By health or by stealth?

MANSFIELD District Hospital (MDH) will be grouped under Hume in one of 12 Local Health Service Networks (LHSNs) to be established across Victoria under the state government’s Health Services Plan. Health Minister Mary-Anne Thomas confirmed groupings last Friday with planning to begin soon as health services come together to discuss priorities, arrangements and logistics, before new networks commence operation on July 1. “This (program) is about expanding access to frontline services, particularly in regional and rural Victoria,” Ms Thomas said. Each of the 12 networks will serve at least 200,000 people, with Hume covering 254,000 Victorians and 107,000 New South Wales residents, providing cross-border healthcare. Hume will be split into two sub-regions to address diverse community needs. Albury Wodonga Health will lead as the “tertiary” provider for complex care in the Ovens Murray sub-region, while Goulburn Valley Health will oversee the Goulburn Valley, with MDH under its jurisdiction. Alongside these, Hume includes Alpine Health, Beechworth Health Service, Benalla Health, Corryong Health, Euroa Health, Kyabram District Health Service, NCN Health, Northeast Health Wangaratta, Tallangatta Health, and Yarrawonga Health. According to the government, the grouping reflects established connections between health services, such as the Hume Health Service Partnership, and the proximity of providers with overlapping catchments. Encompassing 13 health services in total across the North East, “the design of the network supports collaboration and enables sufficient scale for capability, workforce and shared services". Mansfield Medical Clinic’s Dr Graham Slaney said any re-organisation will require extra funding initially for it to be effective. “The real question though is whether this is all just bureaucratic window dressing in creating the new networks or will there actually be increased spending to drive improvements in the government-recognised priority areas of access and flow, workforce, clinical governance, and sustainability," he said. “Cost savings may be found – if indeed there are any - in the longer term through these efficiencies,” he said emphasising the importance of getting it right from the outset. “This did not happen in the Grampians with that amalgamation and services have been reduced as a result in the outlying rural areas.” Shadow Minister for Health Georgie Crozier alongside the newly elected Leader of the Opposition Brad Battin are calling on more transparency from the state government as to how the networks will operate. The opposition is also requesting that hospitals, services and networks are provided with necessary funding beyond the end of the year. Without these assurances, concerns remain the plan will result in reduced services, job losses and force Victorians to travel further for essential care. Following community backlash, the government had previously ruled out forcibly merging the state’s independent government health services, however the opposition has touted the networks as amalgamation by stealth. “There is one very good thing in the latest announcement, and that is the plan to sack our hospital board and executive has been scrapped,” said Dr Will Twycross speaking as a representative of the local pushback. “The two thousand-strong rally we held here in Mansfield attracted national media attention and really shifted the dialogue on what was potentially a very destructive plan. “Reinforced by our petition that garnered over seven thousand signatures, it sent a clear message to the government.” Dr Twycross drew attention to the lack of detail and unclear budgets when it comes to delivering designated regions and networks under the Health Services Plan. “Administering them will inevitably increase the health sector bureaucracy, which seems a backward step,” he said. “Many hospitals sitting around one table will be quite unwieldy.” Dr Twycross said the focus and advocacy must remain local, and the networks must be approached as a partnership. “Our job is to work hard to expand our services to meet growing community needs, and I believe with our great local leadership and dedicated medical, nursing and administration staff we can do that. “Importantly one service we can and must retain and grow is our maternity service." However, Member for Euroa Annabelle Cleeland has queried whether the networks will expedite a trend that has seen healthcare services that were previously available regionally taken and centralised under metropolitan providers. “Rather than measures increasing capacity and availability of services they will instead create another level of bureaucracy,” Ms Cleeland said. Ms Cleeland referred access to healthcare as a “postcode lottery”, with the grouping of hospitals under different networks potentially impacting the range of services available as the government looks to generate budget savings and perceived efficiencies. Maternity is one such service that has been closed or significantly reduced at numerous regional hospitals over the years, with obstetrics transferred to larger providers often many kilometres away. And though neither provide maternity services, for regional healthcare providers like Yea and District Memorial Hospital and Alexandra District Health the possibility that other services will be transferred or reduced is of concern. Both facilities fall under the East Metro and Murrindindi network and are now aligned with bigger providers like Eastern Health and metropolitan-based St Vincent’s Health. Seymour Health is part of the North Metro and Mitchell network, the country hospital grouped with big players like Austin Health, the Mercy Hospital for Women, and Northern Health which encompasses Epping, Broadmeadows, Kilmore, Craigieburn and Bundoora. Ward Steet, Chief Executive Officer of Seymour Health, confirmed network configurations were based on grouping health services in geographical regions taking into account things such as patient and community flows, transport routes and other factors including population growth forecasts, community need, clinical capability and the distance between health services. He hopes the new structure will enhance capability and expand services locally for Seymour Health, however acknowledges there will challenges and obstacles to overcome. “There will be opportunities to gain better access to specialist and subacute services locally, better coordination of clinical care, potential to attract and retain workforce, shared educational opportunities and potential to better support local GPs in the delivery of a sustainable medical model of care,” Mr Steet said. Optimistic, Mr Steet believes over time the resulting healthcare system will be safer and more efficient and easier for the community to navigate. He has called on the Seymour community to embrace the changes. However for community members like Bernadette Bell, it is the mention of overcoming "challenges and obstacles" that causes her concern. "Tell us what these are," she said. "So that we as a community can work together to ensure the challenges and obstacles are known and decrease any negative affects." It is a sentiment echoed locally and across regional Victoria, as healthcare providers work to understand the implications of the plan and the delivery of healthcare models under the new networks.

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