The Public Health System: My Life’s Work

The departing Director General of NSW Health, Debora Picone, AM, reflects on the significant improvements to patient care and safety achieved over the past four years, and commends the NSWNA on its tough but responsible campaign for nurse-to-patient ratios.
The departing Director General of NSW Health, Debora Picone, AM, reflects on the significant improvements to patient care and safety achieved over the past four years, and commends the NSWNA on its tough but responsible campaign for nurse-to-patient ratios.

The departure of Debora Picone, AM, as Director-General of NSW Health was disappointing to the NSWNA, as she was the first nurse to hold the position and demonstrated understanding of issues for nurses, said NSWNA General Secretary Brett Holmes. ‘Her appointment in 2007 was a sign of how far the nursing profession has come.’It was under Ms Picone’s four-year reign that the NSWNA achieved one of its most significant wins – nurse-to-patient ratios with almost 1,400 additional nursing positions. ‘It was not only a great win for the nursing profession, it will ensure great improvements in patient care and safety,’ said Brett.

Ms Picone’s sudden removal occurred days after the election of the NSW Coalition Government.

‘I am proud of improvements to patient care and safety that have occurred over the past four years. NSW has a Public Health System it can be proud of.

‘In particular, there have been significant improvements around open disclosure to patients, implementation of the severe chronic disease management program, improvements in rural health particularly cancer and cardiology services, development of critical patient services at Wollongong and Nepean Hospitals and the establishment of the Agency for Clinical Innovation, and in complaints handling processes. New systems have been introduced to improve staff education and clinical supervision communications.

‘The development of a clinical services plan for community services is also important. I am most proud of the new Liverpool Hospital development.

‘Another significant achievement was convincing the Government to provide a large funding allocation for updating the department’s IT system to continue the implementation of the electronic medical record. It was a significant investment that saw the rolling out of electronic medical records.

‘The final crowning was the recent settlement of the dispute with the NSWNA. The NSWNA ran a hard campaign but it was an extremely responsible campaign.

It achieved the single largest Award gain for nurses in NSW. Some are saying it wasn’t enough but it was the largest industrial award gain for any profession or trade group in the public sector,’ said Ms Picone. ‘I want to particularly acknowledge the leadership of the then Deputy Premier, Carmel Tebutt and Karen Crawshaw, Deputy-Director General.’

‘It was a very tough campaign but the NSWNA showed incredibly good and decent leadership. The NSWNA was determined that these issues needed to be dealt with.  I’m glad it worked it out, and we maintained a respectful working relationship throughout.’

Brett Holmes said that while Ms Picone was a tough negotiator, having a nurse in the top administrative job certainly made it a bit easier to discuss the experiences and concerns of NSW nurses.

‘She was able to navigate a path to finaliising negotiations whenever she was given the opportunity to do so by the Government.’

Ms Picone has worked in the Public Health System for 36 years, starting her career in 1975 as a student nurse at Prince Henry Hospital.

‘My background as a nurse prepared me more than most for the role as Director General. I always had an understanding of the clinical issues. This was always in the back of my mind. I visualised what decisions meant for patients and staff,’ said Ms Picone.

‘Back when I was a NUM at Prince Henry Hospital, I developed a strong set of clinical management skills. Nurses need to be exceptional communicators. It’s the perfect experiential training ground for management.’

Prior to being appointed Director General, Ms Picone held various senior health administrative roles:

Chief Executive Officer South Eastern Sydney Illawarra Area Health Service

Administrator South Western Sydney Area Health Service Deputy Director General (Strategic Development) NSW Health

Acting Chief Executive Officer, New England Area Health Service

Chief Executive Officer, Corrections Health Service.

Ms Picone has also held academic positions as:

Professor, University of Wollongong

Clinical Professor, Prince of Wales Clinical School, University of NSW

Clinical Associate Professor, Department of Surgery, Faculty of Medicine, University of Sydney.

Ms Picone was awarded Member in the General Division of the Order of Australia (AM) in June 2006 for services to public health administration in NSW.

As she advanced through the ranks of NSW Health, Ms Picone has maintained membership of the NSWNA since joining as a student nurse in 1975. She served as NSWNA President between 1987 and 1992.

‘I am very proud to be a member of the NSWNA. I am very proud of the NSWNA – never more so than the past few years,’ she said.

Despite her recent abrupt removal as Director General, Ms Picone considers herself to be ‘the most fortunate person in NSW’, for having had the opportunity to work with wonderful people and for having been lucky enough to have worked throughout her career to improve patient care and safety.

‘The Public Health System has been my life’s work and I imagine it will continue to be so in some other capacity,’ she said.

Brett Holmes said: ‘The NSWNA wishes Ms Picone all the best for the future and we thank her for the contribution to NSW nursing and healthcare.’