LOCAL hospitals are bracing themselves for an announcement, likely to come early in the New Year, of the biggest shake up to hospital management and operations in history.
The decision is set to prove crucial to the flow of public patients from South Gippsland and Bass Coast and for the local hospital workforce.
A feature of the announcement will be the establishment of new Local Health Service Networks across the state including Barwon South West, Grampians, Loddon Mallee, Hume and Gippsland.
The State Government is keen to follow the recommendations of the Expert Advisory Committee, contained in its ‘Health Services Plan’, formally released in August this year, but completed last April, where Bass Coast Health (BCH), Gippsland Southern Health Service (GSHS) and South Gippsland Hospital at Foster join a Gippsland network in which management and service is dominated by Latrobe Regional Hospital.
South Gippsland Hospital at Foster is believed to be supportive of the plan, joining a network which includes Bairnsdale Regional Health Service, Bass Coast Health, Central Gippsland Health Service, Gippsland Southern Health Service, Latrobe Regional Hospital (LRH), Omeo District Health, Orbost Regional Health, and Yarram & District Health Service.
Under that scenario, West Gippsland Hospital (Warragul) would be linked to Monash Health with hospitals at Dandenong and Clayton, and Koo Wee Rup Regional Health Service with the Peninsula Health group.
The sticking point is the proximity for patients of Bass Coast Health, with hospitals at Wonthaggi and Cowes, and Gippsland Southern Health Service, with hospitals at Korumburra and Leongatha, to major Melbourne metro hospitals including Dandenong Hospital, Monash Medical Centre and Frankston Hospital with whom these hospitals have established links.
The State Government’s Health Services Plan has already addressed this issue:
“The Gippsland Network is proposed to serve a population exceeding 250,000 people, which meets the threshold scale to meaningfully support population health outcomes. The geography of this proposed Network, spanning from Bass Coast Shire in the west to the large East Gippsland Shire, aligns well with that of the Gippsland PHN and the Gippsland Mental Health and Wellbeing Region. Latrobe Regional Hospital is proposed to be the provider of the most complex care in the Network, supporting the delivery of greater than 85% of care locally over time. We recognise that the western portion of the Network, notably Bass Coast Shire, has significant patient flow patterns to metropolitan Melbourne health services for higher capability care. However, many of the service delivery issues experienced in Bass Coast Shire have more in common with the challenges faced by other rural communities than with metropolitan areas. Accordingly, the Committee concluded on balance that Bass Coast Health is better grouped with the rest of Gippsland.”
The local hospitals have already been advised of the Health Department’s preferred model for a Gippsland-wide Local Health Service Network, including Bass Coast Health and Gippsland Southern, with the local health services given until Friday this week to propose a different scenario.
The time provided for their response may have been extended to Friday, December 6.
GSHS, it appears, favours a management relationship between itself, BCH, South Gippsland, Koo Wee Rup and Peninsula Health that still offers some of the benefits of existing links with LRH.
BCH at Wonthaggi, which has firm links with Peninsula Health, and is even more remote from Latrobe Regional, “proposed to be the provider of the most complex care in the network”, has not revealed its preference, possibly complicated by the appointment of a new CEO on Monday, December 2.
However, the whole basis of the State Government’s new model of health care, which aims to meet the care needs of the community as close to home as possible, while addressing a massive blowout in the cost-of-service delivery and significant workforce challenges, is viable, geographic networks which offer management, staff and service efficiencies.
At the annual meeting of the Gippsland Southern Health Service on Thursday, November 29, both the board chair Athina Georgiou and chief executive officer Louise Sparkes referred to the imminent announcement of the hospital reforms.
“We have been participating in the regional planning and are eagerly awaiting the government announcement,” said Ms Georgiou.
Ms Sparkes said the reforms had the potential to “bring enormous benefits for our health service”.
However, deputy board chair, Gwen Scheffer, revealed a preference for the blending of services in a tie-up between GSHS, Bass Coast Health, Koo Wee Rup and South Gippsland with Peninsula Health as the network's Group A Hospital, as offering the potential for great outcomes.
Asked after the meeting if Ms Sparkes was hopeful of achieving such an outcome, she simply referred the ‘Sentinel-Times’ to details in the Health Services Plan.
The Health Services Plan contains 27 recommendations, all of which have been accepted by the government, with the exception of Recommendation 7.1 which set out how “each consolidated Local Health Service Network is a single entity”, effectively the amalgamation of all hospitals in the network.
But, as revealed by Secretary, Department of Health, Professor Euan Wallace AM, at a Public Estimates and Accounts Committee inquiry on Friday, November 22, many of the provisions of Amendment 7.1 will come into effect including but not limited to:
- A single employer that can engage and deploy workforce across sites in accordance with community need
- Unified clinical governance and clinical service planning
- Unified financial management, corporate governance and back office
The option of developing a single, skills-based regional board and the appointment of a network chief executive officer is yet to be confirmed.
Clearly these arrangements will have an impact on staff but may be needed to address skills shortage and cost blowouts, revealed by the Opposition Health Spokesperson Georgie Crozier recently as in excess of $1 billion among the 68 health services which tabled their annual reports recently.
“Out of the 68 health service Annual Reports tabled today in the Victorian Parliament (November 14), 52 have recorded deficits for the 2023-24 financial year. In net terms across the 68 health services there is a deficit of $1.013 billion.
Health services recording deficits include:
- Monash Health $321,278,000
- Northern Health $115,791,000
- Western Health $104,509,000
- Eastern Health $100,043,000
- Austin Health $71,915,000
- Peninsula Health $59,122,000
- Albury Wodonga Health $52,419,000
- Grampians Health $46,870,000
Locally, Bass Coast Health reported an operating deficit of $3.233 million on a budget of almost $170 million, Gippsland Southern Health Service an operating deficit of $1.933 million and South Gippsland Hospital, a surplus “net operating balance” of $94,229 to the end of June 30, 2024, as compared to a $160,022 deficit last year.
Recommendations in the State Government’s Health Service Plan can be viewed HERE
Gippsland Southern statement
The Gippsland Southern Health Service issued the following statement after Thursday’s annual meeting:
Gippsland Southern Health Service (GSHS) has continued to improve access to care for the South Gippsland community during 2023-24.
The GSHS 2023-24 annual report released last night (November 28) shows the health service reached 98.11 per cent of its national funding model targets, a 6 per cent improvement on 2022-23 activity, with 3886 people accessing acute and urgent care services.
The health service also surpassed its satisfaction targets, with 98 per cent of patients reporting positive experiences in hospital.
However, like most health services in Victoria, GSHS finished the year with a financial deficit due to unbudgeted costs of agency and locum staff.
In the 2023-24 annual report, Board Chair Athina Georgiou and Chief Executive Officer Louise Sparkes said that GSHS worked successfully during the year to increase care provided locally and introduced new services such as Hospital in the Home, cancer survivorship and workplace models for the post-pandemic era.
Ms Georgiou and Ms Sparkes said a new medical workforce model was introduced during the year to ensure a consistent medical staff presence in the urgent care centre and wards at Leongatha for the community.
Other highlights of the year included:
- Operational efficiency improvements were developed and implemented to reduce waiting times in GSHS allied health clinics
- A financial management plan was developed by GSHS and approved by the Department of Health and implemented
- A Community Advisory Committee was established
- Clinical governance systems were revised and improved
- A new leadership program commenced to increase capability of leaders and to build an enterprise leadership culture
- Retaining accreditation across a number of services.
Ms Georgiou and Ms Sparkes said GSHS did not receive a financial sustainability payment in 2023-24 but had adopted a new level of financial discipline and accountability while ensuring the community has access to the care and services it needs.
Despite GSHS coming very close to meeting activity targets, unbudgeted costs of agency and locum staff led to an operating deficit of $1.9 million on a budget of more than $50 million.
Director of Finance Jason O’Reilly said staffing gap challenges requiring the extensive use of agency staff was the main reason for the operating deficit.
GSHS experienced a 3.74 per cent increase in income from operating activities compared to an increase in expenditure of 9.4 per cent.
Mr O’Reilly said the balance sheet remained in a strong position with $25m of current assets.
“The organisation has made enormous strides in increasing activity levels and with the uplifted unit price of the National Weighted Activity Unit (NWAU), is hopeful of being able to achieve similar activity levels in 2024-25 while reducing the reliance on agency staff, in order to achieve a break-even result,” he said in the report.
Ms Georgiou and Ms Sparkes said GSHS eagerly awaited the outcome of the government’s decision regarding reform and was ready to respond to the final plan.
“Reform will remain an ongoing feature of health both across the sector and for GSHS for the next few years at least and we look forward to an improved system as a result, for our community in the years ahead.”
