Overview
WA Country Health Service Annual Report 2010-11
Significant Issues impacting the
Agency
Working together for a healthier country WA
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WA Country Health Service Annual Report 2010-11
2010 – 11 Highlights and Significant Issues
The WA Country Health Service adopted a new strategic direction during 2009-2010
with Revitalising WA Country Health Service 2009-2012 outlining the way forward for
health service delivery in regional WA. It follows on from the WA Country Health Service
Strategic Plan 2007-2010 titled Foundations for Country Health Services.
Significant Issues
The WA Country Health Service has initiated significant
service reform and infrastructure developments to support
the revitalising goals that will drive improvements for
access to services, better programs to meet community
health needs, and to improve the health of country
Western Australians.
The Royalties for Regions program, has been a key factor
in securing a fairer share of resources for health services
in country regions. The 2009-10 budget contained $214.8
million funding for a Royalties for Regions health package.
There is also a raft of new initiatives funded through
National Partnership Agreements that will help to improve the health and lives of
Aboriginal people living in rural and remote areas. Many of these new initiatives will
attract and build a skilled workforce and help to bring care closer to home for people
living in country WA.
Securing a fair share for country health
Albany Health Campus Redevelopment
The budget for the Albany Health Campus redevelopment project, which includes $60.8
million in Royalties for Regions funding, was increased to $170.4 million following an
announcement of $4.4 million funding for Cancer Services through the Health and
Hospitals Fund, Regional Cancer Centres Initiative. Construction work began in early
2011 following a significant planning process.
Broome Hospital redevelopment
Stage 2 of the Broome Hospital redevelopment, comprising a new Acute Psychiatric Unit
(to service the Kimberley and Pilbara Regions), and a replacement Paediatric Ward
were tendered as one project with a total budget of $17.3 million. Construction is
currently under way with a completion date currently scheduled for January 2012. On
completion of Stage 2, Broome Hospital will be a 66 bed facility (not including
emergency treatment bays).
Esperance Hospital
Funding of $31.8 million, including $18.8 million in Royalties for Regions funding, has
been provided to upgrade clinical services at Esperance Hospital. Service planning has
been endorsed and a business case is currently being prepared, including a Master
Development Plan to examine and plan for possible site usage. A new CT scanner in
Esperance has been operational since November 2010 and forms the first stage of
redevelopment at the site.
Carnarvon Hospital upgrade
Royalties for Regions funding of $20.8 million has been allocated to upgrade Carnarvon
Hospital, including significant remodelling of the hospital’s Emergency Department (ED).
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WA Country Health Service Annual Report 2010-11
Exmouth Health Clinic refurbishment
Royalties for Regions funding of $8.1 million has been provided to refurbish the Exmouth
Health Clinic by 2012-13 to better cater for services including dental, mental health,
pathology, occupational health, community health and PathWest.
Critical care at Bunbury Hospital
The major redevelopment of critical care facilities and services at Bunbury Hospital has
commenced. The four bed intensive care unit (ICU) is at Stage 1 of a three stage
project. Stages 2 and 3 encompass the expansion and redevelopment of the emergency
department.
 ICU works have been completed.
 ICU equipping is complete.
 All ICU staffing is complete except for appointment of the ICU Medical Director.
The current status of the ED components is:
 Schematic Design and Design Development have been completed.
 Contract Documentation is being prepared.
South West Radiation Oncology Service
Construction of new $15.2 million radiation oncology facilities and services at the South
West Health Campus in Bunbury was completed in June 2011, with the first patients to
be treated from early August 2011. The project is jointly funded by the State
Government providing $9.2 million and the Commonwealth providing $6 million.
This project is a first for rural Western Australia. It is planned that the centre will provide
local radiation oncology services for approximately 95 per cent of those South West
residents who require this type of cancer treatment.
Busselton Health Campus
The $117.9 million redevelopment of the Busselton Health Campus, on the current
hospital site, is scheduled to commence in mid-2012 and be completed in mid-2014. The
redevelopment includes a new hospital, new community health centre and new
community mental health clinic. The redevelopment is being managed under a ‘fast
track’ governance structure. Environmental issues were an important consideration in
determining the master plan for the redevelopment and environmental approval
applications have been submitted to the State and Australian Governments.
Hedland Health Campus
The new $138 million Hedland Health Campus opened its doors in Colebatch Way,
South Hedland in November 2010, replacing the 35 year old Port Hedland Hospital. The
newest regional hospital in Australia, the Hedland Health Campus brings together the
majority of South Hedland and Port Hedland’s health related services to become a
health care hub for the Pilbara region. In addition to the 24-hour emergency department
and in-patient beds, the campus includes dedicated obstetrics and paediatrics wards,
day surgery, renal dialysis, medical imaging (X-ray) and a comprehensive range of
specialist services such as urology, speech pathology and home nursing.
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This includes improvements to the internal connectivity of the ED to medical imaging,
cyclone proofing the ED’s roof and a new ambulatory care facility.
WA Country Health Service Annual Report 2010-11
Karratha Health Campus
Construction on the new $150 million Royalties for Regions funded Karratha Health
Campus to replace the Nickol Bay Hospital, is scheduled to commence in 2012 and be
completed by 2015. The new Campus will service the health needs of the growing
population of the State’s North West. The Functional Brief stage was launched in June
2011.
Significant Issues
Kalgoorlie Health Campus
Work is continuing on a major $55.8 million redevelopment of the Kalgoorlie Health
Campus. This includes $15.4 million in Royalties for Regions funding. The four stage
redevelopment includes a new palliative care unit, medical imaging and emergency
departments, together with a significant refurbishment of outpatient and allied health
areas. The new palliative care unit has been completed and work is progressing on the
design and construction of medical imaging and acute services.
East Kimberley Development Package
Under the National Partnership Agreement, WACHS was granted $50 million to
implement a number of targeted priority infrastructure projects across the East
Kimberley.
A number of these projects have been completed or commenced and include:
 $3.4 million to upgrade the Wyndham health facility and associated staff
accommodation, now completed.
 A $20 million new ambulatory care facility and a $4 million expansion of short term
patient accommodation at Kununurra Hospital.
 $3.2 million for Stage 2 of the new Wyndham residential rehabilitation facilities now
completed.
 $4 million for remote aged care facilities and $5.5 million for the remote clinics at the
Warmun and Kalumburu communities. The Kalumburu Aged Care design is
completed. The Warmun projects are currently being re-assessed in light of the March
2011 flooding.
 $4.3 million for environmental health upgrades now underway.
 $0.6 million for sobering up centres at Wyndham and Kununurra which are now
completed.
 $5 million for health service provider housing in Kununurra, under construction.
$1.2 million for medical and imaging equipment
In 2010-11, medical imaging equipment to the value $2.2 million has been purchased for
the regions. Digital imaging equipment has been installed in Narrogin, Busselton,
Geraldton, Nickol Bay, Port Hedland, Broome and Northam. Ten x-ray operator sites
have computed radiography installed. Digital authopantogram units have been
purchased for Merredin, Margaret River, Northam and Kalgoorlie.
Pilbara Cardiovascular Screening Program
The four year, $1.2 million Royalties for Regions funded Cardiovascular Screening
Program, will provide better care and improve health outcomes for Aboriginal people in
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the Pilbara region who suffer from chronic cardiovascular disease. The funding will
provide an outreach programme to improve adult health care screening and, in
particular, for cardiovascular diseases. The provision of primary care for patients
recognises the importance of primary prevention, and increased education and health
promotion along with effective screening will improve health outcomes for the people in
the Pilbara. The program will be provided by outreach services, targeting Aboriginal
people in the Pilbara.
Pilbara Health Initiative
The three year $38.2 million Pilbara Health Initiative continued in 2010-11. This is a
partnership between the State Government’s Royalties for Regions program and major
Pilbara industries (BHP Billiton Iron Ore, Woodside, Chevron, North West Shelf Venture
and Rio Tinto), that aims to boost health services in the region.
This year, the partnership has funded the strengthening of ambulance services with the
appointment of community paramedics at Karratha, and emergency management
education and training for WACHS Pilbara staff to improve disaster response in the
region. It has also boosted regional medical specialist services, including paediatric
services with the appointment of Karratha’s first paediatrician in March 2011.
Under the initiative, the Pilbara Indigenous Employment Program was launched in
October 2010 to provide scholarships, training and employment opportunities to
Aboriginal people in the Pilbara to encourage them to take up roles in the health service.
Also introduced this year under the Initiative are two Aboriginal Liaison Officers based in
emergency departments at Newman Hospital and Hedland Health Campus. Two sexual
health nurses have been employed at Port Hedland and Newman, and women’s and
children’s health services enhanced at Tom Price. Health service planning across the
region is continuing to enable better planning for improved services and infrastructure.
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Significant Issues
WA Country Health Service Annual Report 2010-11
WA Country Health Service Annual Report 2010-11
Service delivery according to need
Significant Issues
Four Hour Rule Program
The Four Hour Rule Program involves significant redesign activity across 17 hospital
sites, seven of which are WA Country Health Service sites (Bunbury, Albany, Broome,
Geraldton, Kalgoorlie, Hedland and Nickol Bay). This program aims to improve the
quality of patient care and reduce pressure on staff and services by streamlining
processes from admission through to discharge to ensure that patients arriving at
Emergency Departments (EDs) are seen and admitted, discharged or transferred within
a four hour timeframe.
The program utilises a rigorous clinical service redesign methodology, tailored to suit the
needs of WA Health. Bunbury Hospital, a Stage 2 site, has a two year milestone target
of 85 per cent by October 2011. The WACHS Stage 3 sites are well into the solution
implementation phase of the cycle and all reached their interim target of 85 per cent by
April 2011. The next milestone target for Stage 3 sites is 95 per cent by October 2011.
Solutions have been developed and are being progressively implemented to address
root causes specific to each site. Solutions however, tend to be themed around
improvements relating to the emergency department, hospital admissions and ward
discharge.
WACHS is currently working with the Institute for Health Leadership, to develop a
medical leadership training program as part of the Four Hour Rule statewide investment
in medical leaders responsible for service improvement. The Area Health Service has
identified senior medical staff who are overseeing clinical reforms, including the Four
Hour Rule Program, as well as those working in senior medical administrative roles, with
workshops due to commence in September 2011.
Elective Surgery
WACHS continues to have a strong focus on managing a growing elective surgery
waitlist, with increased surgical throughout, and particular strategies to address over
boundary cases.
WACHS Kimberley are investing resources to tackle specialist referral and waitlist
management issues, to ensure patients in the Kimberley have timely access to elective
care, particularly Aboriginal children.
WACHS is proposing to target an additional 1,600 cases in 2010-2011 in order to
maintain reasonable waiting times with growing demand for elective surgery.
Cancer Centres
In 2010, the Commonwealth approved $22.291 million for rural cancer services with
specific developments for cancer services facilities and patient accommodation at
Geraldton, Albany, Kalgoorlie, Northam and Narrogin. These centres will have capacity
for office, group and meeting space for a variety of health professionals involved in
supporting people with cancer and their families. The services will provide
multidisciplinary, holistic, patient-centred care closer to home for more people. Service
model planning has been completed which will inform the design of the new cancer
centre services. It is anticipated that 75% of patients requiring chemotherapy will be
treated in these new rural cancer units.
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Aged Care
In 2010-11 WACHS continued to implement a number of programs operating across the
Area Health Service to improve access to aged care services and services for younger
people with disabilities including:
 Increasing Friend In Need Emergency (FINE) complex care coordination across all
seven regions. The program is attached to larger emergency departments to
coordinate care for ‘at risk’ older patients who attend the emergency department.
 Providing a 10 bed Inpatient Rehabilitation Unit Day Therapy service and community
rehabilitation program in Bunbury commencing April 2011 and a full time geriatrician
to the South West was appointed in March 2011.
 Expansion of inpatient and outpatient rehabilitation programs in Albany and
Geraldton.
 Commencement of community physiotherapy and expansion of the Day Therapy
Program in Northam.
 Creation of older adult mental health positions in Goldfields, Wheatbelt and South
West regions.
 An allocation of $1 million for continued growth in Home and Community Care
programs across country regions.
 Full implementation of the National Job Creation Package Program across 16 remote
communities in the Pilbara and Kimberley for the provision of community aged care
services.
 Review and improvement of all multipurpose service residential care documentation
incorporating aged care friendly principles and best practice standards.
Mental health services planning
WACHS developed its Strategic Directions for Mental Health Services in 2010 which will
guide mental health service planning across WACHS to 2020. Service priorities include:
 Early intervention services.
 Collaboration of mental health and alcohol and drug services.
 Infant, child and youth mental health services.
 Statewide Aboriginal Mental Health Services.
A new acute psychiatric unit will commence operation in Broome in early 2012, which
will provide services for both Kimberley and Pilbara patients. Planning is under way for a
similar service at Geraldton Regional Hospital for the Midwest region.
Renal Dialysis Plan
In 2010 WACHS finalised a ten year plan for renal dialysis. It is expected that by 2021
over 650 people resident in WACHS areas will require dialysis. The aim of the plan is to
keep people who require dialysis, closer to home, by increasing the number of people on
home dialysis and exploring alternative options such as placing dialysis facilities (chairs)
in some small hospitals and remote clinics.
Construction of two renal dialysis satellite centres in the Kimberley commenced in May
2011. A 10 chair facility is being constructed in Derby and a four bed facility in
Kununurra. Both are anticipated to be completed by early 2012.
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Significant Issues
WA Country Health Service Annual Report 2010-11
WA Country Health Service Annual Report 2010-11
Significant Issues
Telehealth
Telehealth, is the use of information and communication technology to deliver health
care services at a distance. It is an effective model of healthcare delivery, designed to
minimise disruptions to the patient, and maximise the opportunity for individuals to
access specialist healthcare professionals located within the Perth Metropolitan region.
Patient specific Telehealth, is delivered via videoconferencing between tertiary
healthcare providers in Metropolitan Perth, and remote and rural health facilities. While
the majority of these services are presently delivered from the teaching hospitals,
potential exists to grow the business across all health services and can offer an
alternative to face-to-face consultations when access to existing services is an issue.
The Clever Networks Program, promoting the use of Telehealth, was successfully
completed in 2010. Telehealth services have benefited from funding that has enabled
the establishment of a central infrastructure, thereby ensuring that high standards of
videoconferencing can be achieved across the state.
Communication between health care staff has been made easier with the introduction of
the Scopia platform that allows videoconferencing and other information sharing from
individual desktops to the videoconferencing fleet. Scopia reduces the individual’s
requirement to travel for meetings, and maximises the opportunity to communicate
across the State and has proven to be a popular method of communication. During
2010-11 the users of Telehealth have steadily increased.
To support the ongoing development of Telehealth, the government has recently
announced major funding for the redesign of rural healthcare and Telehealth will play a
significant role in this reform. The Southern Inland Health Initiative will see major
developments in capital works, videoconference technology and the supporting systems
as well as dedicated human resources. This will facilitate improved support for existing
services while providing the opportunity to develop new services for regional patients
based on identified need and health priorities.
Patient Assisted Travel Scheme
The Patient Assisted Travel Scheme (PATS) election commitment has been fully
implemented. Royalties for Regions provided an additional $30.8 million from 2008-09 to
2011-12, to reduce the financial burden on country residents who need to travel more
than 100km one way to access the nearest eligible medical specialist services.
Improvements included increases for kilometre road travel and patient accommodation
subsidies; as well as increased support to patients, particularly the aged, disabled and
people who require treatment for cancer. Trends from January 2009 to date show an
increase in demand for PATS with over 65,000 trips provided between April 2010 and
March 2011 supported by the increased Scheme expenditure. Feedback from country
areas indicates the improvements have met with approval of country residents.
Royal Flying Doctor Service
In 2008-09, the State Government approved increased funding of $68.5 million over five
years, to build the capacity of the Royal Flying Doctor Service (RFDS). The approved
increase in infrastructure for the RFDS has been fully implemented with the purchase of
five new aircraft to replace existing ageing aircraft and three new aircraft to expand the
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WA Country Health Service Annual Report 2010-11
The performance target for patient transfers is for 80% of priority one calls, (i.e. patients
with a life threatening condition which is time critical), to be responded to within 75
minutes. With the additional aircraft, RFDS is meeting the performance target for priority
one patients for the first time; with 83.5% of patient transfers in the January to March
2011 quarter meeting the target response time, an improvement from 68.9% for January
to March 2009 and 79.2% in 2010. Up to 30 May 2011, the RFDS had provided
interhospital patient transfers for 152 country patients over 6.5 million kilometres.
Royalties for Regions funds of up to $3 million over three years were also approved in
2009-10 to underwrite a new medical jet service which commenced in October 2009 with
the support of Rio Tinto Iron Ore.
The jet service is designed to reduce the flight times for country patients in the
Northwest of the State. In 2010-11, the service transported 231 critically ill country
patients to tertiary hospitals in Perth in the 11 months to 30 May 2011. An independent
review of the medical jet service completed in January 2011, showed it to be an effective
service. The review considered the jet transport activity for the first nine months of
operation up to 31 July 2010, with 179 patients transported predominantly to Perth,
including 93 (52%) from the Kimberley and 48 (27%) from the Pilbara. The review found
that the jet had been used economically with 41% of flights carrying three or more
patients and that by July 2010 the service was approaching the ideal utilisation level of
80 hours per month. Given the significant contribution made by Rio Tinto to its operation,
the review found that the current cost of the jet service to WA Health of $3,144 per flying
hour represented value for money when compared to the full commercial cost of $7,000
per flying hour.
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fleet from 11 to 14 aircraft. The increased capacity has resulted in improved response
times for inter-hospital patient transfers.
WA Country Health Service Annual Report 2010-11
Closing the gap to improve Aboriginal Health
WA Health is currently at the midway point of delivering the
two Indigenous National Partnership Agreements for
Closing the Gap and Indigenous Early Childhood
Development.
Significant Issues
Key milestones against the key outcomes, as set by the
Council of Australian Government (COAG), achieved by
the WACHS – Aboriginal Health Improvement Unit include:
 Establishment of an Indigenous Health Planning
governance structure.
 Development of a WA Country Health Service Aboriginal Employment Strategy
2010 –14, including the implementation of a range of culturally secure recruitment and
selection strategies to facilitate the creation of 176.3 COAG positions across WA
Health - 71% occupancy rate as of April 2011.
 11 April Launched Our Footprints – A traveller’s guide to the COAG implementation
process in Western Australia.
The government and non-government sectors are working together to coordinate and
lead a complex suite of new programs and expanded service models. Regional services
include mobile outreach clinics in the Goldfields, Kimberley, and Midwest regions, which
provide adult and child health checks, screening, and management of chronic diseases,
sexual and reproductive health care, and antenatal and postnatal care.
Aboriginal liaison officers have been employed on a statewide basis to provide services
such as advocacy and support for Aboriginal patients (including post discharge) to
facilitate the patient’s journey.
State funded Tackling Smoking programs are being integrated with elements of the
Commonwealth Chronic Disease Package to increase Aboriginal peoples’ access to
tobacco education and prevention programs.
A number of different strategies are being implemented to improve access to social
emotional well being services that will compliment the services provided under the
auspice of the Mental Health Commission’s Statewide Specialist Aboriginal Mental
Health Service.
A memorandum of understanding has been drafted between WACHS and the
Department of Corrective Services to facilitate the delivery of a statewide Aboriginal
Prisoner Health Re-entry program, which will provide ongoing health care support for
Aboriginal prisoners.
Workforce Stability and Excellence Rural Practice Pathway
Rural Practice Pathway previously known as the Rural Generalist Pathway was
developed to provide a clear pathway into rural training places in country WA.
The focus is on developing medical graduates through the internship year and beyond
with wide ranging skills in general practice, obstetrics, anaesthetics and other areas.
Increasing these well supported junior doctor training positions will begin to address the
shortage of medical practitioners in rural and remote WA.
WACHS was successful in receiving funding to provide training places in country WA for
new doctors over five years.
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Staff Accommodation
The Area Health Service provides staff accommodation to over 1,700 staff both in
owned accommodation and properties leased from the private sector. In accordance
with State Government policy, WACHS has been working collaboratively with the
Department of Housing – Government Regional Officer Housing (GROH) towards a
framework to transfer non transient (permanent) staff accommodation responsibilities.
The aim of this transfer is to improve the level of staff housing via a government
department dedicated solely to long term staff accommodation, allowing WACHS to
concentrate on core health-related business.
It is anticipated that this collaborative approach with GROH will see a direct
improvement in the standard and number of accommodation units available for WACHS
staff in the future.
Transient accommodation for staff on short term contracts, and accommodation on
hospital grounds and in remote locations, will remain WACHS responsibility. This style of
accommodation caters for over 900 staff. The high demand for transient accommodation
has been met in part by the current $36.6 million dedicated staff accommodation funding
within WACHS’s Capital Works Program.
WA Country Health Service Nursing and Midwifery Leadership Forum 2010
The WACHS Nursing and Midwifery Leadership direction for 2011, focused on
supporting Nurses and Midwives to attend the 11th National Rural Health Conference
which was held in Perth from 13 - 16 March 2011.
The theme of this conference was Rural and Remote Australia - The Heart of a Healthy
Nation and provided a unique opportunity for rural and remote nurses and midwives
across WACHS to continue to share their innovative ideas, develop and enhance
networks and highlight improvements in nursing and midwifery outcomes for rural and
remote patients.
The forum was again a great success with senior nurses and midwives attending from
all regions over the two days. It provided opportunities for nurses and midwives to
network with their intrastate, state and national rural and remote colleagues and peers,
culminating in a presentation on the final day to Hon.Nicola Roxon; Minister for Health
and Ageing, of recommendations specifically targeted to rural and remote patient health
outcomes.
Cultural Awareness Training
WACHS and North Metropolitan Area Health Service received funding through the
Australian Flexible Learning Framework to develop an introductory Aboriginal cultural elearning package. The package aims to increase awareness of individual responsibility
to build a culturally safe workplace.
As the training is available online, it is timely, accessible and sustainable; and being
developed by WA Health staff, it can also be updated or modified as required. Over 60
Aboriginal and non-Aboriginal staff evaluated the package in April 2011 with nearly 90
per cent of respondents reporting that the content was relevant and flowed in a logical
manner. It also contributed to the understanding of Aboriginal culture and could be
applied in their workplace.
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Significant Issues
WA Country Health Service Annual Report 2010-11
WA Country Health Service Annual Report 2010-11
Priorities for 2011-12
Significant Issues
In the coming year, the WACHS will continue to build on the successes of previous
years through hospital reforms, improvements to the safety and quality of care and
meeting increased service demand. WACHS will play a central role in key statewide
initiatives including the Four Hour Rule, elective surgery, Aboriginal health and Activity
Based Funding and Management.
The centrepiece of the 2011-12 WA Health budget was a
$565 million investment in the Southern Inland Health
Initiative. Delivering this Initiative offers exciting
opportunities to enhance healthcare for communities
across a large section of country WA, and will be a major
focus for WACHS over the coming year. It is also
anticipated that implementing National Health Reform in
WA will contribute further to our reform momentum in
2011-12.
Improving medical coverage and 24 hour emergency care
The ‘Royalties for Regions’ funded Southern Inland Health Initiative will herald a new era
in country healthcare in regional Western Australia, across the southern inland area
stretching from Kalbarri and Meekatharra in the north, to Laverton in the east, and south
to Esperance.
This Initiative includes a $240 million investment in the health workforce and provision of
health services over four years, and $325 million in capital works over five years. The
initiative will redesign the way health services have historically been delivered in regional
WA to meet the growing demand and changing health needs of local communities.
A key focus of the first year will be to address the lack of private GPs across the
Southern Inland region. The initiative will increase significantly the number of general
practitioners and dramatically improve medical and 24 hour emergency capacity across
the region.
Hospital building program
Across country WA, the State Government is undertaking one of the largest country
public hospital building programs in the world. New hospitals are being built and
redevelopments are under way at many locations including Albany, Busselton, Bunbury,
Esperance, Kalgoorlie, Broome, Kununurra and Karratha.
The Broome Health Campus is undergoing redevelopment, which includes a new
paediatric unit and a new Acute Psychiatric Unit, the first of its kind to be built north of
Perth, both due to open early next year.
Service planning in consultation with the community is ongoing to plan for future health
services in the Pilbara and will inform the master planning of the new $150 million
Karratha Health Campus.
A major redevelopment of critical care facilities at Bunbury Hospital will create a new
four bed intensive care unit and an expanded emergency department.
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WA Country Health Service Annual Report 2010-11
The Southern Inland Health Initiative includes capital expenditure of $325 million over
five years, including upgrades to six district hospitals at Northam, Narrogin, Merredin,
Katanning, Manjimup (Warren Hospital) and Collie.
There has been a raft of new initiatives funded through the Council of Australian
Government’s (COAG) National Partnership Agreements (NPA) that aim to improve the
health and lifestyles of Aboriginal people living in rural and remote areas.
WA Health has committed $117.4 million for the Closing the Gap in Indigenous Health
Outcomes NPA. The Commonwealth has contributed $17.12 million and WA Health
$11.25 million for the Indigenous Early Childhood Development NPA initiatives. This
represents the single biggest investment in Aboriginal health reform in the State’s
history. For the first time, Aboriginal people have been involved in both the planning and
development process to improve the delivery of Aboriginal health services across WA.
A complex suite of new programs and expanded service models is being introduced
including mobile outreach clinics in the Goldfields, Kimberley and Midwest health
regions to provide health checks, screening and management of chronic disease;
employment of Aboriginal liaison officers across the State to support Aboriginal patients;
tobacco education and prevention programs and strategies to promote social emotional
well being and mental health.
Additionally, country services in WA will actively participate in the National Hospital and
Health Subsidy Scheme to be introduced for indigenous communities in rural and
remote communities currently serviced by their local St John’s Ambulance sub centre,
who will be able to subscribe for an annual St John’s Ambulance membership.
Four Hour Rule
The Four Hour Rule Program involves significant redesign activity across 17 hospital
sites, seven of which are in regional WA. It aims to improve the quality of patient care
and reduce pressure on staff and services by streamlining processes from admission
through to discharge, to ensure that patients arriving at Emergency Departments (EDs)
are seen and admitted, discharged or transferred within a four-hour timeframe.
Bunbury Hospital is a Stage 2 site, with a two year milestone target of 85 per cent by
October 2011. Stage 3 sites include Albany, Broome, Geraldton, Kalgoorlie, Hedland
and Karratha (Nickol Bay) hospitals. All WACHS Stage Three sites reached their interim
target of 85 per cent by April 2011. The next milestone target for Stage 3 sites is 95 per
cent by October 2011.
Renal Dialysis Plan
The Commonwealth has approved $45.8 million in the 2011-12 Budget for rural renal
dialysis services infrastructure funding over the next five years. An additional $2.55
million Commonwealth funding has been allocated for the expansion of dialysis chairs in
Bunbury for St John of God Healthcare. Additional services to be funded over the four
year years include expansion of regional satellite services in Kalgoorlie and Bunbury;
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Closing the Gap
WA Country Health Service Annual Report 2010-11
establishment of satellite outreach services in Fitzroy Crossing, Roebourne, Laverton
and Leonora; renal support teams in the Kimberley, Pilbara, Goldfields and Midwest and
hospital accommodation for renal patients in Broome, Kununurra, Derby, Fitzroy
Crossing, Carnarvon and Kalgoorlie.
Significant Issues
An agreement has been reached with the Northern Territory government to ensure that
renal patients from the Central Desert area can access treatment at the closest
appropriate service, regardless of what side of the border they live. The Western
Australian and the Northern Territory governments are also undertaking joint planning
for the Central Desert, to ensure that future health needs are met through a cooperative
relationship between States. A study commissioned by the Commonwealth Government
has been completed and identifies the needs and most appropriate renal service
responses for the Central Desert region.
Improving Rural Cancer Services
The Commonwealth approved $22.29 million in 2010 to fund WACHS to build five new
rural cancer and chemotherapy units and patient accommodation at Albany, Geraldton,
Kalgoorlie, Northam and Narrogin with additional funding being provided to St John of
God Hospital in Bunbury to expand the cancer unit on the South West Health Campus.
Planning for these new services is underway.
Royalties for Regions
A key factor in securing a fairer share of resources for health services in country regions
has been the substantial State Government investment into country health, particularly
through the ‘Royalties for Regions’ Fund. For the period 2010-11 to 2014-15, this
contribution to country health is more than $1 billion, with a $130.6 million investment
planned during 2011-12. This investment will bring care closer to home and assist in
attracting a skilled workforce to work in country WA.
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