Executive health managers needed to be less obsessed with balancing the books and more focused on providing the best quality of care possible, a senior clinician believes.
Many of those who were critical of Hunter New England Health chief executive Michael DiRienzo, who resigned this week, argued that he prioritised positive financial outcomes at the expense of deteriorating standards of clinical care.
The issue came to head late last year when a group of John Hunter Hospital specialists threatened to call for a vote of no confidence in Mr DiRienzo .
University of Newcastle clinical pharmacologist Jennifer Martin said community expectations around accountability and quality of care had changed enormously over the past decade.
"From a lot of current research into health and workplace culture we are increasingly aware that leadership of a health organisation is complex, with both technical, executive and people skills also emerging as very important to consider, alongside skills such as finance. That is, it's the way the books are balanced that is key," Professor Martin said.
Expectations for a tertiary hospital included training of a local, quality workforce, the incorporation of cutting edge research into local practice, cutting waste and improving silos of culture.
"There is never enough money for all the interventions and pharmaceuticals in health care that we would like - thus management of such requires listening to the best and broadest advice, including experts that have experience in prioritisation and community engagement" Professor Martin said.
The Health Services Union has called for a Royal Commission into the allocation of funding for health and hospitals.
NSW Secretary Gerard Hayes said some of the criticism of Mr DiRienzo's financial management should instead be directed at the allocation of health budgets.
"There are some people who are getting a hell of a lot more than others and that's why we have called for a Royal Commission. It's an issue for all our health executives. Until a Royal Commission can determine who is making all the money and who isn't they are all going to be driven by budgets."
Mr Hayes said the vast area that the Hunter New England Health District covered needed to be addressed by the incoming executive management.
"It's a complex area and you tend to rely on the big hospitals like John Hunter as a hub," he said.
"Getting clinicians and resources to hospitals like Tamworth and Armidale, which are big centres, has always been a juggling act. It will be a big issue moving forward."
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