Health Care (Governance) Amendment Bill

July 4, 2018

Second Reading 

 

The Hon. J.A. DARLEY (18:05): The bill before us will re-establish governing boards for each local health network which will be responsible for the—

 

The PRESIDENT: Excuse me, Hon. Mr Darley. To the gentleman up there, it is not a viewing platform. Please continue, Hon. Mr Darley, and my apologies.

 

The Hon. J.A. DARLEY: I better start again. The bill before us will re-establish governing boards for each local health network, which will be responsible for the operations, budgets and resources within the local health network. This was a model which SA Health had prior to 2008 before local boards were abolished by the previous government in favour of a more centralised model of healthcare administration. I understand one of the major criticisms of the previous boards was that they were essentially toothless tigers that were hamstrung by budgetary and administrative constraints. That is to say that the boards were often seen to be the scapegoat of the government.

 

If a problem arose, it was very easy for the government to simply shrug their shoulders and place responsibility on the boards, notwithstanding the fact that boards did not have much power. Budgetary constraints, in particular, are a concern for me because I do not believe it is useful to have a board which is hamstrung to provide services or upgrade equipment if they do not have the ability to put forward a budget proposal and discuss the needs within their local health network. I have raised these issues with the minister, who has advised that it will be a two-way dialogue and that boards will be included in the budget setting procedure and have the ability to apply for additional funding on an as-needs basis.

 

The opposition has filed a number of amendments to the bill, with several relating to the composition of the board. In particular, I understand amendments have been filed to stipulate that boards should include a representative voted for by employees of the incorporated hospital, as well as requirements indicating that there must be at least one medical practitioner and one non-medical practitioner on the board. I am supportive of some of these measures; however, I believe that one of the issues with the previous boards was that they were essentially representative boards, which caused issues as they often acted in competition with the hierarchy in SA Health over matters such as staffing and workplace conditions.

 

I believe that if we replicate what was there prior to 2008 the same issues will arise. In briefing me on the amendments, the minister has indicated that the goal is to have a skills-based board to ensure a calibre of people who have the skills required to undertake the business required; that is, the focus of the board should be on running the business of the local health network rather than representing one particular subset of employee or consumer. However, it is important that there is engagement with the clinicians, employees and consumers with the board, and I understand this will be achieved through the requirement for each board to have a clinician engagement strategy and a consumer and community engagement strategy.

 

These will be developed in conjunction with the stakeholders and will be available publicly. The bill outlines that the minister also appoint an adviser to the board to assist with improving the board's performance, and may appoint an administrator if members of the board are dismissed. The bill also introduces inspectors who can be appointed by the minister to investigate the administration, operations, and governance of incorporated hospitals. The opposition has filed amendments to dramatically change the function of inspectors so that there is an inspector for each local health network who must undertake inspections at least once every two months. The minister has indicated that this amendment is outside the scope of the bill. That is to say that the bill currently before us is specifically regarding boards and, more precisely, their composition and eligibility.

 

The minister has advised that these amendments regarding inspectors and other amendments filed by the opposition, such as reporting requirements for the board, do not relate to this bill and, as such, should not be considered now. The minister has also advised that he is happy to discuss these matters further and hopes to address them as part of the second healthcare bill. I will take the minister on his word on these matters. I believe he is acting with integrity and want to give him the opportunity to achieve his objectives.

 

Finally, I understand it is intended that the boards will be responsible for all public health services within their local health network and not just for the hospital. By having this approach, it will allow local health networks to have a more holistic approach to health care, including incorporation of preventative healthcare measures, which I am supportive of. Whilst I have clarified this with the minister's office, I would be grateful if the minister could also clarify this point on the record. I support the bill.

Debate adjourned on motion of Hon. R.P. Wortley.


 

 

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