In 2016, I found myself at the heart of a public health crisis that rocked the NSW Health - the under-dosing scandal at St. Vincent's Hospital. As a staffer for Health Minister Jillian Skinner, I had an inside view of the crisis and its subsequent management. However, the most poignant lesson I took away from was not about policy or politics but about culture.

Professor David Currow, part of the investigative team, succinctly encapsulated this insight in his report: "Culture is about how things are done”.

The hospital's alleged response to the crisis revealed a culture characterised by ambiguity and media management. Emails disclosed under an S052 order illuminated a default towards self-protection over problem-solving and damage control over decisive action. While perhaps offering short-term media management benefits, this approach flowed through to the patients and proved inadequate in addressing the core issue and ultimately led to a larger crisis.

A culture prioritising defensiveness and damage control over patient welfare (or customer centricity) and open communication can never deliver quality consistently - and led to an environment that allowed the under-dosing to take place.

My experience during the under-dosing scandal offered a stark lesson on the importance of culture within organisations. When the undercurrent culture fosters ambiguity and self-protection over problem-solving, it is not just staff who suffer; patients do too.

The under-dosing scandal was not just a reflection of misguided priorities, but also a testament to the courage of individuals within the system. It was brought to light by a courageous whistle-blower, an employee who exemplified a culture opposite to that of self-protection. Their brave action underlines the importance of fostering a culture that encourages transparency above all else.

In the aftermath of the scandal, the simplicity of Professor Currow's quote rings louder. Culture is how things are done, and these 'things' profoundly impact staff morale. The lessons from this scandal should guide us in cultivating a culture that prioritises problem-solving over short-term management, openness over ambiguity, and customer centricity (or patient welfare) over everything else.