Full description
BackgroundMetropolitan Area Health Services had initially been established as statutory bodies under the Area Health Services Act 1986 (Act No. 50, 1986), which was proclaimed to commence on 1 July 1986. (1) The rural Health Services that had been created in 1996 (2) became rural Area Health Services under the Health Services Act 1997 (Act No.154, 1997). The Act also consolidated the administration of health institutions by repealing many acts including the Area Health Services Act 1986 (Act No.50, 1986), and the Public Hospitals Act 1929 (Act No.8, 1929). The function and scope of the Area Health Services were not altered dramatically by the new legislation, or the structure of the Area Health Service Boards which administered the Area Health Services. The Health Services Act 1997 (Act No.154, 1997) came into effect on 1 July 1998. (3) Health institutions governed by metropolitan and rural Area Health Services were now defined under Schedule 1 of the 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. (4) 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.” (5)
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. (6)
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. (7)
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 containing the names of Area Health Services and descriptions of the constituent cities or local government areas. In the new Schedule, the Lithgow Local Government Area had been transferred from the Midwestern Area Health Service to the Wentworth Area Health Services. (8)
Area Health Services
The amalgamations of the Area Health Services were proclaimed in the NSW Government Gazette to commence on 1 January 2005, 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. As a result of the amalgamations the Western Sydney Area Health Service, and the Wentworth Area Health Service were combined to form the Sydney West Area Health Service. (9)
The Area of the Sydney West Area Health Service comprised the following Local Government Areas: Auburn, Baulkham Hills, Blacktown, Blue Mountains, Hawkesbury, Holroyd, Lithgow, Parramatta, and Penrith. (10)
Key Hospitals in the Sydney West area were as follows:
Auburn, Blacktown, Blue Mountains District Anzac Memorial, Cumberland, Lottie Stewart, Mt Druitt, Nepean, Springwood, St Joseph’s Hospital, Auburn, Tresillian, Wentworth, and Westmead. (11)
The main functions of the Area Health Services under s.10 of the Health Services Act 1997 were:
(a) to promote, maintain and protect the health of the residents of its area,
(b) to conduct and manage the public hospitals, health institutions, health services, and health support services in its area,
(c) to give residents outside health services area access to services, if need be,
(d) to achieve and maintain adequate standards of patient care and services,
(e) to ensure the efficient and economic operation of its health services and health support services and use of its resources,
(f) to consult and co-operate with organisations and individuals involved in promoting health care,
(g) to investigate and assess health care of its residents,
(h) plan and develop health services accordingly,
(i) to establish and maintain an appropriate balance in the provision and use of resources for health protection, health promotion, health education and treatment services,
(j) to provide services to persons with whom it has contracted or entered into an agreement under section 37(2)
(k) to administer funding for recognised establishments and recognised services of affiliated health organisations where that function has been delegated to it by the Minister under section 129,
(l) to provide training and education relevant to the provision of health services,
(m) to undertake research and development relevant to the provision of health services,
(n) to make publications about public health issues available,
(o) to carry out such other functions as are conferred or imposed on it by or under this or any other Act or as may be prescribed by the regulations.
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 was proclaimed to commence on 1 January 2005, (12) except for the part of Schedule 1 (2) that concerned the establishment of the Area Health Advisory Councils, which was proclaimed to commence on 8 April 2005. (13) The Act abolished the Area Health Services Boards, which had previously administered the Area Health Services, (14) and replaced them with a Chief Executive Officer. (15) Associate Professor Steven Boyages was appointed Chief Executive Officer of the Sydney West Area Health Service effective 1 January 2005. (16)
The Health Services Amendment Act 2004 (Act No.92, 2004) also established Area Health Advisory Councils which were to comprise 9 to 13 members, one of whom was to be appointed Chairperson. (17) Chairpersons were appointed to the Area Health Advisory Councils in April 2005. (18) The remaining members of the Sydney West Area Health Advisory Council were appointed in November 2005. (19)
The main function of the Area Health Advisory Councils under s.28 of the Health Services Act 1997 (as amended) were: to seek the views of, and to advise providers and consumers of health services and other members of the local community of, the area health service’s policies, plans and initiatives for the provision of health services, and to advise the Chief Executive of the area health service of those views; to confer with the Chief Executive of the area health service in connection with the operational performance targets set by any performance agreements to which the Area Health Service is a party under section 126; to advise the Chief Executive on how best to support, encourage, and facilitate community, consumer and health service provider involvement in the planning, of health services by the area health service; and, to liaise with other Area Health Advisory Councils regarding the provision of health services. (20)
Sydney West Area Health Service was abolished on 1 January 2011 by the Health Services Amendment (Local Health Networks) Act 2010 (Act No.97, 2010) when it was replaced by the Western Sydney Local Health Network and the Nepean Blue Mountains Local Health Network. (21)
Endnotes
(1) NSW Government Gazette, 27 June 1986, p.2946.
(2) NSW Department of Health, Annual Report, 1995/1996, p.8.
(3) NSW Department of Health, Annual Report, 1999/2000, p.15.
(4) NSW Department of Health, Annual Report, 2002/2003, p.ii.
(5) 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).
(6) 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).
(7) 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.
(8) Health Services Act 1997, Schedule 1; NSW Government Gazette, Special Supplement, 28 July 2004, pp.6092-6099.
(9) NSW Government Gazette, 22 October 2004, pp.8129-8137.
(10) Ibid., p.8137.
(11) NSW Department of Health, Annual Report, 2004/2005, p.207.
(12) NSW Government Gazette, 17 December 2004, p.9306.
(13) NSW Government Gazette, 8 April 2005, p.1241.
(14) Health Services Amendment Act 2004, Schedule 1 [30] - Amending Schedule 7 of the Principal Act.
(15) Ibid. Schedule 1 [2] - Substituting s.23-25 of the Principal Act.
(16) NSW Department of Health website, http://www.health.nsw.gov.au/news/2004/20041101_01.html NSW Health Minister, Media Release, Appointments of Chief Executives for new Area Health Services, 1 November 2004 (cited 14 January 2008).
(17) Health Services Amendment Act 2004, Schedule 1 [2] - Substituting s. 26 of the Principal Act.
(18) NSW Department of Health, Annual Report, 2004/2005, p.114.
(19) Sydney West Area Health Service, Annual Report, 2005/2006, p.110.
(20) Health Services Amendment Act 2004, Schedule 1 [2] - Substituting s. 28 of Principal Act.
(21) Health Services Amendment (Local Health Networks) Act 2010 (Act No.97, 2010) Schedule 1 amending the Principal Act, Health Services Act 1997 (Act No.154, 1997) Schedule 7, Part 7, cl.76; Commencement Proclamation (2010 No 716) notified NSW Legislation Website, 17 December 2010.
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