3. Speak up safely

1. Understand the risks and benefits of speaking up

Outlined in this section are approaches that may help you speak up safely, ideally with the support of trusted senior colleagues, peers, and independent treating clinicians. Clearly, these examples of speak up options must be tailored to the specific issues and risks within your workplace in consultation with supportive colleagues.

The pervasive fear of speaking up about hazards and harm in healthcare is real - and damaging - because of the risk of career retaliation. Under new WHS laws, senior clinicians now have both a professional and legal duty to support and speak up on behalf of junior colleagues, as they are in positions of influence and are often less exposed to career harm. 

For decades, the warning signs have been clear. Bullying, sexual harassment, discrimination, racism and violence persist despite decades of policies, awareness campaigns, and professional standards. Clinicians in training continue to report unsafe hours, inadequate supervision, and wage theft. Speak-up systems remain weak, with many clinicians choosing silence over the risk of career damage.

The consequences are predictable.

Exposure to unsafe systems leads to repeated harm. Over time, clinicians lose agency, withdraw, and disengage. Some leave entirely. Others remain but reduce clinical work, avoid leadership roles, or continue working while unwell or distressed.

The underlying pathology is a systemic failure to provide safe, sustainable working conditions.

Too often, unacceptable behaviours are minimised or normalised. Bullying is sometimes incorrectly reframed as “high standards”. 

Discrimination is dismissed as misunderstanding. Excessive workloads are treated as a rite of passage.

When clinicians raise concerns, the response is frequently silence, delay, or defensiveness. In some cases, those who speak up are labelled difficult, lacking resilience, or unsuited to the profession.

These responses do more than fail to solve the problem. They create a second injury - reinforcing fear, discouraging reporting, and perpetuating harm.

Eventually, silence becomes the safest option. It doesn’t have to be this way. 

2. Try a harm minimisation approach first

Healthcare is complex, high-pressure work. Objective peer review, constructive feedback, and robust clinical debate are essential to improving patient care - but clinicians do not always disagree well. Personality differences, stress, fatigue, and hierarchy can all contribute to interpersonal conflict and, at times, harmful behaviour. For these reasons, clinicians must be as skilled in communication and conflict management as they are in clinical practice.

It is critical to distinguish between appropriate professional behaviour and abuse. Routine performance management, justified clinical criticism, or an occasional lapse in temper due to fatigue are not abuse.

By contrast:

· Bullying is repeated, unreasonable behaviour that creates a risk to health and safety (e.g. intimidation, exclusion, belittling, impossible demands, withholding information or spreading rumours).

· Sexual harassment includes any unwanted touching or sexualised comment.

· Discrimination is adverse treatment based on protected attributes such as race, sex, age, disability, pregnancy, religion, sexual orientation, or gender identity.

· Violence includes not only physical assault, but also verbal abuse, psychological or emotional harm, sexual violence, and threats that create fear - even without physical contact.

These unlawful behaviours can cause compensable psychological injury, drive clinicians out of the workforce, undermine safe patient care, and expose employers to serious legal, financial, and reputational penalties.

Abusive behaviour may be overt - such as name-calling, racist or sexual jokes, vilification, crude language, or threats. It may also be subtle, repetitive, coercive, and cumulative, making it harder to identify and prove, particularly when incidents occur privately or colleagues are reluctant to speak up due to fear of retaliation, loss of opportunities or reputational damage.

In an ideal system, these issues would be identified early and addressed through fair, structured processes. In reality, under-resourced health systems and flawed processes can contribute to hostile workplace cultures where complaints and incidents are not managed adequately.

Under new WHS laws, every workplace must implement and monitor effective and safe speak-up mechanisms tailored to the needs of their workforce.

One approach may be harm minimisation. This aims to address concerns early - before escalation, formal complaints or entrenched harm occur. It is not about excusing behaviour, but about stopping it quickly and safely.

This may involve raising concerns confidentially with a trusted senior clinician with words like this:

“May I speak to you confidentially? I have noticed concerning behaviours in X. I am not making a formal complaint, but I am worried about the impact on others. Could you speak with them privately?”

Sometimes a quiet, respectful conversation from a senior colleague may help someone recognise that their behaviour is causing harm.

The principle of harm minimisation is simple: stop the behaviour before it harms both the victim and the perpetrator.

3. Report incidents anonymously (internal systems)

When informal harm minimisation approaches do not work, internal systems - usually via an intranet or website - should allow anonymous reporting of both minor and serious concerns. However, many clinicians, particularly trainees, still avoid reporting due to fear of being identified. In addition, clinicians may not see visible outcomes after reporting, leading to loss of trust in the system.

As a result, underreporting creates a major blind spot for leaders in positions of influence, causing them to underestimate the true scale of harm - particularly psychological injury. This contributes to ongoing inaction.

Nevertheless, under new WHS laws, employers must provide safe speak-up mechanisms, including systems for anonymous reporting of near misses, risks, hazards, and complaints, together with protection from retaliation. All reports should be reviewed by the most senior clinical and organisational leaders to determine whether incidents reflect broader system failures.

For more information about what to report, refer to:

Psychosocial hazards:
https://www.safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/mental-health/psychosocial-hazards/harmful-behaviours

Bullying:
https://www.safeworkaustralia.gov.au/safety-topic/hazards/bullying

Sexual and gender-based harassment:
https://www.safeworkaustralia.gov.au/safety-topic/hazards/sexual-and-gender-based-harassment

Discrimination:
https://www.fwc.gov.au/issues-we-help/discrimination

Racism:
https://www.safeworkaustralia.gov.au/safety-topic/hazards/racism

Workplace violence:
https://www.safeworkaustralia.gov.au/safety-topic/hazards/workplace-violence-and-aggression

4. Make formal complaints under whistleblower protections

Before identifying yourself through a formal complaint, seek confidential advice from a trusted independent GP or mental health professional. Support is essential, as speaking up can be emotionally demanding and investigations may be prolonged.

Key principles when making a complaint include:

· Document patterns over time: keep factual records including dates, times, witnesses, and impacts; collect corroborating evidence such as emails, messages, or CCTV.

· Find allies: collective action strengthens credibility and reduces personal risk.

· Act collectively where possible: group reporting with people who have had similar experiences may provide additional protection.

· Follow correct processes: escalate concerns through appropriate channels such as supervisors, Health and Safety Representatives, managers or HR if they exist.

· Avoid bypassing processes by going directly to a Chief Executive Officer or board unless behaviours are unlawful and urgent police involvement may be required.

· Maintain professionalism: assume all communications may later be scrutinised.

· Know the rules and your rights: review your workplace’s WHS policies and Codes of Conduct in the intranet. WHS literacy protects your career. Read the SafeDr app and if appropriate recommend it to your colleagues to help improve their WHS literary.

· Expect resistance from others: remain calm, factual, and persistent. It may take time for the truth to emerge. 

Unfortunately, perpetrators of abuse may lie, manipulate processes, or behave abusively without witnesses. Bullies may appear superficially charming in public or accuse others of bullying. Under these circumstances, it is entirely reasonable for organisations to take time to investigate the facts carefully.

· Seek external advice early from your medical defence organisation, Australian Medical Association, unions, or a lawyer.

· Hold leadership accountable: request system-level WHS interventions. Psychosocial hazards and retaliation are unlawful and carry serious penalties. If senior clinicians do not understand their responsibilities under new laws, suggest they download the SafeDr app and encourage others in the workplace to do the same.

When complaints are substantiated following investigation, outcomes may include a formal apology (which does not need to occur face to face if this feels threatening or traumatic), disciplinary action or termination of employment. In some circumstances, anonymity for the complainant may be appropriate or preferred.

Employers are legally responsible for preventing and proactively addressing unlawful behaviour, ensuring safe workplaces, and fostering workplace cultures that clearly discourage abuse. 

If your employer is a registered entity, you may also make a protected disclosure - including anonymously as a whistleblower if necessary - to senior leadership or a governing body. Whistleblowers are legally protected when reporting suspected unlawful conduct such as fraud, corruption, or workplace abuses. Retaliation - including identity disclosure, dismissal, harassment, or reputational harm - may constitute both a criminal offence and a civil breach.

Whistleblower disclosures fact sheet:
https://www.fwc.gov.au/documents/organisations/resources/fs003-whistleblower-disclosures-fact-sheet.pdf

Whistleblower protections overview:
https://www.fwc.gov.au/registered-organisations/whistleblowing/whistleblower-protections

Additional resources:
https://www.fwc.gov.au/registered-organisations/whistleblowing/whistleblowing-resources

If you are injured physically or psychologically, you may also consider a workers’ compensation claim. 

5. Seek external support and intervention (when needed)

If internal processes are unsafe, ineffective, or inappropriate, external escalation may be necessary.

Start by seeking confidential advice from a trusted GP or independent professional to help guide your approach, as there are many potential pathways to navigate, including:

Australian Medical Association - legal advice and advocacy

Australian Salaried Medical Officers Federation - industrial representation

Medical defence organisations - legal guidance

Australian Human Rights Commission:
https://humanrights.gov.au

Fair Work Commission:
https://www.fwc.gov.au

Safe Work Australia:
https://www.safeworkaustralia.gov.au

More detailed information

Australian Human Rights Commission:

Causes and risk factors:
https://humanrights.gov.au/sites/default/files/factsheet_-_causes_and_risk_factors_of_sex_discrimination_sexual_harassment_and_other_unlawful_behaviours_0_0_0.pdf

How to complain:
https://humanrights.gov.au/complaints#main-content

Additional mechanisms:

Stop bullying (FWC):
https://www.fwc.gov.au/issues-we-help/bullying/what-do-if-youre-bullied-work

Workplace Advice Service:
https://www.fwc.gov.au/about-us/information-your-language

Fair Work Ombudsman:
https://www.fairwork.gov.au/about-us/contact-us

Sexual harassment support:

1800RESPECT (24/7): 1800 737 732

Respect@Work: 1300 656 419 | respect@humanrights.gov.au

Support services:
https://humanrights.gov.au/sites/default/files/factsheet_-_seeking_support_-_counselling_and_support_services_0_0_0.pdf

Fair Work:
https://www.fairwork.gov.au/employment-conditions/bullying-sexual-harassment-and-discrimination-at-work/sexual-harassment-in-the-workplace

Discrimination support:

AHRC services:

https://humanrights.gov.au/our-work/sex-discrimination/list-support-services

FWC hub:

https://www.fwc.gov.au/issues-we-help/discrimination

Mental health resources:

National Mental Health Commission:
https://www.mentalhealthcommission.gov.au/

Find support:
https://www.mentalhealthcommission.gov.au/find-support

Safe Work Australia mental health:
https://www.safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/mental-health

State and Territory government law and justice services:

(NSW) Law Access; Law and Justice
(VIC) Law and Justice
(ACT) Justice and Community Safety
(QLD) Law and Safety
(NT) Law and Safety
(TAS) Law and Public Safety
(WA) Community Safety
(SA) Crime, Justice, and the Law

Legal Aid:

(NSW) Legal Aid | (VIC) Legal Aid | (ACT) Legal Aid Commission | (QLD) Legal Aid | (NT) Legal Aid | (TAS) Legal Aid | (WA) Legal Aid | (SA) Legal Aid Services