The NSW Government has formally responded to the Special Commission of Inquiry into Healthcare Funding (Health Inquiry), placing health workers, preventative care, hospital infrastructure, and federal funding at the cornerstones of its agenda for reform. 

The Health Inquiry visited every local health district and specialty health network across metropolitan as well as regional NSW, receiving 226 written submissions; hearing testimony from 225 witnesses over 70 days of hearings, including clinicians, patients, unions, providers and policy experts.

The NSW Government response supports in full or in principle the majority of the 41 recommendations from the over 1,000-page report prepared by the Inquiry, with work already underway to address a number of the recommendations.

Supporting and empowering health workers 

Health workers are at the centre of the health reform agenda.

Priority work in progress includes the development of an internal locum agency within NSW Health, working closely with the Health Services Union (HSU) to support an award modernisation process, and supporting clinicians to work to their full scope of practice across the healthcare workforce.

As part of the NSW Government response, NSW Health will:

• review its approach to statewide clinical service planning over the next 12 months, to determine the best ways to identify health needs and shape future public health services;
• enhance transparency by establishing a central workforce unit to better monitor data on workforce supply and demand to guide workforce strategies that will help to fill vacancies, address and prevent future workforce supply challenges, and to inform future workforce planning across local health districts;
• strengthen the focus of workforce wellbeing by creating a Chief Wellbeing Officer to lead system-wide wellbeing strategies and actions from the People Matter Employment Survey to enhance staff wellbeing and engagement; and 
• strengthen prevention and early intervention on staff safety and wellbeing, along with the enhancement of the complaints and grievance portal for staff.

Priority work already underway, in conjunction with the Health Services Union (HSU), includes:

• Establishing an internal locum agency, to provide an alternative service offering in addition to the third-party locum agency model. A central approach to the management of this critical workforce will reduce the recruitment burden on hospital staff, the administrative burden on doctors, as well as the State’s spend on locum agency fees over the coming decade.
• Modernising industrial awards. NSW Health has committed to working with the Health Services Union to reform allied health industrial awards and is committed to working with states, territories and the Commonwealth to remove barriers to support health practitioners to work to their optimal scope of practice. 
• Supporting practitioners to work to their full scope of practice through innovative workforce models, including recent trials of paramedics working within emergency departments and within the community.

Preventative healthcare

It is clear from escalating demand on our hospitals from an increasingly aged population that preventative healthcare will become even more central to the function of our health system.

To that end, the NSW Government, through NSW Health, will:

• develop a statewide paediatric strategic plan to clearly define roles and care pathways for the delivery of world-class care to children across the state; and
• continue to examine low value, cost inefficient medical interventions and diagnostics while also invest in alternate and preventative models of care to deliver outcomes that matter to patients and provide long-term sustainability for the health system.

This builds on the existing work of our health system geared towards prevention, including promoting healthy eating and active living, reducing the prevalence of diabetes, supporting a healthy start to life in the first 2000 days, improving oral, mental and sexual health, and reducing tobacco and e-cigarette, and drug and alcohol related harms.

Hospitals meeting community health needs

The Health Inquiry examined health infrastructure, noting our hospitals must ‘reflect an assessment of the health needs of the population’.

The state government is committed to delivering the hospitals and beds the community needs and deserves, including delivering new hospitals for Rouse Hill and Bankstown, new upgrades to Blacktown, Fairfield and Canterbury, and more beds for Blacktown and Mount Druitt Hospitals.

Further work completed by NSW Health or currently underway includes:

• An Infrastructure and Asset Management Division has been established within NSW Health, streamlining capital planning, infrastructure delivery and strategic asset management to ensure investments are sustainable, efficient and responsive to emerging challenges.
• Expanded wait time monitoring including moving to increased central oversight of wait time monitoring in public specialist outpatient clinics through the rollout of the Single Digital Patient Record. Emergency department wait time reporting measures have also been expanded to include quarterly reporting against new Hospital Access Targets.

NSW’s fair share of Commonwealth funding

The Health Inquiry made two sobering observations – the challenges in accessing primary care (GPs); and the lack of Commonwealth Government aged care and NDIS placements, are both placing tremendous pressure on state hospitals.

State governments are responsible for hospitals, and we’re making record investments in the NSW public hospital system.

Meanwhile, the Commonwealth is responsible for primary care, aged care and NDIS. The difficulty accessing these services however, are impacting state hospitals as people who are unable to find a GP end up presenting to emergency departments. 

Patients ready to be discharged lie waiting in hospital beds because they cannot access an aged care or NDIS placement.

The NSW Government’s response makes it clear that it will continue to strongly advocate with fellow states and territories, for its fair share of health funding from the Commonwealth Government.

Reforming the health system

The Health Inquiry and the changes arising from it build on the NSW Government’s reform of the health system, delivering more staff, building more hospitals, delivering more beds, and beginning to turn around the long wait times – wait times that exploded under the Liberals who cut staff, delayed hospital construction, and planned to privatise hospitals.

The NSW Government will continue to closely monitor progress and report on the implementation of the recommendations, which will benefit both the people who work for NSW Health and the communities they serve. 

The full NSW Government Response can be accessed here: Government Response to the Special Commission of Inquiry into Healthcare Funding (PDF).

NSW Premier Chris Minns said, “We asked this Inquiry to tell us, honestly, what’s working in our health system and what isn’t – and now we can get on with improving it.”

“This is about backing our health workers, planning properly for the future and making sure people can get care when and where they need it.”

“Health workers are at the centre of this response. We want better data, better planning and better support so they can focus on what they do best – looking after patients.”

Minister for Health Ryan Park said, “The completion of this inquiry and the Government’s response to it makes good on a core election commitment, first championed by the HSU, for a root and branch review of our health system.

“Let me be clear, today’s response does not mark the end, but the beginning of a new chapter of reform that supports and empowers health workers; embraces preventative care; ensures hospitals meet the health needs of the community; and secures NSW’s fair share of health funding.

“We know the Liberals are determined to brush over this health inquiry – but they cannot rewrite their history of cuts to wages; cuts to staff; and delays in delivering the hospitals and beds our community needs and deserves.”

HSU Secretary, Gerard Hayes AM said, “I commend the response of the Minns Labor Government to this inquiry, it recognises the expertise of allied health and paramedics with the need to support these clinicians to work toward their full scope of practice. The Government is also supporting the need to replace outdated awards to recognise the critical role our members play in a modern health system.

“Better data, stronger workforce planning and transparency measures are essential if NSW is going to address staff vacancies, tackle maldistribution and build a more sustainable workforce.

“A health system that prioritises prevention, integration and the wellbeing of its own staff will not only be fairer, it is the only way to keep people well and stop pressure overwhelming the system.

“The Health Services Union looks forward to continuing to work with the NSW Government in the new year on the implementation of the recommendations within this Report”