Organisation

AGY-2730 | Far West Health Service (1996-1998) Far West Area Health Service (1998-2005)

NSW State Archives Collection
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Full description

The Pre 1986 Metropolitan and Rural Health System
In 1929 the control and supervision of public hospitals by the Hospitals Commission, was established by s. 11 and 12 of the Public Hospitals Act 1929 (Act No.8, 1929). The Public Hospitals Act also defined Hospitals as either Second Schedule, or Third Schedule. Second Schedule Hospitals were public, incorporated, and governed by their own boards. Third Schedule Hospitals were administered by charitable institutions or religious bodies that appointed their own governing bodies, and received extensive subsidies from the NSW Government. (1)

In the late 1960s and early 1970s the Hospitals Commission created rural and metropolitan hospital regions, in order to promote better information flow between the Hospitals and the Commission. (2)

In 1970, the Public Hospitals Act 1929 (Act No.8, 1929) was amended to include Fourth Schedule Associated Organisations, such as the Red Cross. (3) In April 1973 the Hospitals Commission and the Board of Health were dissolved, and the Department of Public Health abolished by the Health Commission Act 1972 (Act No.63, 1972). (4) This Act also established the Health Commission, (5) and added a Fifth Schedule to the Public Hospitals Act. (6) Fifth Schedule Hospitals were largely psychiatric hospitals. The Health Commission also established Health Regions (or Regional Offices) which effectively combined the functions of the former Health Districts and the former Hospital Regions. The Health Districts of the Department of Health had been responsible for functions such as the control of infectious diseases. (7) In 1986 the Department of Health decided to create Metropolitan Area Health Services to replace the individual hospital boards in the newly created areas. (8)

Rural Area Health Services
In 1993, a restructure of the health system resulted in the replacement of six Health Regions (or Regional Offices), and the boards of 137 Hospitals, with 23 District Health Services. (9) The creation of the District Health Services was formalised by the amalgamation of incorporated hospitals under s. 13A (2) of the Public Hospitals Act 1929 (as amended). This section allowed for the amalgamation of two or more incorporated hospitals upon the recommendation of the Minister to the Governor. The amalgamations were proclaimed in the NSW Government Gazette to commence on 1 July 1993, under s. 13A (2) of the Public Hospitals Act 1929. The order also amended the Second Schedule of the Public Hospitals Act, which listed the incorporated hospitals. (10)

In 1996, the District Health Services were amalgamated to form eight rural Health Services. These amalgamations were caused by the need to allow for better population planning and to increase the status of rural health administration. (11) The amalgamations were conducted under s. 13A (2) of the Public Hospitals Act 1929 (as amended), and were proclaimed in the NSW Government Gazette to commence on 16 March 1996. (12) The appointment of Chief Executive Officers to a majority of the newly created regions was proclaimed in the NSW Government Gazette on 1 July 1996. On 1 July 1996, Directors were also appointed to the Health Service Boards which governed the Health Services under s. 22 of the Public Hospitals Act 1929 (Act No.8, 1929). (13) In the interim between the creation of the Rural Health Services and appointment of the Chief Executive Officers and Health Service Boards an administrator had been appointed to each region to oversee the transition. (14)

As a result of the amalgamations in 1996 the Far West District Health Service, The Orana District Health Service (15) and the Shires of Wentworth and Balranald in the Murray District Health Service were combined to form the Far West Health Service. (16)

The Area of Far West Health Service comprised the following local government areas: City of Broken Hill; Shires of Balranald, Brewarrina, Bourke, Central Darling, Wentworth, Walgett, and the unincorporated area. (17)

Key Hospitals and health services in the Far West area were as follows:

Hospitals
Balranald District, Bourke District, Brewarrina District, Broken Hill Base, Collarenebri District, Goodooga District, Ivanhoe District, Tibooburra District, Walgett District, and Wilcannia Multi - Purpose Centre.

Other Public Health Facilities
Lighting Ridge Emergency and Community Health Centre, Menindee Nursing Service and White Cliffs Nursing Service. (18)

The passing of the Health Services Act 1997 (Act No.154, 1997) increased the status of all the Rural Health Services by renaming them Area Health Services. The rural Area Health Services were then granted the same obligations and powers granted to the Metropolitan Area Health Services, which were defined as statutory corporations. Health Institutions governed by metropolitan and rural Area Health Services were now defined under Schedule 1 of the Health Services Act. The Health Services Act came into effect on 1 July 1998. (19)

Functions of Board
The Far West Health Service was initially governed by a Health Services Board under s.22 of the Public Hospitals Act 1929 (Act No.8, 1929). Upon the Proclamation of the Health Services Act 1997 (Act No.154, 1997) the Far West Area Health Service Board was established by s. 23 of that Act. S. 26 of the Act specified that the Board was to consist of the Chief Executive Officer of the Area Health Service, and eight to 11 persons appointed by the Minister. The Board was responsible for managing health care facilities in the area.

The main functions of Area Health Services under s. 10 of the Health Services Act were to: promote, maintain and protect public health for residents in the area; manage the Public Hospitals, health institutions, health services and health support services in the area; to give residents outside health services area access to services, if need be; to achieve and maintain adequate standards of patient care and services; to ensure the efficient and economic operation of its health services and resources; to consult and co-operate with individuals with organizations and individuals involved in promoting health care; to investigate and assess health care needs of residents and plan and develop health services accordingly; to establish and maintain an appropriate balance in the provision and use of resources for health protection, health promotion, health education, and treatment services; to provide services to persons whom it has contracted or entered into an agreement under section 37(2); to administer funding for recognised establishments and services of affiliated health organisations where that funding has been delegated to it by the Minister under section 129; to provide training and education of health services personnel; to undertake research and development relevant to the provisions of health services; to make publications about public heath issues available.

In 2003, the Independent Pricing and Regulation Tribunal (IPART) conducted a review of the New South Wales health administration, on the request of the NSW Health Department. (20) The review recommended “streamlining the administration structure and more clearly delineating roles and responsibilities between the Area Health Services and the Department of Health”, and “improvements in accountability in the health system and increased community and clinician involvement in health service decision making.” (21)

In July 2004, the NSW Health Minister responded to the recommendation of the IPART review by announcing a restructure of the New South Wales public health administration. The main elements of the restructure involved a reduction of the number of the rural and metropolitan Area Health Services from 17 to 8. The purpose of the restructure was to create a more streamlined administrative structure that would unlock resources which were to be directed to frontline clinical services. (22)

The other key elements of the restructure of the public health administration which affected the Area Health Services were enacted in the Health Services (Amendment) Act 2004 (Act No.92, 2004). The Act replaced the Area Health Services Boards with Chief Executive Officers, (23) effective 1 January 2005. (24) The Act also established the Area Health Advisory Councils in order to provide clinicians, health consumers and local communities with a greater input into the planning and delivery of health care, (25) effective 8 April 2005. (26)

On 28 July 2004, the Area Health Service Boards were dissolved, and administrators appointed until 31 December 2004, in order to oversee the transition to the new administrative structure. (27)

The amalgamations of the Area Health Services were proclaimed to commence on 1 January 2005, in the NSW Government Gazette, under section 20 of the Health Services Act 1997 (Act No.154, 1997). This section allowed for the amalgamation, renaming or dissolving of an Area Health Service. The amalgamation of the Far West Area Health Service, the Macquarie Area Health Service, and the Mid Western Area Health Service abolished all these areas, and resulted in the creation of the Greater Western Area Health Service. (28)

Endnotes
(1) NSW Government Directory, 1999, p.189.
(2) Report of the Hospitals Commission of New South Wales for 1968, pp.6-7 in NSW Parliamentary Papers, 1968-1969, Vol. 3, pp.516-517; Report of the Health Commission of New South Wales for 1973, p.8 in NSW Parliamentary Papers, 1973-1974, Vol. 2, p.70.
(3) Public Hospitals (Amendment) Act 1970 (Act No.73, 1970) s. 2 (1) (a) (i) and (ii), s. 2 (1) (j) – Amending s 1 (2) (Division of Act) of the Principal Act.; A new Fourth Schedule of the Principal Act
(4) Health Commission Act 1972 s. 16 (2).
(5) Ibid. s. 4 (1).
(6) Ibid. Schedule, Amendment of Acts – Amending s. 1 (2) (Division of Act) of the Public Hospitals Act 1929 (Act No.8, 1929); a new Fifth Schedule of the Principal Act.
(7) Report of the Health Commission of New South Wales for 1973, p.8 in NSW Parliamentary Papers, 1973-1974, Vol. 2, p.70; Report of the Health Commission of New South Wales for 1974, pp.67-107 in NSW Parliamentary Papers, 1974-1975, Vol. 3, pp.653-693; Report of the Director-General of Public Health for 1967, pp.128-129 in NSW Parliamentary Papers, 1968-1969, Vol. 4, pp.256-257.
(8) ‘History of the Health Department ‘in NSW Department of Health, Annual Report, 1999-2000, p.15.
(9) NSW Department of Health, Annual Report, 1993-1994, p.10.
(10) NSW Government Gazette, 14 May 1993, p.2266; NSW Government Gazette, 25 June 1993, pp.3123-3130.
(11) NSW Department of Health, Annual Report, 1995-1996, p.8.
(12) NSW Government Gazette, 15 March 1996, pp.1110-1114.
(13) NSW Government Gazette, 1 July 1996, pp.3805-3813.
(14) Midwestern Health Service, Annual Report 1996, p.11 - see also Administrators/General Managers report in other Health Service Annual Reports for 1996.
(15) NSW Government Gazette, 15 March 1996, op.cit, p.1110.
(16) Far West Health Service, Annual Report, 1995/1996, p.6.
(17) NSW Department of Health, Annual Report, 1996-1997 Appendix 2, Profiles of Area and Rural Health Services, p.88.
(18) loc. cit.
(19) NSW Department of Health, Annual Report, 1999-2000, op.cit, p.15.
(20) NSW Department of Health, Annual Report, 2002-2003, p.ii.
(21) NSW Department of Health Website, http://www.health.nsw.gov.au/pubs/2004/pdf/pbh_booklet.pdf, Planning Better Health - Background Information, 1 July 2004, p.5 (cited 9 January 2008)
(22) NSW Department of Health Website, http://www.health.nsw.gov.au/news/2004/20040727_00.html, NSW Minister for Health, Media Release, Planning Better Health - Minister announces reform of NSW Health System, 27 July 2004 (cited 9 January 2008).
(23) Health Services Amendment Act 2004, Schedule 1 [30] – Amending Schedule 7 of the Principal Act; Schedule 1 [2] – Substituting s.23 – 25 of the Principal Act.
(24) NSW Government Gazette, 17 December 2004, p.9306.
(25) Health Services Amendment Act 2004, Schedule 1 [2] - Substituting s. 26 of the Principal Act.
(26) NSW Government Gazette, 8 April 2005, p.1241.
(27) Order under section 29, Health Services Act 1997 in NSW Government Gazette, Special Supplement, 28 July 2004, pp.6107-6108; Planning Better Health, op.cit, p.5.
(28) NSW Government Gazette, 22 October 2004, pp.8129-8137.

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