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    I have to disagree that politics is absent from the impressive Garling report, through which I have now spent hours of NSW Health time paging through in Acrobat Reader. Garling actively acknowledges the enormous number of stakeholders in public health, from governmental, institutional and educational bodies to professional groups and the general public, through carefully balancing the submissions and viewpoints of these stakeholders in his report.

    What is most refreshing about the Garling report is the timely reminder that ‘Patients come first.’ Garling has heard all about the petty politics of turf wars and professional grievances on his whistlestop tour around the state and implicity understands the vital Political (with a capital ‘P’) implications of this inquiry. But, quite frankly, he seems to have had enough of politics as a diversion from the sine qua non of healthcare: patient care.

    ‘Patients first’ is a theme which Garling constantly returns to. Every other issue, and there are many, is subordinate; every recommendation he makes is with the constant goal of improving patient care and satisfaction with that care.

    Garling is at times indignant but overall shows a remarkable degree of sympathy for those at the coalface of NSW Health. This is particularly true when it comes to the main issues that junior doctors in NSW regularly face: lack of supervision, inordinately high levels of responsibility and often dangerous workloads. He clearly and insistently states that the current way of doing things is so far removed from putting patients first that it would be laughable if it weren’t so tragic.

    The Garling Report should be mandatory reading for anyone working in NSW Health. Its recommendations will be actively resisted by many groups; many doctors are already bristling at the mandate to wear uniform vests colour-coded by rank and specialty. But after reading the report it’s hard to argue with Garling’s conclusions, predicated as they are on the desire for safe and satisfactory patient journeys through public hospitals.

    Indeed, one begins to feel sheepish at having their pride wounded by the suggestion that they have to wear a red vest to work. For too long now, doctors, nurses and bureaucrats have been taught, explicity and implicity, that their needs come first. Garling, humanely and firmly, points us back towards the core reason we all said we got into this industry in the first place: helping people.


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