Australian Doctor Australian Doctor 7th July 2017 | Page 13

Smart Practice

Your Health

Professor Leanne Rowe

Tackling the culture of medicine

IN response to an outbreak of crime near your practice you decide to install closedcircuit TV cameras( CCTV) inside and outside the premises to provide added security. You consider installing cameras in the reception area to deter theft, and keep staff and patients safe. You also plan to have cameras in the consulting and treatment rooms.

Background Before taking these steps, note that private medical practices must comply with state laws regarding the installation of CCTV and meet obligations under the Commonwealth Privacy Act in relation to the handling of personal information collected. In some states it may be a criminal offence to film people without their consent, so it is essential to get advice before you install any security cameras.

There are a number of issues you need to consider including:

• informing patients, staff and others entering the premises that CCTV is used;

• whether to store and how to secure recordings;

• dealing with requests for footage; and

• amending practice policies, including your privacy policy.

Informing patients and the public Warning signs to alert people entering your practice that CCTV cameras are in use should be placed in a prominent location.

While the presence of cameras may help to improve safety and security for staff and patients, this needs to be carefully balanced against the need to respect the privacy and confidentiality of medical consultations. For this reason, installing cameras is generally not recommended in treatment areas, unless there is a specific need for it and patients provide their express consent to the use of such cameras.

Camera concerns

MEDICOLEGAL

Safeguarding your practice with CCTV makes sense, but what are your legal obligations?

TRACY PICKETT AND DR OWEN BRADFIELD

Informing employees It is not just patients who need to be considered when installing CCTV. Legislation in the ACT and NSW requires notification be given to employees, and in Victoria, surveillance cannot occur in workplace toilets, washrooms or change rooms. Practices in those jurisdictions should check their state’ s specific requirements before installing CCTV.

In the other jurisdictions, it is good practice to provide notice to employees before the security system begins operating. Using the requirements in the NSW legislation as a guide, they should be told about the kind of surveillance, starting date, why cameras are being installed, how footage will be recorded and stored, whether footage will be on live feed, and whether surveillance will be permanent or temporary.

Storing and securing recordings Personal information should only be collected by private medical practices if it is“ reasonably necessary for one or more of the entity’ s functions or activities”, according to the Australian Privacy Principles.

The Office of the Australian Information Commissioner( OAIC) provides advice on the use of surveillance devices.

The OAIC says that if you are using CCTV, personal information recorded must be kept securely and destroyed or de-identified when it is no longer required.

Information gathered through CCTV should only be kept for as long as necessary to fulfil the purpose of the cameras.

Requests for footage Requests for access to CCTV footage should be treated like other requests for personal information and assessed on a case-by-case basis. The footage must not be used or disclosed for a purpose other than the reason it was collected, without the consent of the individual affected, unless an exception applies under the Privacy Act.

If a person who has been recorded seeks access to that CCTV footage, it can be provided if it covers only that person. There are exceptions to providing access, such as if the footage recorded other people and it would therefore have an unreasonable impact on the privacy of those people.

CCTV footage may also be subject to a subpoena or other disclosure requirements as part of legal proceedings.

If CCTV has been installed to safeguard

KEY POINTS:

• Display signs inside and outside the practice to warn those entering that they will be under surveillance.

• Amend your practice’ s privacy policy and patient registration forms so they refer to the presence and operation of CCTV and location of cameras. This should include: information on how the footage will be stored and how long it will be kept; if the system will include live feeds; how people entering the practice will be advised about the security system; and whether security footage will be disclosed to any entity and, if so, the likely circumstances of disclosure.

• If you are in NSW, ACT or Victoria check the specific requirements of the legislation in relation to your staff before installing CCTV.

your staff and premises, and to prevent crime in the practice, the consent of individuals may not be required if access to the footage is reasonably necessary to a police investigation. However, be wary of requests for access to CCTV footage from the media or individuals not included in footage. Such disclosure may breach the Privacy Act.

Seek advice from your medical defence organisation if you are uncertain how to respond to a request for CCTV footage.

Practice policies You will also need to amend the practice’ s privacy policy, including details of how you will deal with requests from the police, the media or other interested parties for a copy of footage from your cameras.

Ms Pickett is a medicolegal adviser and Dr Bradfield is content development manager at Avant.

Online resources: Privacy Act bit. ly / 2f2HWEi

Using surveillance devices bit. ly / 2tPpvIl

Australian Privacy Principles bit. ly / 2f2zbdm

“ WHEN one of the doctors in our practice was unfairly terminated while recovering from a serious illness, it was demoralising for all of us. I couldn’ t get it out of my mind that I could slave away for 10 years and this could happen to me if I became unwell. I left soon after”.

This quote comes from a rural doctor who reluctantly left her understaffed general practice because of the poor culture.

In the past few months, this magazine has run a series of articles tackling difficult topics such as doctor suicide, trauma, and bullying. These complex issues are at the tip of an iceberg of poor medical leadership and negative medical workplace cultures, which is why selfhelp strategies don’ t always work.

There is a mountain of self-help books, but many doctors find generic strategies don’ t work because of the excessive demands of a medical career. Slowing down, relaxing, maintaining boundaries between work and life, or saying‘ no’ are easier said than done.

What is required is a collective, rather than an individual, response. This involves working together and supporting each other to create healthy clinical teams and to manage challenging behaviours of patients, carers, health professionals, and managers. Anger, criticism and conflict are inevitable in medical practice. A practice with a healthy culture empowers its people to deal with these issues openly, constructively and collaboratively.

Common unconscious biases in relation to gender, sexuality, culture and disability must be called out. Although unconscious biases may be unintentional, they are often harmful as the views of diverse groups of people are suppressed or dismissed. We must all promote diversity in our workplaces and our medical organisations.

Bullying, harassment, discrimination are against the law, and there should be zero tolerance for transgressions. Each of us should understand how to recognise and respond to bullying, harassment and discrimination as part of basic work health and safety practices.

Doctors who are diagnosed with serious mental or physical illness must be supported by their colleagues. Whether the diagnosis is an advanced cancer, mental illness or substance abuse, doctors must be proactive in ensuing their colleagues receive the right professional help from independent medical practitioners. One of the most obvious indicators of a caring workplace is when leaders and others stand by a someone through difficult times. There must be constructive discussions by the whole clinical team about how to manage increased workload in the absence of a doctor on short term or prolonged sick leave.

Medical workplaces must be as empathetic to their doctors and other staff as they are to their patients.

Whatever the challenge, we can meet it more effectively if we work together and support each other. When we care for our colleagues, we care for our patients and ourselves, because we create a positive culture, in which we can all thrive. Professor Rowe AM is a GP who blogs at www. medicineisbeautiful. com

This column is part of our coverage to raise awareness of doctors’ mental health.

DOCTORS ARE HUMAN TOO For support on suicide prevention call: Lifeline 13 11 14.

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