Proposed Local Health Network boundaries finalised, with Australia’s first networks on track to be in place in January 2011 - Media Release by the Premier of NSW - Wednesday 29 September, 2010
The NSW Government today outlined the future shape of our health system, with the announcement of 18 proposed Local Health Networks to strengthen local decision-making and community involvement in health service delivery.
The Government intends to introduce legislation in this session of Parliament to enable the networks, and deliver some of the most significant health reforms in a generation. The networks will replace the current eight Area Health Services and have their own budgets, management and accountabilities within their local areas.
They will be administered by a Chief Executive and Governing Council that includes local clinicians, health and health care management experts and community representatives. Local Health Networks are a key plank of the historic national health reforms agreed with the Federal Government in April 2010.
These reforms are delivering an extra $1.2 billion in funding to the NSW health system over four years and are contributing to 488 beds being opened in NSW in 2010/11.
In line with the National Health & Hospital Network Agreement, Premier Kristina Keneally will write to Prime Minister Julia Gillard to seek agreement on the boundaries.
“This is the latest demonstration of how the NSW Government is leading the way in the national health reforms,” Ms Keneally said.
“The boundaries we are outlining today were determined after one of the most extensive consultation processes ever conducted across the NSW health system.
“This structure would deliver better patient care, strengthen local decision-making and continue NSW’s work to build a world-class health system.
“NSW is on track to have among the first Local Health Networks in Australia, with plans finalised for them to be in place in January and recruitment now underway.”
The 18 networks will be as follows:
• Eight will be geographically based and cover the Sydney metropolitan region;
• Seven will be geographically based and cover rural and regional NSW; and
• Three specialty networks will focus on Children's Health, Forensic Mental Health, and services delivered by St Vincent’s Health.
The Local Health Network model was developed following extensive consultation with clinicians, health professionals and communities across NSW.
That model was put out for consultation in August 2010, via a discussion paper that proposed potential borders and governance arrangements for 17 Local Health Networks.
Nearly 400 submissions were received from the public, community groups and health
professionals, leading to further improvements to the model being put in place, including:
Establishment of a specialist 18th network that covers the St Vincent’s facilities (St Vincent’s and St Joseph’s hospitals, and Sacred Heart Hospice);
• Putting in place Ministerial directions for each network, including for Blacktown Hospital, the Orana Region and St George, accounting for local feedback and local population health needs.
• Establishing clinical support clusters that will support services such as cancer, renal, mental health, and drug and alcohol programs;
• Expediting discussions to develop cross-border health agreements with the ACT, Victoria, Queensland and South Australia;
• Providing an enhanced role for the Clinical Excellence Commission, to strengthen interaction with clinicians in the new, localised public health structure;
• Establishing formal agreements between Governing Councils and local government (Governing Councils oversee each individual network) to strengthen local government engagement with health services; and
• Continuing a strong role for Local Health Advisory Councils, which will provide local advice to each network’s Governing Council.
“The networks are based on what most clinicians told us would be the most effective way of strengthening local decision-making and delivering high quality care,” Ms Keneally said.
“I’m very proud that NSW is leading the nation with these important health reforms.
“I would like to thank the hundreds of people from the health system, community groups and individual members of the public who helped design the system we are announcing today.”
Deputy Premier and Minister for Health, Carmel Tebbutt said the original model proposed has been further improved after the wide range of feedback received.
“In particular, we have established a specialty network that will cover the facilities of St Vincent’s Public Health Services in Sydney,” Ms Tebbutt said.
“This aligns with the approach being taken in other states, and means St Vincent’s facilities and services will be integrated into the health system, rather than split across two networks.
“We have also moved to put administrative arrangements in place to ensure a close
relationship between the networks, local government and communities.
“The Government will enter a Statement Of Intent with the Local Government and Shires
Association, particularly in relation to the Western and Southern Local Health Networks.
“And in light of the feedback we have received, we will continue to quarantine mental health funding, meaning it will be used directly for providing mental services.
“We will now move quickly to recruit the right balance of local knowledge and medical expertise to manage the new Local Health Networks.”
Each Governing Council will have between 6 and 13 members (including a Chair) depending on the size of the network, complexity of the services to be provided, and other local factors.
Expressions of Interest for Chairs of the Local Health Network Governing Councils have been sought, and a selection process is scheduled to take place in October.
Advertisements will appear this Saturday, calling for Expressions of Interest for general members of the Network Governing Councils. Recruitment will be finalised in November.
Upon finalisation of those appointments, a final round of recruitment will start for Local Health Network Chief Executives, who will be appointed by each Network Governing Council with the approval of the Minister for Health.
The networks will be established in January 2011, and the NSW Health system will progressively transition to the new structure over the following 6 to 12 months.
Background Notes
National Health Reform
• On 20 April 2010, the Commonwealth reached an historic agreement with States and
Territories (except WA) to implement national health reform – National Health and Hospitals Network for Australia’s Future.
• The Agreement will result in major funding and structural changes to the NSW health system that will further improve the quality and accessibility of health services.
• In May, June and July, NSW Health conducted an extensive consultation process with health professionals across the State, seeking their input into developing suitable boundaries for the new Local Health Networks (LHNs) which will replace Area Health Services under the national reform.
• That feedback was used to develop proposed LHN boundaries, outlined in a Discussion
Paper released by the NSW Premier on 5 August. This opened a further and final round of consultation which attracted almost 400 submissions.
• Those submissions along with advice from a number of senior clinicians has informed the configuration of a new health system structure in NSW. The outcome was confirmation of 15 geographically-based LHNs – eight metropolitan and seven regional – and three specialist LHNs, comprising a Children’s Network, Forensic Mental Health and St Vincent’s.
Further elements of the Local Health Network structure:
Blacktown Hospital – Special Recognition
• Some submissions were received calling for Blacktown Hospital to be separated from the Western Sydney Local Health Network because of its large and growing population. Other submissions supported the integration of Blacktown into the Network.
• It was concluded that the new LHN offers the best overall outcome for patients and staff, but acknowledged that special recognition was needed for Blacktown.
• Blacktown will be established as a distinct sector within Western Sydney LHN with its own Service Agreement.
• Blacktown Hospital will have a distinct sector budget within the LHN, as well as additional control over resourcing and accountability.
Orana – Special Recognition
• Some submissions supported a stand-alone LHN for the Orana region in the State’s
northwest, rather than including Orana in Central West LHN. However experience indicates that it would be difficult to recruit key clinical staff to a smaller, stand-alone LHN in regional NSW.
• The Government has responded to the submission by establishing a distinct Western Sector budget for the Orana region, as well as a Service Agreement governing specific service levels and capital works planning for Dubbo Hospital.
St George – Special Recognition
• Ministerial directions will be issued requiring the service agreement with South East Sydney to recognise St George/Sutherland as a distinct sector with its own budget, reflecting the successful network and Clinical Council which currently operate.
Clinical Support Clusters
• Submissions acknowledged the importance of maintaining existing clinical service networks that were developed across existing Area Health Service structures.
• However concerns were raised about how the new, smaller LHNs could continue to deliver networked services including mental health, drug and alcohol, renal, cancer and pathology.
• NSW Health and the Government have responded by creating three Clinical Support Clusters that will support inter-LHN networked services across the health system.
• In light of the feedback we have received, we will continue to quarantine mental health funding, meaning it will be used directly for providing mental services.
St Vincent’s Health Network
• A submission from St Vincent’s Health Australia recommended creating a new network based on three of its Sydney health facilities – St Vincent’s Hospital and Sacred Heart Hospice in Darlinghurst, and St Joseph’s Hospital in Auburn.
• Together, these facilities play a significant role in the delivery of publicly-funded acute and sub-acute healthcare services, including cardiology, immunology and virology, cancer, palliative care and rehabilitation. They also make a major contribution to medical research and teaching new generations of clinicians.
• Prior to receiving St Vincent’s submission, the three facilities were to be placed within the geographically-based LHNs of South Eastern Sydney and Western Sydney.
• The Government acknowledges the high degree of integration of St Vincent’s facilities with the public health system and agrees with its submission.
• St Vincent’s existing local management satisfies requirements of the National Health and Hospitals Network Agreement.
• St Vincent’s public health operations will be funded in a similar manner to other LHNs, and subject to the same reporting processes.
Clinical Excellence Commission
• The Clinical Excellence Commission (CEC) was established to ensure public healthcare organisations in NSW maintain high standards of patient care, maintain high levels of accountability, and strive to continuously improve the quality of clinical services.
• A large part of the CEC’s success has been based on unimpeded, two-way flow of
information between clinicians, hospitals, Area Health Services and NSW Health.
• The Government recognises that increased localisation and specialisation creates a need for enhanced interaction between the CEC and the new LHNs.
• To ensure the CEC is adequately resourced and connected to the new structure, three
Regional Coordinators of Clinical Governance reporting to the CEC will be established.
Next Steps:
• With the LHN boundaries now finalised, the NSW Premier will write to the Prime Minister seeking formal sign-off, as required under the National Health and Hospitals Network Agreement.
• Recruitment has already commenced for Chairs of the LHN Governing Councils.
• An advertisement calling for Expressions of Interest in general membership positions on LHN Governing Councils will appear in newspapers around NSW this Saturday and recruitment will be finalised in November.
• Upon finalisation of appointments to the Governing Councils, a third round of recruitment will commence for LHN Chief Executives.
• It is anticipated that Australia’s first Local Health Networks will be established from January 2011.
Socrates says that it seems that the fate of the Southern Highlands has been determined by the Premier and Minister in this Media Release. One has to ask the question: "What representations have been made from medical staff or other health staff or the community members from our own region which have been even considered by the Premier or Minister in making their decision about the future of health services in the Southern Highlands". The tragedy is quite simply, that we have the same system, the same executive members and the same limited view of the health needs of the people of the Southern Highlands. If the community do not take the initiative to become the advocates and agitators for the health services our population requires we are doomed to the whimseys of those in Liverpool who see no further afield than Campbelltown.
