The NSW State Government's approach to health, immediately after the election, gets a big tick from Socrates for terminating the incumbent Director General of Health, Ms Debra Picone.
Her departure is possibly the first of many who will depart from a Health Department, populated as it was by the previous government and Minister, of political appointees who had their snouts in the trough to obtain the best outcome for themselves and their pet projects.
Now to the last thing the previous NSW government did before it was shown the door in March. On the 1st of January 2011, the Health Minister announced that the new Local Health Networks (LHNs) had commenced in NSW. This meant that the previous Area Health Services had, in many cases, been divided into (marginally) smaller LHNs.
For us in the Southern Highlands it simply reverted back to the partition of SSWAHS into the old Central Sydney AHS and the old South West Sydney AHS, with this time, an additional layer of bureaucratic governance with a CEO overseeing a cluster of such LHNs.
Now here was the catch. Previously the old SSWAHS had streamed their clinical services to provide their specialist services across the entire jurisdiction of the SSWAHS. This meant, for example, that cancer services, cardiac services, mental health services, etc, would be provided to, and be accessible by, all residents in the SSWAHS.
After initially stating that the Area-wide clinical services will still provide access to all the residents of the old SSWAHS it now seems that the current administration of the Sydney LHN (the old Central Sydney AHS) is suggesting that they have sole right to all the clinical services within the Sydney LHN jurisdiction. Put simply, that means no resident of the Southern Highlands can expect to have access to the clinical services located at Concord Hospital, Royal Prince Alfred Hospital, Sydney Hospital, Balmain Hospital and St Vincent's Hospital.
This may seem very little loss to residents in the Southern Highlands as we still have access to Campbelltown Hospital, Camden Hospital, Liverpool Hospital and Bankstown Hospital as well as our own Bowral Hospital. The reality is, however, there are not a sufficient range of medical specialties in Bowral, and Camden Hospitals and the distance to Bankstown Hospital is considerable.
So, for example, suppose someone in the Southern Highlands requires treatment and residential care for an acute mental illness. Bowral Hospital has a couple of beds available for people with a sub-acute episode which does not require involuntary treatment. The beds are embedded within the whole complement of available beds in the hospital so they could be available, but then again, they may not. And what if the person requires an involuntary treatment and admission?
In the old SSWAHS people from the Southern Highlands requiring specialist treatment in one of the old clinical streams went first to Campbelltown Hospital and then to Liverpool, Concord, RPAH and Bankstown hospitals wherever the specialist beds were available. With the new LHNs our residents will be limited to Campbelltown, Liverpool and Bankstown hospitals.
Another feature of the old SSWAHS was that the local health funding for Bowral Hospital and its Community Health Services was drawn back into the specialist Clinical Divisions to fund, among other things, the budget over-runs of the big northern hospitals. It was also used to fund the budget over-runs and other capital costs associated with the building and renovations of the big northern hospitals. At the same time, Bowral Hospital survived on the donations and fund-raising of the local people, businesses and community groups to fund our two renal dialysis chairs and the refurbishment of the children's ward.
It is, perhaps, not unexpected that a SSWAHS Executive, that was appointed by the previous NSW Labor government, was drawn mainly from the old Central Sydney AHS. After all the previous Labor Minister for Health has her seat in Marrickville - central to Central Sydney AHS. The SSWAHS CEO, his Deputy and most of the Directors and Executive members all came from Central Sydney AHS. Some, but not all have headed back to the Sydney LHN taking with them the bulk of the funding and the capital works developments of Concord Hospital and RPAH.
As I have said in the blog many times, SSWAHS administration has overlooked Bowral Hospital and the Southern Highlands, probably because it was seen as a "safe" Liberal seat. Now that we have a new Liberal/National coalition government we appear to be again overlooked because we are an even "safer" Liberal seat!
By now some of you may be wondering why the title of this blog posting has changed to SWSLHN + SLHN = SSWAHS. Well, it does seem as the wheel may have turned full circle again. An informant has told me that the Federal Labor government is unhappy about the additional layer of bureaucracy imposed on the NSW health system with the LHNs and the LHN Cluster overseers. It would appear that even prior to the dismal showing of the NSW Labor government in March they had been advised to revert back to the super Area Health Services. Hence, the Southern Highlands will likely come under a re-formed SSWAHS but, hopefully, without the Executive misfits who always found it hard to look beyond Campbelltown.
Socrates, ever the optimist, is hoping that the new coalition government, and their new Director-General for Health, will not only accept the advice of the Commonwealth but also ensure that any new NSW health structure will take into consideration the possibility of local members having a greater say in their local hospitals, and that funding be commensurate to ensure that the hospital and community health services can provide the services required by the local people, locally.
