In 2005, Bundaberg Base Hospital (BBH) made world news after Surgeon Jayant Patel was arrested over the deaths of patients on whom he operated as Director of Surgery at the Hospital. Patel was alleged to have caused at least 18 deaths through negligence. While medical staff making mistakes is not a new phenomena this was a rare case where employees attempted to voice concerns but a substantial system failure led to very public and extended legal proceedings that laid bare processes normally dealt with ‘in house’.

Giving staff a say in what happens in their workplace in the hope that it will influence their employer’s operations and business affairs for the better is what employers want. Equally, employees wish to put forward views both for this reason as well as asserting their own interests. These are both what researchers refer to as ‘employee voice’.

The assumption cannot be made however, that formalised means of capturing voice (which are usually designed by managers and can look nothing like they were intended when implemented), resolves all the issues raised. While yet to make the same impact on global headlines, a series of recent news articles has informally captured the voice of current and former Centrelink workers as the ‘robo-debt’ recovery saga plays out. Whistleblowers have highlighted the ‘deaf ears’ upon which their reported voicing of concerns (using in-house protocols) has fallen.

In the BBH case, the complex information networks; professional conflicts; gaps between capturing employees’ concerns through formal and informal means; and the institutional apathy marked by modern hospitals’ bureaucratised systems led to a blockage of voice.

And it is often difficult to ensure the integration of the different voices that emerge from different professional perspectives. The expertise of the nurse or doctor takes place against a background of institutional noise that makes it likely that much voice is not heard, rather than deliberately repressed. At Bundaberg, managers heard employees’ voices informally, but under time and resource pressures and sensitivity to issues of power and professional expertise, they either discounted them or set the bar so high that single voices were ignored unless there was corroborating data. (FYI – the managers never sought to get such data).

The BBH case also illustrates the importance of active listening to complaints as part of the employee voice system. It illustrates how stifled voice can rapidly create a sense of learned helplessness.

As Managing Director of HR Business Directions Leisa Messer, reminded organisational leaders and managers in a recent HR Daily Community blog:

“…although employees’ views and / or opinions might be negative or positive,…either way they are close to your customers, operations, other colleagues and competitors and can make you aware of problems so that you can rectify them before it’s too late.”

This article was authored by Professor Adrian Wilkinson, Director, Centre for Work, Organisation and Wellbeing.

Further reading on the Bundaberg Hospital case referenced in this article, and ’employee voice’ generally can be obtained from:

  • A. Wilkinson, K. Townsend, T. Graham and O. Muurlink 2015, ‘Fatal Consequences: An Analysis of the Failed Employee Voice System at Bundaberg Hospital’, Asia Pacific Journal of Human Resource Management, Vol. 53, No, 3, pp. 265-280.
  • A. Wilkinson and M. Barry 2016, ‘Voices from Across the Divide: An Industrial Relations Perspective on Employee Voice’, German Journal of Human Resource Management,Vol. 30, No. 3-4, pp.338-344, doi:10.1177/2397002216649899.
  • M. Barry and A. Wilkinson 2016, ‘The HR Literature Won’t Give You a Complete Picture of Employee Voice’,LSE Business Review, 23 August. Available at