Government Update – from Board Chair, Julianne Clift

There has been recent media coverage regarding a couple of sector wide issues – both matters have been reported either together or at around the same time which may be confusing but both deserve further detail.

Both matters represent change in the health sector both in terms of funding and structure. EWHS is always prepared for our organisation and our sector to continuously evolve and change in order to best serve our communities and we are entering a period of more rapid change than usual.

The first matter is finances in public health. Around one third of government money in Victoria goes into health. Demand for funding in health keeps growing but if the State Government keeps putting more money into health, it comes at the expense of other needs like education or roads.

EWHS is only small compared to the rest of the sector but like all Victorian Health Services, we have been asked to do our part in controlling healthcare expenditure. All Victorian Health Services have been asked to submit a financial improvement plan to demonstrate that we’re trying to control costs and over the next three years seek to reduce our costs by around 5%.

We are constantly seeking to contain costs so this request is in line with what we do already as an organisation. For example, at the moment we are working hard to reduce the cost of agency Nursing staff.

EWHS is not submitting a plan that involves the loss of any jobs.

The second and more significant matter involves the development of a Health Services Plan. We can provide the following summary that has been provided to us.

Background

• Victoria has a world-class public health system – but we know people have different access to and experiences of care, depending on where they live, particularly those in rural and regional areas.
• The structure of the Victorian health services system has been largely unchanged for decades, despite changing population needs and new innovations.
• Now is the time to build on the successes of the past to continue developing a modern, safe, and sustainable health, wellbeing and care system.
• With this in mind, the Department of Health has established a process to develop a draft Health Services Plan to consider the optimal design and governance of the public health services system – looking at how public health services can better work together to deliver improved care for all Victorians.
• An external Expert Advisory Committee (EAC) is leading the development of a Health Services Plan in collaboration with the health sector, and with the support of the Department of Health. The Committee is independent from government.

Consultation

• The EAC have recently finished their presentation of options to structure the Victorian system.
• Based on feedback and ideas from previous consultations sessions, the Committee presented their two concepts:

o Option A: Strengthened partnerships -This would see formal relationships established between a Local Health Service Network and a major tertiary hospital to achieve stronger collaboration and connections. It would mean services could have greater access to specialist expertise, teaching, training, education and research.

o Option B: Health service consolidations – This is about creating more formal Local Health Service Networks for each geography to ensure all care needs, from a broken arm to complex trauma are met for their population, and delivered as close to home as possible. The networks would be established based on a range of factors including natural patient flows, geography and transport networks, and population and community characteristics.

• The Committee has sought feedback on both these options and no decisions have been made at this point. EWHS identified a strong preference for Option A.

• They are working hard to ensure the views and ideas from every health service are heard, and that what we’ve told them is reflected through the consultation process and final report. EWHS has provided a range of views at various points in the process although we’ve not received specific confirmation about how those views are being used.

• They are also taking advice from other jurisdictions as well as other national and international health system experts.

• Some of the main issues raised with the EAC include inequities in patient experience and difficulties accessing care, workforce attraction and retention, and resourcing inefficiencies. EWHS has fed back that the committee is taking a very hospital centric view of inequity and access where for example EWHS would look at these issues in relation to local primary care. EWHS is keen to see system improvements that reduce inequity but not just structural changes.

Next steps

• We recognise that some of the possible solutions being discussed may be daunting but it’s important every option is explored to ensure we’re delivering exactly what Victorians need and want from our health system.
• Innovation and reform start with these kinds of conversations – and we can only achieve this kind of whole of system improvement by sharing ideas and working together.
• We know there has been much speculation and media coverage recently and we recognise this uncertainty can be distressing for staff and community members
• We have been assured by the Minister that no decisions have been made at this point, and they won’t be until Government has considered the EAC’s final report, which is due at the end of April.
• Importantly, the Minister has made it clear that there will be no individual hospital or site closures, which I know will be a relief for staff and community.
• EWHS will still be here for our communities and will play an important role in the future of Victoria’s health system.
• Government have assured us the EACs final report will be received with an open mind, and with the shared goal of improving equity and access to health care for all Victorians.

Q&As – Health Services Plan

What is the process for the Plan’s consideration by government?

• The Committee will provide the plan to the Department of Health for consideration in April 2024.
• The Department will provide recommendations to the Victorian Government and will keep the sector informed of progress and any government decisions about the Plan.

Is this all about financial savings?

• The purpose of the draft Health Services Plan is not to cut costs across the health service system – it is to improve equity and access for Victorians, ensuring they get the right care, in the right place, at the right time.
• This may include consideration of how current resources can be better invested in patient care.
• While the Plan may indicate that changes will result in cost benefits, that is not its objective and the Committee were not asked to inquire into financial sustainability in its Terms of Reference.

Will implementation of the Plan result in job losses?

• The Committee’s draft Plan will not include any specific proposals that directly impact on workers’ roles, place of work or terms and conditions. Local hospital and site closures remain out of scope.

Will implementation of the Plan result in site closures?

• The Committee’s draft Plan will not include any specific proposals recommending local hospital or site closures and will seek to maintain or enhance community access to safe, high-quality services.

This is the information we have at the moment and we will continue to provide any updates that become available.

Julianne Clift

Board Chair