Tuesday, September 21, 2010

SSWAHS and it's view of National Health Reform

SSWAHS created such a cute piece of spin for the Director-General of NSW Health to suggest what they might like to do with the Federally imposed carve-up of the current NSW Area Health Empires.

Here they used a powerpoint presentation to suggest the great achievements their Area based Clinical Divisions have launched in the old SSWAHS.

Take for example, their Population Health Area Network:

  • Promoting Equity: Monitoring inequalities of health status and health service utilisation; targeted health promotion activities in disadvantaged areas.
  • Focus on Primary Prevention: Critical mass enables health promotion activities to reduce risk factors.
  • Regional Partnerships: Working with LGAs, Housing NSW, Landcom and other developers on urban development and regeneration.
  • Promoting Evidence Based Practice: Healthy Urban Development Checklist.
  • Population Health Based Service Planning: Population health principles incorporated into all service and facility plans.
  • Capacity Building for Primary and Secondary Prevention: Health promotion traing course; Locational Disadvantage training course.
Now if anyone out there can translate that SSWAHS spin please let me know! But, can anyone see how this is meant to apply to the Southern Highlands with expanding and aging population? What does SSWAHS Population Health take us for - God's Waiting Room? And can anyone tell us what a "Locational Disadvantage training course" is meant to look like?

The other point to make is that it's been some years since we had anything like a health promotion staff member in the SSWAHS portion of the Southern Highlands. Again, a vacancy never to be filled. Is the Southern Highlands meant to be an urban or a rural area in the minds of the SSWAHS Executive, or is that little dot to the far south of the SSWAHS map on that cute presentation to the D-G still out of sight of Liverpool.

And here's the presentation of the achievements of the SSWAHS Mental Health Clinical Network:

  • Improved Clinical and Corporate Governance: Standardised policies, procedures and care pathways/guidelines; Centralised application of specialist human resources across a whole network, achieving economies of scale; Timely implementation of state-wide initiatives.
  • Improved Human Resource Management: Better recruitment and retention of staff because of clear identification with clinical specialty; Better support to registrar training especially since IMET initiative; Standardised education programs.
  • Improved Service Delivery: Ability to support small community teams in rural areas; Access to intensive, Sub-specialist and Tertiary services which could not be resourced at the local or district level; Ability to promptly rotate staff to local services with urgent shortfalls; Improved planning of services and facilities to serve a regional population.
This one I really like (oh yeah!). Clinical and corporate governance. This is the SSWAHS clinical network who failed to answer the complaint of a local woman with terminal cancer until after she had died. Then said they'd tried to speak with her but unfortunately she was dead. Not laughable - just tragic.

This is the same Clinical Network who has still refused to answer some serious complaints about their failure to respond appropriately to complaints, about their service and their service providers, according to the NSW Health Code of Conduct.

This is the same network who, in 2009, had one of their Southern Highlands patients involved in the murder of another of their patients after both patients had been notified to the local service with a request to provide assistance.

Better recruitment and retention of staff is another bit of spin from SSWAHS. This is the organisation which spent an inordinate amount of time terminating, or getting resignations from, a number of clinical staff in their Area Mental Health Network.

Now, they have the temerity to say in their "Improved Service Delivery" that they have achieved the ability to support small community teams in rural areas, and their ability to rotate staff staff to local services with urgent shortfalls. Is that why they have made the Bowral Mental Health Service less effective by making part time their Welfare worker position, their Aboriginal Health worker position, and their Rehabilitation/Recovery Program Coordinator? Perhaps that fits into the plan for the SSWAHS Mental Health Network's "ability to rotate staff to local services with urgent shortfalls"! It certainly doesn't fit in with the SSWAHAS Mental Health Network's "ability to support small community teams in rural areas."

Again, from the "Improved Service Delivery" item the SSWAHS Mental Health Network states as an achievement "Access to Intensive, Sub-specialist and Tertiary services which could not be resourced at the local or district level." Well, I guess that if you mean by "access" that the local Southern Highlands Mental Health team still has to argue with Mental Health bed managers every time they have a need to transport someone with an acute mental illness to any of the inpatient facilities mentioned. The patient from the Southern Highlands could, currently, sit in the Emergency Department of Campbelltown Hospital for hours (or days) before being admitted to the hospital's Psychiatric Emergency Care Centre, or be shuffled around the other various facilities located at Campbelltown Hospital, or Liverpool Hospital, or RPH Hospital, or Concord Hospital.

However, don't think that's still a great response because if the proposed slice-up of the current SSWAHS Empire proceeds according to the LHNs that Southern Highlands mental health patient will only have access to the mental health facilities at Campbelltown and Liverpool Hospitals - so the wait just got longer and the Improved Service Delivery just went belly-up!

Go figure it! Perhaps the SSWAHS Mental Health Network should have been concentrating more on which of their so-called "Achievements" would be lost to the Southern Highlands, Macarthur, Wollondilly and Liverpool LGAs and their residents.