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.
Showing posts with label LHNs. Show all posts
Showing posts with label LHNs. Show all posts
Sunday, April 10, 2011
Thursday, March 24, 2011
SSWAHS = SWSLHN + SLHN and the Medicare Locals - 11
In my previous posting I noted the negative response from the general practitioners in the Blue Mountains in regard to their non-representation on the Board of the Nepean-Blue Mountains Local Health Network. Here is an abbreviated part of what they had to say:
Katoomba out in cold on hospital board: specialist
BY SHANE DESIATNIK
Blue Mountains Gazette
23 Mar, 2011 09:55 AM "Australian Medical Association (AMA) Blue Mountains district representative Dr John England has raised questions over the makeup of the Nepean/Blue Mountains Local Hospital Network board (LHN) established in January, claiming it is virtually a Nepean Hospital establishment.
“The consensus at the meeting was that we don’t know anyone [on the Nepean/Blue Mountains LHN board] except Dr James Bramley, who is based at Nepean Hospital but does relief and occasional weekend work at Katoomba Hospital,” Dr England said.
“Nobody really represents Blue Mountains hospitals [on the board] — that is the truth. “You know the saying, the big dog eats all the food.
“We hope that in the future there will be actually people who work full-time at Katoomba Hospital appointed to the board.
“But what I really think is needed is that doctors appointed to Nepean Hospital should have to work at least one day per fortnight at Katoomba Hospital as part of their contracts.” These statements made me interested to find out something about the SWSLHN Board members and just what they had in the way of qualification to be able to manage the delivery of health services from Fairfield to Bowral.
Here is the published list for the SWSLHN: Professor Phillip Harris AM (Chair); Mr Timothy Bryan; Ms Carolyn Burlew; Ms Christine Carriage; Professor Brad Frankum; Dr Kathryn Gibson; Mr Mark Johnson; Professor Margot Kearns; Dr Jens Kilian; Ms Debbie Roberts; and Professor Jeremy Wilson.
With the magic of Google it is simply amazing what one can find out about people!
Professor Phillip Harris is, among other appointments, Head of Cardiology at the Royal Prince Alfred Hospital (not in the SWSLHN);
Mr Timothy Bryan is a bit of a mystery as it appears he hasn't done much in his life, yet - though there was a convict with the same name who was given his ticket-of-leave in the Colony of NSW at Mudgee on 30th of April 1850!
Ms Carolyn Burlew is the Vice President of the Institute of Public Administration Australia (NSW Division) and has an impressive pedigree of working for the NSW Government and its various Departments. Ms Burlew currently has another 7 positions on various Boards and other ventures in addition to her place on the SWSLHN Board;
Ms Christine Carriage is an Indigenous Project Officer and has a career in helping to improve the health of Aboriginal communities through the "Close the Gap" program;
Professor Brad Frankum is Professor of Clinical Education at the University of Western Sydney's Medical School and also is a specialist in the field of immunology. He has been used in the Macarthur area to inspire school students to consider a career in medicine and he is sufficiently a realist to state: that there is a real battle approaching with the access to, and distribution of, health care. At the Macarthur Anglican School he noted: "Western Sydney gets ripped off with health services". Well, I just hope that Brad Frankum can set his sights upon the more rural parts of the SWSLHN when he begins to argue for more health resources.
Dr Kathryn Gibson (not to be confused with Dr Katherine Gibson of the UWS) is the Head of the Rheumatology/Immunology Unit of the Liverpool Hospital as well as being an Associate Professor in the Medical School.
Mr Mark Johnson could be the same Mark Johnson (AO) who, until July 2008 was the Deputy Chairman of the Maquarie Infrastructure Group (MIG), which in 2007 made a loss of $1.7 billion. Nevertheless, he does have some powerful credentials in his pedigree with a law degree (Melb) and an MBA from Harvard. It has been stated that he is one of the most widely respected, accomplished, and experienced corporate advisers in Australia. Gee! I hope I got the right guy here! If I have, then I imagine that Mr Mark Johnson AO will be distracted by being on the Board of Westfield and the 3 other Advisory Boards for the Australian Government.
Professor Margot Kearns is Pro Vice Chancellor and Executive Dean of Nursing at the University of Notre Dame in Sydney which had its first graduating class in December 2008. The photos of her seem to indicate a maternal and caring person. Hopefully, Professor Kearns will be cognizant of the needs of the nursing staff in the more remote and rural areas of the SWSLHN.
Dr Jens Guenter Kilian is the Director of Cardiology at Bankstown Hospital and also Conjoint Senior Lecturer in Medicine at the University of Sydney. He studied medicine at the University of Melbourne and has qualifications from there in medicine and surgery. Dr Kilian obtained his degrees in 1998 and has been working as a staff specialist in cardiology since October 2006.
Ms Debbie Roberts is the CEO of Youth Solutions, a Macarthur-based NGO which, obviously enough, seeks to improve the health and well-being of young people in the Macarthur area. However, I do know that Youth Solutions has also taken an interest in what happens to the youth of the Southern Highlands.
Professor Jeremy Wilson graduated in medicine from the University of Sydney in 1974. He specialised in Gastroenterology at Concord and Prince of Wales hospitals. At the latter he tinkered a little with drug and alcohol services and it was here that he aspired to create the first of his Very Big Buildings to celebrate his work. Unfortunately, he didn't get his way and so he took off to America with his bat and ball, to undertake research as a Visiting Fellow at the Mount Sinai School of Medicine. Upon his return to Sydney he was appointed as a Conjoint Senior Lecturer of School of Community Medicine at the UNSW and became Associate Professor of Medicine in 1997. Following a surge of appointments to Bankstown-Lidcombe Hospitals and the newly established SWS Clinical School he became Professor and Director of Medicine at Liverpool Hospital. While Professor Wilson is a renowned pancreatologist, he is more renowned in the old SSWAHS as the lead developer of "The Way Forward" document in which the SSWAHS divided itself into divisions of clinical streams. He was renowned for being one of the most senior SSWAHS to completely forget about Bowral Hospital and the community health services in the Southern Highlands. At least, out of that debacle he did manage to wrangle another of his Very Big Buildings at Liverpool Hospital.
So what does this little expose tell us? Well we appear to be no better off in the SWSLHN than our friends up in the Blue Mountains.
No representation by the significant health care providers in the community - the general practitioners. No real health consumers representing the mainstream community members. No real opportunity to engage in public discussion or consultation, with the bulk of the Board consisting of academics and senior clinicians who have mixed roles. Those who are not clinicians or academics are equally tasked with multiple positions in multiple organisations.
Somehow this whole exercise of appointing a Board to govern the activities of a Local Health Network seems to be a cynical exercise in developing a framework structure for a hollow organisation. Maybe returning to the autonomy of a Board for a local hospital will be the only way local health services will get the resources and funding they need. Is the current trend just another way for the senior specialists getting the machines that go "ping" at the expense of the basic clinical and health needs of the communities the health service is meant to serve?
Katoomba out in cold on hospital board: specialist
BY SHANE DESIATNIK
Blue Mountains Gazette
23 Mar, 2011 09:55 AM "Australian Medical Association (AMA) Blue Mountains district representative Dr John England has raised questions over the makeup of the Nepean/Blue Mountains Local Hospital Network board (LHN) established in January, claiming it is virtually a Nepean Hospital establishment.
“The consensus at the meeting was that we don’t know anyone [on the Nepean/Blue Mountains LHN board] except Dr James Bramley, who is based at Nepean Hospital but does relief and occasional weekend work at Katoomba Hospital,” Dr England said.
“Nobody really represents Blue Mountains hospitals [on the board] — that is the truth. “You know the saying, the big dog eats all the food.
“We hope that in the future there will be actually people who work full-time at Katoomba Hospital appointed to the board.
“But what I really think is needed is that doctors appointed to Nepean Hospital should have to work at least one day per fortnight at Katoomba Hospital as part of their contracts.” These statements made me interested to find out something about the SWSLHN Board members and just what they had in the way of qualification to be able to manage the delivery of health services from Fairfield to Bowral.
Here is the published list for the SWSLHN: Professor Phillip Harris AM (Chair); Mr Timothy Bryan; Ms Carolyn Burlew; Ms Christine Carriage; Professor Brad Frankum; Dr Kathryn Gibson; Mr Mark Johnson; Professor Margot Kearns; Dr Jens Kilian; Ms Debbie Roberts; and Professor Jeremy Wilson.
With the magic of Google it is simply amazing what one can find out about people!
Professor Phillip Harris is, among other appointments, Head of Cardiology at the Royal Prince Alfred Hospital (not in the SWSLHN);
Mr Timothy Bryan is a bit of a mystery as it appears he hasn't done much in his life, yet - though there was a convict with the same name who was given his ticket-of-leave in the Colony of NSW at Mudgee on 30th of April 1850!
Ms Carolyn Burlew is the Vice President of the Institute of Public Administration Australia (NSW Division) and has an impressive pedigree of working for the NSW Government and its various Departments. Ms Burlew currently has another 7 positions on various Boards and other ventures in addition to her place on the SWSLHN Board;
Ms Christine Carriage is an Indigenous Project Officer and has a career in helping to improve the health of Aboriginal communities through the "Close the Gap" program;
Professor Brad Frankum is Professor of Clinical Education at the University of Western Sydney's Medical School and also is a specialist in the field of immunology. He has been used in the Macarthur area to inspire school students to consider a career in medicine and he is sufficiently a realist to state: that there is a real battle approaching with the access to, and distribution of, health care. At the Macarthur Anglican School he noted: "Western Sydney gets ripped off with health services". Well, I just hope that Brad Frankum can set his sights upon the more rural parts of the SWSLHN when he begins to argue for more health resources.
Dr Kathryn Gibson (not to be confused with Dr Katherine Gibson of the UWS) is the Head of the Rheumatology/Immunology Unit of the Liverpool Hospital as well as being an Associate Professor in the Medical School.
Mr Mark Johnson could be the same Mark Johnson (AO) who, until July 2008 was the Deputy Chairman of the Maquarie Infrastructure Group (MIG), which in 2007 made a loss of $1.7 billion. Nevertheless, he does have some powerful credentials in his pedigree with a law degree (Melb) and an MBA from Harvard. It has been stated that he is one of the most widely respected, accomplished, and experienced corporate advisers in Australia. Gee! I hope I got the right guy here! If I have, then I imagine that Mr Mark Johnson AO will be distracted by being on the Board of Westfield and the 3 other Advisory Boards for the Australian Government.
Professor Margot Kearns is Pro Vice Chancellor and Executive Dean of Nursing at the University of Notre Dame in Sydney which had its first graduating class in December 2008. The photos of her seem to indicate a maternal and caring person. Hopefully, Professor Kearns will be cognizant of the needs of the nursing staff in the more remote and rural areas of the SWSLHN.
Dr Jens Guenter Kilian is the Director of Cardiology at Bankstown Hospital and also Conjoint Senior Lecturer in Medicine at the University of Sydney. He studied medicine at the University of Melbourne and has qualifications from there in medicine and surgery. Dr Kilian obtained his degrees in 1998 and has been working as a staff specialist in cardiology since October 2006.
Ms Debbie Roberts is the CEO of Youth Solutions, a Macarthur-based NGO which, obviously enough, seeks to improve the health and well-being of young people in the Macarthur area. However, I do know that Youth Solutions has also taken an interest in what happens to the youth of the Southern Highlands.
Professor Jeremy Wilson graduated in medicine from the University of Sydney in 1974. He specialised in Gastroenterology at Concord and Prince of Wales hospitals. At the latter he tinkered a little with drug and alcohol services and it was here that he aspired to create the first of his Very Big Buildings to celebrate his work. Unfortunately, he didn't get his way and so he took off to America with his bat and ball, to undertake research as a Visiting Fellow at the Mount Sinai School of Medicine. Upon his return to Sydney he was appointed as a Conjoint Senior Lecturer of School of Community Medicine at the UNSW and became Associate Professor of Medicine in 1997. Following a surge of appointments to Bankstown-Lidcombe Hospitals and the newly established SWS Clinical School he became Professor and Director of Medicine at Liverpool Hospital. While Professor Wilson is a renowned pancreatologist, he is more renowned in the old SSWAHS as the lead developer of "The Way Forward" document in which the SSWAHS divided itself into divisions of clinical streams. He was renowned for being one of the most senior SSWAHS to completely forget about Bowral Hospital and the community health services in the Southern Highlands. At least, out of that debacle he did manage to wrangle another of his Very Big Buildings at Liverpool Hospital.
So what does this little expose tell us? Well we appear to be no better off in the SWSLHN than our friends up in the Blue Mountains.
No representation by the significant health care providers in the community - the general practitioners. No real health consumers representing the mainstream community members. No real opportunity to engage in public discussion or consultation, with the bulk of the Board consisting of academics and senior clinicians who have mixed roles. Those who are not clinicians or academics are equally tasked with multiple positions in multiple organisations.
Somehow this whole exercise of appointing a Board to govern the activities of a Local Health Network seems to be a cynical exercise in developing a framework structure for a hollow organisation. Maybe returning to the autonomy of a Board for a local hospital will be the only way local health services will get the resources and funding they need. Is the current trend just another way for the senior specialists getting the machines that go "ping" at the expense of the basic clinical and health needs of the communities the health service is meant to serve?
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