Local Hospital Networks: why this issue is important

Alice Springs Hospital

A gathering of health professionals, administrators, hospital board members, community health organisers and local politicians gave unaminous backing to the creation of a separate local hospital network  for Central Australia at a public forum in Alice Springs last night

But the twenty or so people present expressed disappointment townspeople had been given little notice about the meeting, or information about what the process would mean for Alice Springs and Central Australia.

They called on organisers to ensure another meeting was planned, appropriately publicised and held before the end of November. But several expressed fears that their opinions would be ignored by the Darwin-based Territory Government.

Participants complained that the only official notice of the meeting, which was facilitated by a South Australian consultant employed by the NT Health Department, was a small advertisement on page 15 of last week’s Centralian Advocate. Most had heard about the forum through email networks.

The department has officially declared its preference for the Territory to be considered as a single local hospital network under the new national health system, which is expected to be put in place around the country by next year. But participants at last night’s meeting said a single network would be counter to the concept of regional autonomy central to the philosophy of local hospital networks.

The idea of local hospital networks emerged from meetings of the council of Australian governments (COAG) in 2009 after two years of discussion in response to frustrations about how the hospital system was working — or not working — under existing funding and bureaucratic arrangements.

All states except Western Australia have agreed to form local hospital networks,under which 6o percent of a predetermined “efficient price” would be provided to those networks by the Federal Government from GST revenue, with the rest coming from the State or Territory Governments.

As part of the deal, the Federal Government would also fund primary health care and aged care and general practice policy, impose national standards for health care and promote eight “reform streams”: in hospitals, primary health care, aged care, mental health, national standards and performance, workforce, prevention and E-health.

Although LHNs around the country are likely to include populations of up to 500,000, advocates of a separate local hospital network for Central Australia believe the Territory is a special case, with its community having distinct needs and common interests separate from those in the Top End.

At least one administrator — Jon Wakerman from the Centre for Regional Health — believe that the trend to centralising Territory health services in Darwin has already led to fewer services for Central Australians and less access to services.

Forum attendants could identify few benefits of a single Territory LHN other than that it would involve “minimal change” for the Government and would give Central Australians “someone to blame” when something went wrong.

Asked to identify what they were “passionate about”, people at the meeting listed:

• local autonomy;
• “No borders” – not disadvantaging people who didn’t fit within state borders in their choices of treatment centres and availability of care and diagnosis;
• access to services regardless of where people live;
• establishing a health model not dependent on population
• co-ordinated health care
• no “silos” in the health system.

Former Alice Springs hospital director Mike Tyrell said Central Australia had the opportunity to set a ‘world benchmark ‘ for delivering health services in a complex and remote arid zone environment.

Some delegates were keen on an LHN that would include the north of South Australia and parts of western Australia, but were informed by National Health Reforms project manager Christine Quirke that the SA Government would not support such a framework.

While the Government claims it has not reached a final position on LHNs, its consultation paper emphasises the importance of an LHN framework “which maximises economies of scale available for delivery of frontline services, and minimises adminstrative duplication. In this regard, the NHHNA requirement that there be no net increase in the number of health bureaucrats is also an important consideration.” – Dave Richards.

Meanwhile Alice Springs Hospital Board Bruce Simmons has told ABC Radio most staff prefer a regional hospital network that links Alice Springs and Tennant Creek hospitals, rather than a Northern Territory-wide network.

He says when the concept was first introduced, the Federal Government intended it to operate locally.

“The board, the hospital staff and from the tone of last night’s meeting, everyone who’s got an interest or expressed an interest so far, is very keen that it should be two local hospital networks, one in central Australia and one in the Top End, and we’re doing all we can to try and bring that about,” he said.

Submissions (of any length or detail) can be lodged via email to healthreforms@nt.gov.au or mailed to:

Christine F Quirke, Project Manager National Health Reforms, Office of the Chief Executive, Department of Health and Families, PO Box 40596, Casuarina NT, 0811

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