Hospital managers are so focused on keeping their political masters happy that they’ve seriously compromised their duty to the public. That’s the strong opinion of respected medico David Henry, who has a long and distinguished history of upsetting bureaucrats, drug company executives and even the occasional Health Minister.

It’s one of the qualities that have made Henry such an asset; in an age when many academics are too timid to speak their minds, not wanting to upset employers or potential funders, Henry is famously direct.

But after 24 years, he’s packing up his office at Newcastle’s Mater Hospital, where he’s been a consultant physician, and heading to Toronto for a plum job heading up a prestigious research institute. He’s also leaving behind his post as professor of clinical pharmacology at Newcastle University.

It’s fitting that he bows out with a typically fearless assessment of the Australian health scene. When Henry, 59, joined the Mater all those years ago, he was impressed. Patients got better care than he had seen at his previous job, in a Nottingham hospital.

His diagnosis today, as told to Crikey, is much more pessimistic. Not only about the standards of care — people would be shocked if they realised just how stretched public hospitals are, he says — but about the quality of health service management and the bureaucracy generally.

He heartily endorses the concerns of former Federal Health Department Secretary Andrew Podger, shared recently with Kerry O’Brien, that the bureaucracy’s independence has been compromised.

Henry says hospital managers and health bureaucrats have become too much like politicians — saying and doing whatever it takes to keep their jobs — rather than true servants of the public.

“Two things drive modern health management — the desire to hang on to their jobs, and to do that, they have to please their seniors,” he says. “They’re so concerned with keeping the Minister happy that they can’t be true advocates for the services they manage.”

“These people will never put their own jobs on the line when they recognise their service is grossly underbudgeted and underserved. They will not put themselves at risk to try and get what is needed by the community.”

Henry, Glaswegian-born and an Australian citizen, believes the problem is not peculiar to the health sector but is a broader cultural issue.

“I’ve found people here are much more easily intimidated than I ever thought Australians would be,” he says.

“The rest of the world sees us as robust, outgoing, very strong willed, but it’s remarkable how a culture of bullying has developed in this country. It’s a very worrying feature. I find in Canada people are more inclined to speak out openly.”

Henry has himself paid a price for speaking out about dodgy pharmaceutical industry marketing. He hit the headlines several years ago when former Federal Health Minister Michael Wooldridge dropped him from the Pharmaceutical Benefits Advisory Committee, despite his internationally recognised work in evaluating the cost effectiveness of drugs. It was widely seen as a victory for the industry.

Henry is also well known for his research, demonstrating the side effects of non steroidal anti-inflammatory drugs like ibuprofen, and for his efforts to improve the media’s often overly promotional coverage of medicines.

Australia’s loss is Canada’s gain. But we’re not only losing Henry: his wife Dr Julia Lowe, director of diabetes for the Hunter New England Area Health Service, is also Toronto-bound.