Friday, March 27, 2009


Red News Readers,

Power to the People? Bulldust!! This is about the Liberal Party giving their mates, the rich doctors more control of the health system, and business men and commercial traders some say in the running of the district hospital. But as the Opposition keeps saying - how does this proposal add one more bed to the system, or one more nurse? This is just window dressing, and does nothing to solve the real problems of the health system, some of which have been accurately identified and addressed by Garling.

The Government's proposal to extend the CIN nurse program in emergency departments will improve waiting times in EDs and expedite the passage of patients but the return to single gender wards will make admission from ED to ward bed more difficult. What is needed is more staffed beds, and both sides of politics in NSW and Federally need to understand that nothing will be solved in the NSW health system until more beds are re-opened.

Jenny Haines

Coalition's radical surgery on state health system

Alexandra Smith

March 27, 2009

THE Coalition says that if it won power in NSW it would replace area health services with smaller health districts in a radical restructure of the troubled health system.

In a policy announcement to be made today the Coalition will say it plans to axe the eight area health services and their 30 clusters and create about 20 districts that would answer to boards.

Hospital general managers would have more power to make decisions and would run their own budgets to ensure bills are paid on time. A senior doctor would be appointed as an executive clinical director in each district and an independent body would publish information such as budgets and rates of infection, broken down to individual hospital wards.

The Opposition spokeswoman on health, Jillian Skinner, said the policy was about "returning power to the people".

"We will break up Labor's huge, unpopular and inefficient area health services, removing an entire layer of bureaucracy and set up new smaller health districts. The area health services have failed. It's time to remove them and reorganise health management in NSW."

In a 1100-page report on the health system last year Peter Garling, QC, advised against abolishing area health services. However, the Opposition said that without significant structural change Mr Garling's other recommendations, such as giving hospital general managers more power to make decisions and run budgets, could not be implemented.

The Government will provide its full response to the Garling report, published in November, early next week.

Mrs Skinner said the health districts would be large enough to deliver a comprehensive range of health programs in hospitals and the community, but small enough to maintain links with local communities and clinicians.

No jobs would be lost in the restructure, she said, and it would be cost-neutral to implement..
Board members would not be political appointments but would be selected on merit following the placing of advertisements seeking people with medical expertise and financial and risk management skills.

"NSW has the most skilled medical workforce in Australia - they want to be involved in the management of our health system, and under our policy they will be," Mrs Skinner said.

"Developing clinical networks that link experts in a particular field will provide a stronger health system capable of the best quality care."

Mrs Skinner said she had asked several of the state's most senior doctors, including Brad Frankum, an associate professor of clinical education at the University of Western Sydney, and John Dwyer, the emeritus professor of medicine at the University of NSW, to review the policy.

Professor Dwyer said in his response that he supported the policy, particularly "restoring an appropriate degree of influence for clinicians, the champions of the public hospital system, in the running of their institutes".

He wrote: "Without addressing the problems you are tackling here, I fear we will see a major leakage of clinicians from our hospitals, making an already serious workforce shortage that much worse."