AGY-2709 | Hunter Area Health Service

Full description

The Pre 1986 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 New South Wales 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. In 1986, the Department of Health decided to create Metropolitan Area Health Services. The creation of Area Health Services effectively abolished the individual boards of hospitals located in the newly created Area Health Services and replaced them with an individual Area Health Service Board. (7)

Area Health Services
The Area Health Services were established as statutory bodies under the Area Health Services Act 1986 (Act No.50, 1986). The act was assented to 14 May 1986, and was proclaimed to commence on 1 July 1986. (8)

In 1988, the initial 23 Area Health Services created under the Act were amalgamated into ten. The rationalisation was caused by a need to promote a greater degree of autonomy and authority to the local administration. (9) The amalgamations were proclaimed in the NSW Government Gazette to commence on 1 August 1988, under s. 9 of the Area Health Services Act 1986 (Act No. 50, 1986). This section allowed for the amalgamation, renaming or dissolving of an Area Health Service. As a result of the amalgamations the Greater Newcastle Area Health Service, the Lower Hunter Area Health Service, the Northumberland Area Health Service, and the Upper Hunter Area Health Service were combined to form the Hunter Area Health Service. (10)

The area of Hunter Area Health Service comprised the following local government areas: Merriwa, Murrurundi, Scone, Dungog, Port Stephens, Muswellbrook, and Singleton Shires; Lake Macquarie, Cessnock, Newcastle and Maitland Cities. (11)

Hospitals in the each Area Health Service were classed either as A Hospitals and Nursing Homes, funded and administered by the Area Health Services or B Hospitals and Nursing Homes funded by Area Health Services but administered by religious and other organisations. Area Health Services also administered a variety of centres related to health including: Community Health, Early Childhood, Day and Living Skills Centres, Dental Clinics, Rehabilitation workshops and Mental Health 24 hr Crisis teams. (12)

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

(A) Hospitals

Belmont, Cessnock District, Dungog and District, James Fletcher, Psychiatric, John Hunter, Kurri Kurri District, Maitland, Merriwa District, Muswellbrook District (including Denman), Nelson Bay Polyclinic, Rankin Park, Royal Newcastle, Scott Memorial, Scone, Singleton District, and Wilson Memorial, Murrurundi.

(B) Hospitals

Newcastle Mater Misericordiae. (13)

The Hunter Area Health Service was governed by an Area Health Services Board as established by s. 12 of the Area Health Services Act. S. 15 of the Act specified that the Board was to consist of a Chief Executive Officer and 8 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. 20 (1) of the Act were:
(a) To promote, maintain and protect public health for residents in the area
(b) To manage the health services in the area
(c) To consult and co-operate with individuals with organizations and individuals involved in promoting health care
(d) To investigate and assess health care needs of residents
(e) To plan and develop Health Services accordingly
(f) To set aims and objectives
(g) To provide training and education of health services personnel
(h) To give residents outside health services area access to services, if need be
(i) To make publications about public heath issues available.

The Health Services Act 1997 (Act No.154, 1997) consolidated the administration of Health Institutions into one piece of legislation. In order to achieve this consolidation of legislation many acts including the Public Hospitals Act 1929 (Act No.8, 1929) and the Area Health Services Act 1986 (Act No.50, 1986) were repealed. The function and scope of the Hunter Area Health Service were not altered dramatically, or the structure of the Hunter Area Health Services Board. The Health Services Act came into effect on 1 July 1998. (14) Health Institutions governed by Area Health Services were now defined under Schedule 1 of the Health Services Act.

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. (15) 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.” (16)

In July 2004, the New South Wales 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. (17)

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 (18), effective 1 January 2005. (19) 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 (20), effective 8 April 2005. (21)

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. (22)

In preparation for the amalgamations, the Health Services Amendment (Description of Areas) Order 2004 made under s. 19 (1) (c) of the Health Services Act 1997 was published in the NSW Government Gazette on 28 July 2004. In the Order Schedule 1 of the Health Services Act 1997 was replaced with a new Schedule 1 containing the names of Area Health Services and descriptions of the constituent cities or local government areas. In the new Schedule, the Gloucester, Great Lakes, and Greater Taree Local Government Areas had been transferred from the Mid North Coast Area Health Service to the Hunter Area Health Service. (23)

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 Hunter Area Health Service and the New England Area Health Service abolished both areas, and resulted in the creation of the Hunter-New England Area Health Service. (24)

Endnotes
(1) NSW Government Directory 1999, p.189.
(2) Report of the Hospitals Commission of New South Wales for the Year ended 30 June 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 year ended 30 June 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 subsection 1 (a)1 and 11; s. 2 (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) 'History of the Health Department' in NSW Department of Health, Annual Report, 1999-2000, p.15.
(8) NSW Government Gazette, 27 June 1986, p. 2946.
(9) NSW Department of Health, Annual Report, 1999-2000, p.15.
(10) NSW Government Gazette, 29 July 1988, p.3999 .
(11) Ibid., p.4000.
(12) Department of Health, Annual Report, 1992-1993, Appendix 2, Profiles of Area Health Services and Country Health Regions, p.67.
(13) Ibid., pp. 67-68.
(14) NSW Department of Health, Annual Report, 1999-2000, p.15.
(15) NSW Department of Health, Annual Report, 2002-2003, p.ii.
(16) 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).
(17) 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).
(18) 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
(19) NSW Government Gazette, 17 December 2004, p.9306.
(20) Health Services Amendment Act 2004, Schedule 1 [2] - Substituting s. 26 of the Principal Act.
(21) NSW Government Gazette, 8 April 2005, p.1241.
(22) 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.
(23) Health Services Act 1997, Schedule 1; NSW Government Gazette, Special Supplement, 28 July 2004, pp.6092-6099.
(24) NSW Government Gazette, 22 October 2004, pp.8129-8137.