Health reform focusses on building a better health system driven by accountability through measurement of outcomes and performance, investment in new models of care, building capability to lead the system into the future, providing services across a continuum of care settings, and using new technologies to promote innovation.
A history of reform
In 2011, the NSW Government implemented major reforms across the NSW Health system at the state and local level focussing on:
- building a health system that is patient focussed
- adoption of the CORE values of Collaboration, Openness, Respect and Empowerment
- increasing the emphasis on health prevention to avoid unnecessary hospitalisations
- implementing a devolved governance structure where decisions are made as close to the patient as possible and
- reliance on strong evidence based policy, and a commitment to greater transparency and public accountability.
As part of the overall organisational reforms in the NSW Health system, the NSW Health Services Amendment (Local Health District and Boards) Act 2011 restored local decision making to introduce a more efficient management structure.
The new organisational model delivered greater local decision making joined with a strong accountability framework. Local health districts received increased resources and responsibility, and were empowered to determine how they deliver services to meet local needs and meet their responsibilities under new service agreements with the Ministry of Health.
A new streamlined NSW Ministry of Health replaced a centralised Department with a focus on policy, and devolved major functions to local health districts and to five health pillars:
In 2012, the Mental Health Commission Act 2012 established the NSW Mental Health Commission, which provided a new champion for mental health patients to deliver a more accountable mental health system.
Further reforms have strengthened health prevention capacity and services to keep people healthy and out of hospital through new funding, the establishment of the Office of Preventive Health, the NSW Tobacco Strategy 2012-17, and amendments to the Smoke-free Environment Act 2000 to provide for the regulation of smoking in certain outdoor public places.
A major strategic review of medical research in NSW resulted in the establishment of the Office of Health and Medical Research, commencement of a 10 year NSW Health Medical Research Strategic Plan, and provided significant resources to enhance quality health and medical research which will lead to better patient treatment and outcomes.
Improved accountability and performance have also been delivered through the NSW Health Purchasing and Performance Frameworks, new approaches to Service Agreements with LHDs, and new patient activity, access and treatment targets. A new State Funding Framework introduced on 1 July 2012 provides a clearer more transparent basis for funding public hospitals and comparing their technical efficiency. We also provided funding for enhanced ICT systems to address the data and reporting tasks associated with the new funding reforms, activity based funding, and monitoring of performance.
Transparency in public hospital performance has been delivered through the Bureau of Health Information, providing improved access to information about hospital performance across NSW. We also actively participate in the MyHospitals website and other national performance reporting frameworks.
In 2014 the Cancer Institute NSW, which had previously been established under the Cancer Institute (NSW) Act 2003 to lessen the impact of cancer across the State, also became a pillar organisation.
In 2015, NSW Kids and Families became the Office of Kids and Families, reporting through the Strategy and Resources Division of the Ministry of Health. The functions of the Office of Kids and Families were then aligned under two new units established within the Health and Social Policy Branch as of 1 September 2016.