A PROPOSAL for doctors to be involved only in clinical practice and standards in local hospital networks as part of the federal government’s health reforms has infuriated the AMA.

The discussion paper ― Lead clinicians groups: enhancing clinical engagement in Australia’s health system ― proposes that lead clinicians groups will focus on providing the “right care, at the right time, in the right location, by the right provider”. (1)

It says the priority of clinicians groups should be to “promote evidence based clinical practices and standards, safety and quality improvements, and more effective (and efficient) care processes”.

AMA president Dr Andrew Pesce (pictured above) says the discussion paper is contrary to the intended clinician role in the National Health and Hospitals Network (NHHN) reforms announced by former Prime Minister Kevin Rudd in May last year.

Mr Rudd had told the AMA’s national conference that clinicians would guide local hospital networks in “service planning and the most efficient allocation of clinical services”.

Dr Pesce said that, in its response to the discussion paper, the AMA would advocate that the proposed New South Wales model to the NHHN reforms be adopted federally.

NSW plans to establish hospital clinical councils that will allow clinicians to be involved in management decisions impacting on public hospitals.

The councils will provide leadership and advice on health service performance, quality and safety programs, models of care and clinical standards, budget management and planning.

Dr Pesce said the AMA had made it clear to the federal government and the Department of Health that doctors must be involved in decisions made at the local hospital level about resource allocation, service planning and provision, and patient care.

“We need to have transparent and accountable processes for doctors to have a say on how their hospitals are run,” he said.

“Specifically, doctors should be involved in decision making about funding for infrastructure, staffing and training with their hospital to ensure it is allocated efficiently and equitably.

“But the discussion paper falls well short of proposing a mechanism for ensuring that doctors have a meaningful say in how health care is delivered in their local community.”

Dr Pesce told MJA InSight that the AMA was looking for positive ways to ensure that lead clinician groups had more input into hospital and health service management.

He said the NSW model provided a good template for how clinician groups could work.

However, he said the discussion paper seemed to indicate continuing tensions between the federal government and the states over how the hospital reforms would work.

– Kath Ryan

1. Lead clinicians groups: enhancing clinical engagement in Australia’s health system. Department of Health and Ageing.


Posted 31 January 2011