longer after Ms Giles went on leave, a resignation that many believed was forced and which has effectively now been confirmed by the Department.

“The board and leadership of Portland District Health were restructured following the lack of progress and opposition to implementing the recommendations of the Hillis Report, the high number of board member resignations, unresolved safety concerns at Harbourside Lodge and ongoing financial issues – any suggestion otherwise is false and misleading,” a Health Department spokeswoman said.

“We have no tolerance for bullying or harassment of any kind, in any area of our health system and all allegations are taken seriously.

“We have attempted to engage with Ms Giles on multiple occasions to understand her issues so we can thoroughly investigate and address any concerns she may have. We have yet to receive a response.”

Ms Giles rejected the Department’s claims that it had tried to contact her several times, telling the Observer “they haven’t attempted to engage with me at all”.

It has led to the extraordinary situation of the chief executive of a major Portland institution not working there but her employer saying it has no idea why.

Ms Giles said she was now on unpaid sick leave, after using up her sick leave entitlements, but was considering lodging a WorkCover claim.

“I’ve been seeing a psychiatrist and two GPs, and they’ve told me I’m not to return to work until the stresses have been removed, until the board can guarantee a safe workplace,” she told the Observer.

“I can’t work with the current board because they’re not supportive of the community.

“One of the main roles of the CEO is to advise the board on the effects of decisions on the community and the board has a responsibility under the (Health) Act to consider the effects on the community of any decisions they make.

“I can’t feel comfortable working with them.”

Ms Giles welcomed the community support, even though her position meant she could not attend events such as last Friday’s public march, which attracted 200 people.

“The support is the reason that I’ve done what I’ve done all the time, and it’s good to know the community appreciate what I’ve done,” she said.

“It’s heartbreaking to sit here and watch it all being undone.”

She also called for gender balance on the current board, which she believes would lead to more calming behaviour.

“The government regulations say it should be 50 per cent, but that’s completely off on the board at the moment (it is now three of 10),” she said.

“I’ve got a different style of leadership and (the board) just don’t get it.”

The Department said it and the government were committed to improving gender diversity, which was a key consideration during the annual board appointment process.

A range of specialised skills and gender diversity were hallmarks of a good health service board, and the Department would continue to support the PDH board to develop an appropriate mix of directors in future, it said.

Ms Giles and Dr Levings also hit back at the government’s claims that they resisted the Hillis report.

Dr Levings pointed out he and another board member actually commissioned the 2020 report, then the-then Department of Health and Social Services sat on it for months before giving the board a week to respond to it – his version is backed by Ms Giles, who worked closely with Associate Professor David Hillis while he went through the process.

“I negotiated a further week so we had time to respond, and we gave a positive response,” Dr Levings said.

“The idea that we resisted implementation of the Hillis Report is a just complete nonsense and it’s a fabrication of what happened.”

The only issue he raised was that Hamilton be included in any regional partnership, but the Department insisted it only be limited to Warrnambool and Portland.

As revealed previously in the Observer – the “Towards a sustainable medical healthcare workforce in Portland” report has never been publicly released – the Hillis report calls on a new model for funding PDH.

It calls for the use of rural generalist doctors – doctors with a wider range of skills suited to rural environments – to staff the hospital, a process that will take 5-10 years, rather than any model which would see Portland become an outpost of a larger health service.

The Health Department said it accepted the Hillis recommendations – Regional Health Services Partnerships had been established to support collaboration, and these would also support the implementation of the statewide rural generalist program.

The Department had also been helping PDH in planning and providing specialist medical services, a particular problem it claimed was inadequately managed previously.

The government provided additional funding of $6.9 million to PDH this financial year, taking the total to $38.4 million, a 21.8 per cent increase on 2020-21.

The crisis at PDH deepened when seven specialists at the hospital – backed by five GPs – wrote an open letter to the public in the Observer recently, saying the board and Health Department were endangering lives, and the future of the hospital, by ignoring longstanding requests for more staff and upgraded facilities – as well as spending large amounts on more expensive locums rather than trying to attract permanent salaried staff that were needed.

Dr Levings said the Department was now “creating a sideshow that takes peoples’ attention away from the central issue which is chronic underfunding of essential health services,” he said.

Both Dr Levings and Ms Giles called for a review into the board appointments that saw it stacked with outsiders to replace locals.

The Department said there was a prescribed process in place for board appointments and the process was overseen by a Ministerial Advisory Committee independent of it.

Ms Giles said she fully supported rural generalists in hospitals such as Portland – backed by appropriate other specialists – and sat on a federal government expert committee on the subject.

But she believed one level of bureaucracy could be removed in rural health in general.

“The money that goes from the Commonwealth to the states to employ rural generalists is being swallowed up by the bureaucracy,” she said.

“My recommendation is we take out all these levels of government in rural health and the federal government take direct responsibility.

“The money that goes to the states could go directly to the local community o employ their own health services but what we’re doing at the moment is just supporting a whole lot of people in suits who walk around the metro area and add no value.

“The Hillis report should be used to make Portland a demonstration site for the whole of Australia, that’s what should happen but it can’t happen under the current (funding arrangements).”

She also called on the state government to appoint a Rural Health Minister, pointing out the issues facing communities such as this were far removed from those in Melbourne.

“Rural health money is subsidising metropolitan health,” she said.

“My whole aim has been to improve the health of rural communities, and Glenelg Shire has one of the worst sets of health statistics in the state.

“We’re dying younger, the amount of chronic disease we face is much higher and we’re asked to subsidise our health care all the time because we can’t access services.

“How does a dairy farmer tell his cows ‘I’m not going to milk you for three days because I’ve got to go and see a specialist’? What happens in rural communities is they say ‘I just can’t do it’ and they end up sicker and live lesser than anywhere else.

“What I’ve tried to do is change that.”

Ms Giles and Portland GP Marg Garde will present a paper at a health conference titled ‘The mouse that roared that details their plans, developed over several years, for Portland to develop its own doctors.

“We introduced a world-first program (from internship through to registration) which encouraged young medical students to settle in rural areas as they continued their training,” she said.

“It took all the advice from expert committees, thinking it through and coming up with an innovative approach – we needed to do something different because the same old way isn’t working.

“My fear is that program could be dismantled.”