The VHA has welcomed the end to uncertainty facing publicly funded healthcare services with the release of the Health Services Plan, but notes the push towards ‘clinical service amalgamation’.

The Victorian Government has accepted all but one of the 27 recommendations detailed in the independent Health Services Plan review – mandatory amalgamations. Instead, the Victorian Government will be supporting the strengthened partnerships model and pursuing other means of centralisation.

The three key pillars detailed within the Health Services Plan - establishing Local Health Service Networks, formalised relationships, and a Victorian role delineation framework – effectively amounts to a clinical services amalgamation. VHA CEO Leigh Clarke said, ‘with required network-wide consolidation of clinical activity and clinical management – this is centralising administration and resources across health services without immediately having to consolidate.’

In addition, Ms Clarke said she is pleased the Victorian Government has listened to the VHA and has returned $1.5 billion back into the health system. This will go some way to support the current crisis impacting upon clinical staff and services within the health system, but more is needed to deliver on reform.

Key to achieving financial breakeven within one year is the creation of a new entity called Hospitals Victoria within the Department of Health – which will be focused on driving financial sustainability in the system and partnering with services on financial management initiatives.

‘We note the creation of a new entity known as Hospitals Victoria and would like to see a more collaborative way of working with health services – we must not repeat the mistakes of the past few months. We call for improved communication and collaboration in the development of health service budgets,’ Ms Clarke.

The Victorian Government is progressing measures to contain costs within the health budget. The VHA had warned repeatedly of the risks of doing this. Services will still need to meet financial breakeven within a year – which may now be easier to achieve with the return of $1.5 billion.

‘The VHA are pleased to have supported publicly funded healthcare services to navigate what has been a significant period of uncertainty surrounding reform and potential budget cuts. The Victorian Government has listened to the VHA’s concerns, and the concerns of the sector, but there is more to unpack in the days ahead.’

‘The Victorian Government needs to deliver further consultation with the health sector to enable considered implementation of the reform recommendations. This requires further consultation with stakeholders before embarking on any major changes, including health service employees, consumers and clinicians.’

Ms Clarke added that reform of any kind is not a cost neutral exercise and additional funding will be required to actualise the recommendations of the Health Services Plan review.

‘The VHA supports the intent of reform – to achieve equity of access to clinical care for all Victorians. The return of funding of $1.5 billion is focused on avoiding the most significant of risks to clinical staff and services – and we look forward to seeing the additional funding to achieve system reform.'

Ms Clarke welcomed the government’s commitment to roll out a connected Electronic Medical Record to all hospitals - which the VHA called for in its budget submission earlier this year. This is a welcome outcome in addition to greater coordination of waitlists; networked clinical service planning and better use of available capacity across the system.

‘Secure and sustainable funding is needed to address the key enablers of reform such as filing workforce gaps with a skilled and mobile workforce and investing in good change management that minimises disruption such as loss of CEOs and other leaders.’

‘Reform is not without its risk and this needs to be carefully considered. The Victorian Government must take strong leadership in implementing the recommendations of the Health Services Plan review with appropriate levels of funding.’

Background

The Health Services Plan review makes 27 recommendations to achieve a more integrated and equitable healthcare system.

Key points include:

• Establishment of 11 Local Health Service Networks, including 5 for regional Victoria: Barwon South West; Grampians: Loddon Mallee: Hume; Gippsland Metropolitan Melbourne and statewide services; West Metro; Parkville; North Metro; East Metro; South Metro; Bayside
• Mandatory consolidation off the table – clinical services amalgamations will be effected
• Government to hold department accountable for fulfilling stronger role in setting strategic directions; monitoring and ensuring accountability
• Investment in change management and other key skills to support consolidation of the system
• Review of funding models to promote sustainability and support clinical and organisational practice through digital transformation
• Department to clarify roles and responsibilities of registered community health providers and health services – in context of broader reforms to integrate primary and acute care
• Work with Commonwealth to establish regional governance structures that span primary; acute; non-acute mental health and AOD
• Continuous improvement of the health system through review of the system in 3 years from commencement of reform implementation and another in 5 years to evaluate outcomes
• Role delineation framework with clear roles and responsibilities for each health service site
• Continuation of existing collaboration, such as Rural ICT Alliances or pathology networks where these span a wider geography than Local Health Service Networks recommendation.

The Health Services plan was informed by consultation and engagement with publicly funded healthcare services spanning almost a year.

The VHA’s position paper Victorian Health Services Plan: enabling success for major healthcare system reform highlights 4 key enablers to achieving large-scale reform:

1. Funding: that no matter the final reform option – secure sustainable funding is needed to ensure the long-term sustainability of the Victorian public healthcare system
2. Infrastructure: the quality and level of infrastructure varies across health services. The Victorian Government must ensure that health services have the right infrastructure to perform their role in the broader healthcare system
3. Workforce: policies to support reform will be needed that attract and retain workers, particularly in rural and regional areas
4. Change management: such a major reform brings with it very high risk – such as loss of leadership, workforce exhaustion and clinical governance. The Victorian Government and Department of Health must commit to meaningful sector and community engagement and undertake reform in a considered manner.

 

For further information contact Primary contact Toli Papadopoulos toli.papadopoulos@vha.org.au 0408 851 302   Secondary contact Tanya Vieyra Tanya.vieyra@vha.org.au 0400 515 444