David Nicholson and Alex Tay
Department of Health and Human
Services
Policy, Information and Commissioning Group
Department of Health and Human Services
Background: National Health Reform
National Health Reform is underpinned by the:
• National Health Reform Agreement (NHRA)
Signed in August 2011
• National Partnership Agreement on Improving Public Hospital
Services (NPA IPHS)
Also signed in August 2011
NHRA - outlines the governance and operational arrangements of the
new system
NPA IPHS - designed to drive improved service delivery across
Emergency departments, Elective surgery and Sub acute care
National Health Reform Key Stakeholders
•
•
Many stakeholders – existing, new and reformed
Some relationships are clearly defined the remainder continue to be
discussed (state-wide services, support services, medicare locals)
•
Implementation of the
reforms needs to be well
considered and reflective of
local needs
Strong consultation on
outstanding elements will
occur
The focus of this discussion is
the implementation of Local
Hospital Networks in
Tasmania
•
•
Hospitals under the NHRA
• Under the NHRA, management of public hospitals will change to ensure:
• A nationally consistent model – Local Hospital Networks
• Independent governance
• Local decision making – Governing Councils
• Transparency – Funding and Performance
• All LHNs are to be fully operational by 1 July 2012
In Tasmania
• LHNs will be called Tasmanian Health Organisations (THOs)
• Three THOs will be formed as statutory bodies, independent
from DHHS
• THOs will have the same boundaries as existing Area Health
Services
• Each THO will have a Governing Council (board)
Purpose of THOs
• The primary purpose of a THO is to:
– Provide relief to sick and injured citizens,
through the provision of care and treatment.
– To promote, protect and maintain the health of
the Tasmanian community.
Impact on patients
• THOs will help to improve patient care through:
– greater autonomy to ensure care delivery meets patient
expectations and needs
– improved engagement with local clinicians
– improved community engagement
– higher performance standards
– unprecedented levels of transparency
• The government will clearly state its expectations of THOs
and service arrangements will be formally agreed with clear
funding attached.
Impact on staff
• Steps have been taken to minimise disruptions to staff
• THO staff will remain under the State’s industrial relations
system and the State Service Act 2000
• The establishment of THOs will not affect current employee
entitlements for staff eg: leave entitlements, superannuation
arrangements and salary packaging
• Existing AHS employees will transition across to the
corresponding THO
Impact on staff continued
• New staff will have the same entitlements as existing staff
• THO CEOs will have the delegated authority for the day-today management of THO employees
• Enterprise bargaining agreements will continue to be
negotiated centrally with the respective industrial bodies, to
ensure consistency of application across all services and all
regions of the State
Current Governance Structure
Minister
DHHS
Central Agency
Secretary
Secretary
AHS
AHS
CEO
CEO
CEO
CEO
AHS
CEO
CEO
Future Governance Structure
Future role of DHHS and THOs
• DHHS
-System manager acting on Ministers’ behalf (requirement of NHRA)
-Purchaser of services
-System-wide policy (high level) and planning
-Performance monitor and manager
-A “Business Services Network” will provide support services to both the
THOs and the Department.
•
THOs
-Service providers (without bureaucratic interference)
-Collaborate with Medicare Local at the local level to close gaps
-Local service planning
-Strengthening local voice in health care delivery
Chair
Chair
Chair
Governing Council
Governing Council
Governing Council
CEO
CEO
CEO
THO
THO
THO
Operating Environment
Establishes
functions and
powers of
THOs
Allows for
appointment of
Governing
Council
members
Sets out
corporate
governance
requirements
Establishes
functions and
powers of
Governing
Councils
LEGISLATION: Underpins new structure
Establishes
contractual
and
performance
arrangements
Benefits of proposed legislation
• Focus on maintaining and improving patient care
• Provides flexibility
• Allows for transition arrangements to ensure orderly change
• Builds strong accountability
• Minimises disruption to employees and the community
• Maintains staff entitlements
• Based on a proven model (GBE)
Performance of THOs
• THOs will have autonomy over the day to day management of their
hospitals and services
• The Ministerial Charter and the Service Agreement will be the
main instruments for Government Direction. Expectations will be
clear and will be matched with funding
• The Minister remains ultimately accountable for the State’s public
health system
• If there are performance issues, the Minister will have tools available
to protect the interests of patients as well as the broader
community (eg emergency preparedness requirements)
Additional features - TCC
• The Legislation will also establish a strong advisory body to be
known as the Tasmanian Clinical Council (TCC). The TCC will be a
‘lead clinician group’
• At a broad level, the TCC will:
• be a multi disciplinary, skills based group with strong regional
representation
• provide independent clinical advice on health priorities in
Tasmania
• provide advice to all levels of the system
• receive funding to support its aims
Where to from here?
• The draft THO legislation is now available for public comment
• Public comments will be accepted up until Tuesday 6 September 2011
• Comments can be emailed to health.reform@dhhs.tas.gov.au or
alternatively posted to GPO Box 125, Hobart TAS 7001
• Comments do not need to be written as formal submissions to be
considered by the Health Reform Implementation Team
• A copy of the draft Legislation can be found on the health reform
website www.dhhs.tas.gov.au/healthreform
• Fact sheets have been developed to assist understanding
• Ongoing consultation will continue until legislation is introduced to
Parliament later this year
QUESTIONS