Experts worry that a “culture of fear” within the New South Wales health system will not be stamped out and patients will be at risk, after the state government ruled out the creation of a new independent watchdog as recommended by a recent inquiry.
Handing down its response to the damning parliamentary inquiry into regional health on Thursday, the government said it supported in part, or in full, 41 of 44 recommendations, and “noted” the remaining three.
The regional health minister, Bronnie Taylor, said people deserved access to health services “no matter where you live in our state”.
The inquiry made 22 findings after hearing from dozens of witnesses and receiving more than 700 submissions about the state of regional, rural and remote medical care in NSW.
The government accepted the need to urgently address workforce issues and engage on a ministerial level with the federal government on those problems, as well as funding for regional health.
It has also formed an advisory panel to help the government in creating a regional health plan that will be released later this year.
But while the government accepted the majority of recommendations, it rejected calls for an independent health administration ombudsman to investigate concerns over the conduct of NSW Health and local health district management.
“The NSW ombudsman has written to the NSW government indicating these matters already fall within their jurisdiction,” the government said in its response.
“The NSW ombudsman and the Health Care Complaints Commission (HCCC) are existing bodies with accountability, authority and responsibility to investigate decision-making by NSW Health, including clinical and administrative decisions.”
The inquiry had found doctors and nurses had been operating in a “culture of fear” and were scared to speak up about staff shortages and unsafe practices.
The government’s decision has been rebuked by the Australian Lawyers Alliance, a national group dedicated to justice, freedom and the rights of the individual.
The group’s spokesperson, Catherine Henry, said the current model was “not working” and needed to be reformed.
“We are concerned that the government has ruled out creating an independent health administration ombudsman to address the high volume of complaints,” she said.
“A new fully independent ombudsman would have provided an opportunity to make a real difference to the system. Without this ombudsman, there needs to be significant and urgent change within existing oversight bodies.
“We know that there continues to be tragic outcomes for rural and regional patients, and we know that it is often challenging for frontline staff to raise concerns.”
The government has also rejected calls from the inquiry to establish a review into regional and rural mental health, stating it would be a duplication of recent examinations of the issues.
It said it will consult with the South Australian government to learn about its “health in all policies” framework, which was also recommended.
The Australian Paramedics Association’s acting NSW secretary, Scott Beaton, who gave evidence to the inquiry, was disappointed the government had not accepted all the recommendations in full.
“In failing to back the full recommendations of this inquiry, we’re concerned the government are shying away from a once-in-a-generation opportunity to address the root causes of health inequality across our regions,” Beaton said.
The Gilgandra-based paramedic said the response “noticeably fails to commit to investment in specialists” like extended care paramedics.
“In a rural area, having an extended care paramedic can mean the difference between an hours-long transport to a hospital waiting room and a patient getting swift, effective treatment in the comfort of their home,” Beaton said.
The opposition’s health spokesperson, Ryan Park, welcomed the government response.
“[I] now want to see them going from supporting the recommendations to implementing them because we can’t have a situation where a cook or a cleaner looks after patients in regional and rural hospitals,” he said, referring to evidence given during the inquiry.
