Allegations of bullying and mismanagement have put the Canberra Hospital maternity unit's training status at risk, after an official report raised serious concerns about standards.
A review completed in September by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists gave Canberra Hospital a six-month accreditation for training of young doctors, the shortest possible period awarded by the professional standards body.
Limited accreditation periods are imposed where serious concerns about standards exist. A further critical report could see the hospital lose its accreditation.
Doctors have alleged a toxic culture exists at the hospital, with hapless management and departures of senior staff contributing to poor patient outcomes.
One visiting assessor reportedly described Canberra as having "the worst maternity training unit in Australia" and Opposition Leader Jeremy Hanson has questioned Chief Minister Katy Gallagher's ability to improve conditions.
Doctors speaking on the conditional of anonymity have told The Canberra Times that some patients are being moved from beds due to shortages while supervision and rostering problems have reached crisis point.
Mr Hanson is considering calling for a board of inquiry and says Ms Gallagher and ACT Health should take immediate action.
Staff have been called to a meeting on Tuesday to discuss the report and other organisational problems. Officials won't release the report, which ACT Health director-general Peggy Brown said contained a number of urgent recommendations.
Ms Gallagher has been briefed on the report's contents after she was first alerted to the concerns via an anonymous letter in September.
Dr Brown said she was not aware of any adverse outcomes for patients in the unit, despite allegations raised against at least one senior doctor resulting in a formal investigation and a number of staff leaving the unit.
One doctor said the new Centenary Hospital for Women and Children, opened in 2013, had too few beds and staff being trained faced bullying and unrealistic work demands.
Another person with specific knowledge of the situation said serious cultural problems existed and they feared a serious accident or staff suicide.
"They will need to man up to really make hard decisions," the person said.
"I am concerned that worker fatigue could lead to errors in clinical judgement or adverse outcomes in home and family life including an accident or physical harm, intentional or non-intentional.
"There's extreme distress, fatigue and lack of coping. Everybody is still performing their job as best they can in very difficult circumstances. This has been ongoing for months or even longer."
Mr Hanson said three doctors had contacted him to express concern about dysfunctional leadership and patient safety.
"I am angry that this has all happened before on Katy Gallagher's watch. It happened in 2010 where we saw 13 registrars resign, complaints of bullying and a damaging report. I am very disappointed we are back in the same situation four years later," he said.
"I think Katy Gallagher needs to question if she is up for the job. Is she too busy, is she distracted or is she not paying enough attention to the health system?"
Dr Brown rejected Canberra being described as the worst training unit in the country and said the hospital would improve standards before a further inspection next year.
"I would not accept that it is the worst hospital in Australia and I certainly do not accept that it is a disaster waiting to happen. The hospital provides a very high standard of obstetric care, which was specifically mentioned in the accreditation report."
A 2010 report into the maternity unit found serious shortcomings in staff management, clinical care and training.
Ms Gallagher has directed officials to ensure that training could continue at the hospital in 2015 and said she will monitor improvements closely.
"I have been assured by Health that they will be able to meet the recommendations that have been outlined.
"The issue for me is this has to be something that the managers at the hospital and managers at Health deal with. That is what we pay them to do. Everything that can be done is being done but the issues are complex, they are not simple."
Australian Medical Association ACT president Elizabeth Gallagher said she was not concerned about patient safety.
"I think the hospital is running well. I think the staff are all quite distressed by this report and there are some workplace issues that need to be addressed."
Dr Gallagher, who is no relation to the Chief Minister, said there was no reason to believe the concerns wouldn't be addressed in full.