Engaging Communities And Clinicians For Better Health

If elected in March 2018, a Marshall Liberal Government will implement major reform by decentralising South Australia’s health system, through the establishment of metropolitan and regional boards of management.

The Problem

During the past 10 years, Labor has more than doubled SA Health’s head office staff; it has grown four times faster than our nursing workforce.

Labor’s priorities have been all wrong.

Decision-making has become so centralised that administration is getting in the way of quality health care.

Despite the growth, the bureaucracy has failed to manage the health budget and major projects, and maintain a culture which respects patients as coming first.

The cost of the new Royal Adelaide Hospital has gone $600 million over budget and its opening has been long delayed.

The cost of EPAS, SA Health’s electronic patient record system has more than doubled to almost $500 million yet still fails to provide the service improvements promised.

South Australians should be able to rely on their public health services to provide quality care when they need it.

The quality of care relies on the skills of our nurses, doctors and other health professionals.

But under Labor, the culture of SA Health has lacked a focus on quality and patient safety.

Our health services are crying out for a transformation in leadership, governance and culture.

The following issues demand immediate attention:

  • Centralised bureaucratic decision-making disconnected from the needs of local communities and the input of health professionals delivering patient care
  • Waste of taxpayers’ money in excessive bureaucracy and poor project management
  • Poor culture and, in particular, a lack of focus on patient safety

The State Liberal's Plan

If elected in March 2018 a Marshall Liberal Government will implement major reform by:

  • Decentralising the public health system through the establishment of metropolitan and regional boards of management
  • Putting real responsibility and accountability at the local level, with strengthened oversight
  • Improving patient safety and holding boards accountable for delivering real progress

Within its first 100 days a Marshall Liberal Government will:

  • Move to establish governing boards for the existing three metropolitan health networks
  • Consult on the boundaries of up to six regional health networks as the first step to establish their boards of management
  • Put legislation into the Parliament to underpin the new governance and accountability framework and establish board powers and functions

All board chairs will be appointed by 31 July 2018.

Each board will be accountable for the delivery of health services within its areas of responsibility which are:

  • Safe, high-quality and accessible
  • Reflective of local values, needs and priorities
  • Sustainable within the resources available

Each board will:

  • Appoint and manage its chief executive
  • Control the health budget for its area of responsibility
  • Actively engage with its communities and frontline health professionals

Negotiate an annual Service Level Agreement (SLA) with the Chief Executive of the Department of Health that reflects local needs while recognising state-wide priorities and service coordination – by the 2019-20 financial year all regions will be operating under SLAs agreed with a board

Report annually against the SLA on progress in meeting key performance targets, and engagement with communities and health professionals on service delivery

The Minister for Health and Wellbeing will be empowered to intervene if a board does not meet its responsibilities, including in relation to the quality of the services provided and financial targets.

Decentralising the management of the public health system recognises that health care needs and challenges can vary between areas within metropolitan Adelaide and across regional South Australia. Decisions need to be made as close as possible to the area and people affected and with the full and effective involvement of local health professionals.

This means cutting unnecessary bureaucracy which frustrates people seeking to work productively in our hospitals and health centres, allowing them to maximise the time they devote to the safety and care of patients.

Our doctors, nurses and allied health staff work under great pressure. They don’t need more of it imposed by a remote head office out of touch with local needs and challenges.