At the start of the month Health Minister Meegan Fitzharris announced it had recruited a new boss to head the Canberra Hospital and health services, Janet Anderson.

Meanwhile, ACT Health acting boss Michael De'Ath would look after the governance side.

Its solution to many of ACT Health’s woes - to split the department in two - was, publicly at least, coming together.

But just days after her appointment, Ms Anderson pulled out of the job.

After the announcement - in the wake of a string of ongoing culture, poor management and bullying allegations - all hell broke loose.

The influential Australian Medical Association declared it had had enough and nothing short of a board of inquiry into the territory's public health system would do.

Ms Fitzharris partially caved and announced an independent review instead.

So how did we get here?

Lack of consultation

The pressure within ACT Health had been building for years.

Privately and publicly, many health organisations were frustrated by the lack of consultation and closed shop nature of ACT Health.

The organisation was at the time under the leadership of director general Nicole Feely who was recruited from WA in 2015.

Many staff felt there was a "jobs for the boys mentality", compounded by the fact a number of top executives were parachuted from WA where Ms Feely used to work.

While many organisations kept a polite face in public, the Australian Salaried Medical Officers Federation has been a vocal dissenter.

Executive officer Stephen Crook has described some members of ACT Health as a "protected species" with everyday doctors and nurses scared to make complaints for fear of retribution.

Mr Crook said the processing of complaints took too long, during which time management would sometimes try to find “dirt” on the person.

Issues which played out within the department in 2017 were made public in an audit report into the conduct of Ms Feely and her then deputy director general, which found they failed to handle bullying complaints properly.

The report said some senior staff felt they lived in fear that their positions would be made obsolete under the department's aggressive reform program.

Ms Fitzharris' relationship with the department has been questioned at times, with the minister admitting she had not been briefed on several key issues in 2017.

Data problems plaguing the ACT

Data integrity problems in the ACT are nothing knew. The department was rocked by scandals in 2012 when it was discovered hospital waiting times had been manipulated in previous years.

A fresh investigation into ACT's data was launched in 2017 when the territory failed to submit its emergency department, elective surgery waiting times and mental health for 2016 to the Productivity Commission after inaccuracies were found. 

ACT Health has since spent millions trying to develop a better system. 

Poor elective surgery and specialist waiting time

The ACT has consistently ranked poorly in its emergency department and elective surgery wait times.

Health groups and doctors say some Canberrans are forced to wait years just to see a specialist before being placed on a surgery wait list.

Trouble recruiting specialists has compounded problems, with claims doctors do not want to work for ACT Health due to its poor cultural reputation and lack of financial incentives.

The adult mental health unit has been plagued with staffing issues, and for a number of months in 2017 and 2018 it was not staffed by any permanent psychiatrists.

And the radiology department has been forced to outsource its reports to a private company due to staffing issues around "unplanned leave".

The unit is also at risk of losing its teaching accreditation, after flunking an audit which found specialists in training were being left unsupervised and not being given access to the necessary teaching.

Split announced, Feely leaves and accreditation disaster.

In a sudden announcement in March, the government announced ACT Health would be split into two organisations, one focussing on clinical health services and the other on governance.

The new organisations are due to be established on October 1.

In a major move, Nicole Feely left the organisation "to pursue other opportunities".

While the opposition claimed the health split was a knee jerk reaction to address ACT Health's growing woes, the government said it would bring the territory in line with other jurisdictions.

It was perhaps a preemptive move for a disastrous initial accreditation audit of Canberra Hospital.

The report, released by the government in April, found a number of examples of "extreme risk" in the hospital, including the risk of harm to patients in the adult mental health ward.

It painted a bleak picture of the administration of the hospital, finding systemic problems in its management and governance.

A bugbear of ACT Health staff for years has been the complex and unnecessary approvals needed to affect any positive change.

The report highlighted these issues and gave staff the validation about their concerns they had sought action on for years.

The hospital was give three months to lift its game and eventually passed the accreditation with flying colours in a final report.

The minister has hung her hat on that report since, complaining it was not lauded enough by the media and commentators.

But others have questioned the extent an organisation of thousands could meaningfully change in just three months, when it was given a comprehensive list of everything that needed to be fixed.

Staff take matters into their own hands

Staff fed up with years of inaction at the Centenary Hospital for Women and Children, located at the Canberra Hospital campus, in April staged a revolt in the form of an anonymous letter.

The letter was sent directly to government and alleged women and babies at Canberra Hospital were being put at risk due to mismanagement, low morale, inadequate staffing and chronic overcrowding. 

Mothers followed suit with their sometimes shocking experiences at the maternity ward, with a common theme of overcrowding and low staff morale.

That scandal prompted the Legislative Assembley's standing committee on health to launch its own inquiry into the maternity unit.

Bullying and culture claims intensify

The issues were not confined to Canberra Hospital with concerning allegations of bullying and poor culture also coming from Calvary Public Hospital.

Calvary Hospital launched an internal investigation after the suicide of an emergency department nurse in 2017, who was allegedly subjected to bullying.

Those closest to him said he faced relentless psychological bullying while in the workplace in the leadup to his death.

In July, the opposition jumped on the escalating tensions within ACT Health to call for a full board of inquiry into ACT Health, which would have had the powers of a royal commission.

Ms Fitzharris dismissed this as a political stunt that would cost millions, but the calls steadily intensified .

On August 1, a damning audit report into the highest ranks of ACT Health said then director general Nicole Feely and a deputy director general had inappropriately handled an investigation they launched into two health executives.

It also found bullying allegations directed at Ms Feely and her deputy director general were not appropriately handled.

Ms Fitzharris stood firm that no board of inquiry would be called nor was it warranted.

ACT Health staff continued to speak out anonymously  in favour of the board of inquiry while the government worked to recruit staff for its two new health organisations to exist after the split on October 1.

The last straw

In September a former public surgeon Maurice Mulcahy went public with his claims of poor culture and bullying in the ACT health system, which at times put public patient lives at risk.

He alleged he was pushed out of the public system for trying to improve training of young doctors and call out problems in the system. 

The same day his calls were published in The Canberra Times, the government's pick for the new boss of the Canberra Hospital and other health services - a role created for the split of ACT Health - pulled out of the role.

It came just days after her appointment was announced at a press conference by Ms Fitzharris.

The recruitment failure was the last straw for the Australian Medical Association, which came out and publicly backed a board of inquiry for the first time. 

Ms Fitzharris then caved to pressure and announced there would be a comprehensive independent review of workplace culture within ACT Health.

It appeared to be somewhat of a compromise, without the judicial powers of a board of inquiry, but a move that may satisfy some.

Health groups and unions are now split on whether the independent review is enough.

The Australian Medical Association, the salaried doctors' unions and the Visiting Medical Officers Association all remain united that nothing short of a board of inquiry will be able to hold the organisation to account.

But the nurses union, Healthcare Consumers' Association and Royal Australasian College of Surgeons maintain an independent inquiry is enough.

Whether the review will be enough to stem the calls of dissenters and lead to real change within an organisation with deeply imbedded cultural problems remains to be seen.

But the minister will be hoping this time ACT Health really has turned a corner.