8. Prevent physical injury/death

Hospitals and medical practices are inherently hazardous workplaces. Preventing work-related physical and mental injury - and death - is a core Work Health and Safety (WHS) obligation, not an optional extra.

Like all employers, health services must implement robust WHS systems, policies and cultures to protect employees, contractors and visiting consultants.

The good news: boards, senior leaders and practice owners can significantly reduce personal and organisational legal liability by proactively designing safer workplaces. However, the law is complex, and specialised legal advice is now essential due to major recent changes in federal and state WHS legislation (see Topic 3).

Physical incidents: what doctors often don’t know

Health services usually provide detailed guidance on physical safety (e.g. infection control, falls prevention, musculoskeletal injury, and workplace violence) because of workers’ compensation costs. Doctors are familiar with this training.

What many doctors - especially those in training - do not realise is that employers now have a mandatory duty to notify WHS regulators immediately after becoming aware of serious work-related physical injuries, illnesses or dangerous incidents, whether a workers’ compensation claim is made. These are known as notifiable incidents.

An incident is notifiable if it results in physical injury or illness where:

• immediate hospital admission is required (any duration)
• immediate treatment is unavailable due to remoteness or lack of      specialist care
• treatment was required but refused
• a person is (or is likely to be) unfit for usual work for 7 days or      more (supported by a medical certificate)

More information:
https://www.safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/incident-notification

Doctors frequently avoid incident reports or compensation claims due to fear of career damage and bureaucratic consequences - fears that are often justified. But without accurate incident data, employers can minimise or ignore serious physical and psychosocial hazards affecting doctors.

Reducing under-reporting requires fair, confidential processes, training on human rights at work, and clear employer accountability.

Industrial manslaughter: the ultimate WHS failure

Industrial manslaughter occurs when grossly negligent conduct by an employer or officer breaches WHS duties and causes death - including deaths of staff, contractors, patients or members of the public.

Employers (including Directors and Officers of public hospitals) may face severe fines, criminal charges and imprisonment if failures to address known hazards lead to death from:

• hazardous working conditions
• accidents
• suicide linked to work-related mental injury
• assault or violence

Examples include:

• death of a pregnant doctor or unborn child due to unsafe work conditions (e.g. long shifts, radiation, infection risk, violence, hazardous chemicals) - the duty to modify work lies with the employer, not the individual
• fatal accidents caused by exhaustion from unsafe rosters and excessive job demands
• suicide linked to unmanaged bullying, harassment, racism, discrimination, verbal violence or stalking
• physical assault resulting in fatal injury

Such deaths trigger regulatory investigations to determine whether industrial manslaughter charges apply.

Consequences for employers and leaders

Where WHS breaches result in serious physical or mental harm, consequences may include:

• multi-million-dollar fines (often not insurable)
• criminal charges
• imprisonment
• disqualification from managing organisations
• escalating directors’ and officers’ insurance premiums

Ignorance of the law is no defence. Failure to implement system changes after WHS training increases prosecution risk, particularly where employers cannot produce documented evidence of prevention, monitoring and follow-up.

Prevention is the point

This is not a bureaucratic tick-box exercise.

The expanded WHS duties - and serious personal penalties - are designed to drive early, evidence-based prevention of work-related injury and death.

Practical protection includes:

• clear, widely distributed WHS policies
• visible leadership commitment
• safe reporting systems
• independent staff surveys
• early intervention and follow-up after incidents

The largely government-funded health system has higher rates of work-related injury and mental harm than many industries. It is not exempt from WHS law. Medical leaders are not immune from personal liability, including imprisonment.

For more on preventing suicide and industrial manslaughter, see the relevant article under topic 10: Industrial manslaughter – it only ends with us

Helpful references

https://www.safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/mental-health/psychosocial-hazards/poor-physical-environment
https://www.comcare.gov.au/safe-healthy-work/prevent-harm/physical-hazards
https://www.australianworkplacesafety.com.au/common-workplace-hazards-in-australia/
https://www.safeworkaustralia.gov.au/sites/default/files/2021-01/workplace_violence_and_aggression_worker_information_sheet.pdf