This paper's reporting on MP Maggie Barry's alleged bullying, the local DHB emergency department staffing shortages, and the reopened investigation into the CTV building collapse, have in common the inconvenient truth that there is apparently no accountability for the misdeeds of the powerful.

The institutions where these erstwhile leaders serve, act to protect them and punish or dismiss those juniors who may be their victims.

It brings to mind memories from my own medical training. In the medical schools of the 1950's, in the USA, surgeons were king.

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Most conducted benign dictatorships, but there were those occasional tyrants who might, if the impulse struck, throw instruments in the operating theatre, berate junior surgeons, denigrate medical students, swear without restraint. In short, these men — there were only male surgeons then — acted out of entitlement, with no regard for the feelings of those with lesser powers.

In the pyramids of ascendancy toward the lofty rung of full professorship, the behavioural mode was "kiss up, kick down."

That was the accepted atmosphere of the times, and no one dared question it — certainly not a lowly medical student. And it continued until the 1980s when house officers organised and external bodies including laymen questioned and brought changes, and today that behaviour is totally unacceptable. Which is as it should be.

If my experience can be a guide, I'd imagine that those underlings, those secretaries in Maggie Barry's office who allege that she created a toxic work environment, those junior doctors working in emergency without senior supervision, the inexperienced structural engineer designing on the CTV, all probably felt isolated and personally deficient. As if the mistreatment were deserved.

Because that's how it used to be and was taken for granted. Whether it was the children abused by priests, the young lawyers at Russel McVeigh, the women and men accusing Harvey Weinstein and Kevin Spacey and too many others. Their initial silence — sometimes for decades — self-imposed by assumption of guilt.

There's a new wind blowing. It's blowing away the old droit de seigneur of the showbiz bigwigs and casting out the casting couch. And it needs to happen in everyday fields of endeavour, wherever the possibility exists of abuse of power. Obviously, parliament is a good place to begin.

The problem is that the mechanisms for accountability have been demonstrated as unreliable. If we've learned anything from the church scandal it's that the first loyalty of an institution, even one with the loftiest goals, is to itself.

At our own DHB, Chief Medical Officer, Dr Frank Rawlinson, first acknowledges the junior doctors left to fend for themselves but then says, in defence of the situation, that the nursing staff are there as support. That's outrageous. Nurses have enough to do as nurses. No competent experienced nurse wants to be responsible for the working of a doctor.


It's as good an example as any of administrators not really listening to the complainant and acting to solve the problem. In this case that means increased staff and ultimately it means an outlay of money to avert potential harm to patients and junior staff. The latter, and those SMO's who stay late, take on a responsibility that rightly belongs to the bosses, the administrators.

What's needed is a clear understanding of frank and more subtle bullying. It's disrespecting the dignity and integrity of those co-workers of lesser power. Some lines crossed are subject to criminal proceedings. There are mechanisms for those situations.

For the more common garden variety bullying an external agency, one with investigative power is necessary, both to hear and assess the complaint and to afford the accused, too, the protections of Natural Justice.

One thing is clear. The institutions won't do it themselves, neither Parliament, whose victims describe a mafia-like code of silence, nor the DHB which appears to value its own defensive interests above the safety of its staff and their patients.

As voters, ratepayers, workers, patients, everyday folks, we've got to do it for them, and for all our safety.

Jay Kuten is an American-trained forensic psychiatrist who emigrated to New Zealand for the fly fishing. He spent 40 years comforting the afflicted and intends to spend the rest afflicting the comfortable.