WA Health Infrastructure Development 
Governance
Effective governance means competent management of resources in a way that is fair, open, accountable and responsive to people's needs.
Public sector agencies must satisfy a complex range of political, economic and social objectives and operate according to a different set of external constraints and influences than do businesses in the private sector. For instance, agencies are required to operate within a system of checks and balances and value systems that emphasize issues of ethics, openness and public accountability. In contrast, private sector corporate governance pays greater attention to shareholders’ returns and preservation of shareholders’ value. 1
The four key components of corporate governance include: 2
- Clear Planning and Direction
- Appropriate and Timely Information
- Sound Resource Management
- Adequate Controls
Good governance is essential to ensuring the successful implementation of WA Health’s Infrastructure Program and as such, the following governance structure has been established.
| 1 | Ministry of the Premier and Cabinet. Corporate Governance Guidelines for Western Australian Public Sector CEO Government of Western Australian, 1999. |
| 2 | Ibid. |
For further information on the roles and responsibilities of these groups / positions, including Terms of Reference, Operating Procedures and Organisation Charts, click on the box of interest.
Visit Infrastructure Development – Key Stakeholder Roles and Responsibilities (PDF 267KB) relating to the Infrastructure Development Process.
Health Reform Implementation Steering Committee (HRISC)
Background
On 14 September 2005, the Expenditure Review Committee (ERC) requested the Under Treasurer and the Acting Director General of Health to formulate a model for steering, monitoring and reporting on health reform implementation, including the compliance by DOH in achieving 5.5% annual expense growth constraint.
Following consultations with Department of Treasury and Finance, the Health Reform Implementation Steering Committee was established, and endorsed by ERC on 19 October 2005.
Purpose
The Steering Committee assumed the role of the External Reference Group outlined in recommendation 84 of the HRC report ‘A Healthy Future for Western Australians’ (Reid Report) with its purpose being:
- The ongoing evaluation of the effectiveness of health reform implementation;
- Provision of advice to the Treasurer and Minister for Health on the progress towards achieving the Government’s target for health expenditure growth of 5.5% pa; and
- To highlight the major risks and opportunities in the health reform process.
Measurement of the effectiveness of health reform are based on the original objectives of the Health Reform Committee being:
- Promoting and protecting health
- Reducing inequities
- Provision of safe, high quality, evidence-based health care
- A patient centred continuum of care
- Value for money
- Transparency and accountability
- Optimal public / private mix
- Sustainability
The Health Reform Implementation Steering Committee reports to ERC via jointly the Minister for Health and Treasurer. A report is prepared and submitted to ERC following each meeting of the Steering Committee.
Membership
The Steering Committee consists of:
- Director General of Health, as Co-Chair
- Under Treasurer, as Co-Chair
- Professor Mick Reid
- A representative of the Minister for Health
- A representative of the Treasurer
Terms of reference
Health Reform Implementation – Joint Senior Officers Group
Background
In addition to the establishment Health Reform Implementation Steering Committee (HRISC), ERC requested the establishment of a Senior Officers Group to provide support and advice to the HRISC.
Purpose
The Senior Officers Group provides support and advice to the HRISC with its purpose being:
- Advise the HRISC on the progress and outcomes of the health reform agenda;
- Monitor and report on actions and recommendations of the HRISC;
- Advise the HRISC on issues which impact on the health expenditure target of 5.5% per annum;
- Ensure appropriate planning, governance and project management practices are evident throughout the main streams of health reform; and
- Ensure alignment of health reform objectives with WA Health Operational and Strategic Plans.
Measurement of the effectiveness of health reform are based on the original objectives of the Health Reform Committee being:
- Promoting and protecting health
- Reducing inequities
- Provision of safe, high quality, evidence-based health care
- A patient centred continuum of care
- Value for money
- Transparency and accountability
- Optimal public / private mix
- Sustainability
The Senior Officers Group reports to the Director General Health. A progress report is prepared and submitted to the Health Reform Implementation Steering Committee at each meeting.
Membership
The Senior Officers Group consists of:
- Executive Director Health Reform Implementation Taskforce (HRIT)
- Project Coordinator Health Reform (HRIT) (Chair)
- Chief Finance Officer
- Executive Director Health Policy and Clinical Reform
- Consultant Infrastructure Health Reform Implementation Taskforce (HRIT)
- Executive Director Technology
- Director Organisational Development
- Executive Director Health System Support
- Director Officer of the Director General
- Project Director HRIT
- Representative/s of the Department of Treasury and Finance
Terms of reference
Director General
The Director General leads WA Health towards its goal to ensure healthier, longer and better lives for all Western Australians. Under his guidance WA Health is working to implement its vision to improve and protect the health of Western Australian by providing a safe, high quality, accountable and sustainable health care system.
The role of Director General of Health encompasses two levels of responsibility:
Whole of Government Level
At this level, the Director General contributes to the development and achievement of high-level strategic goals for the Government. This requires understanding of the policy objectives of the Government of the day across the whole of Government.
Agency Level
At this level, the Director General is responsible for the effective and efficient running of the Department of Health and delivering the implementation of the extensive health reform agenda.
At both levels, the role of Director General includes representing the interests of Western Australia and its people, and effectively promoting the policies, processes and objectives of WA Health and of the Government as a whole.State Health Executive Forum (SHEF)
Purpose
The State Health Executive Forum (SHEF) is the principal advisory body to the Director General of Health (DG) and assists the DG to manage the WA Government Health System through discussion of, and provision of advice to the DG on strategic service, policy and administrative issues.
Notwithstanding the seniority of the SHEF and its standing as the peak advisory committee of the WA Government Health System, it is an advisory body only, and does not have decision-making powers. The SHEF may however make recommendations to the DG, who is accountable for all decisions he/she makes arising from those recommendations.
The SHEF’s role is to raise, discuss with and provide advice to the DG on policy and administrative issues relating to the overall management of the WA Government Health System.
Membership
The SHEF consists of:
- Director General of Health, as Chair
- Chief Executive, North Metropolitan Area Health Service
- Chief Executive, South Metropolitan Area Health Service
- Chief Executive, Women and Children’s Health Service
- Chief Executive, WA Country Health Services
- Executive Director, Technology
- Executive Director, Health Policy and Clinical Reform Division
- Executive Director, Health System Support
- Chief Medical Officer
- Chief Finance Officer
- Project Director, Organisation and Governance, HRIT
Terms of reference
Health Infrastructure Sub Committee(HISC)
Purpose
The HISC is the peak decision-making body at a whole of health level. It has responsibility for developing, managing and monitoring the overall health infrastructure program as agreed with Government. This involves:
- Providing direction on infrastructure development strategies and objectives
- Developing and monitoring Health’s capital expenditure program and capital investment plan
- Approving new project concepts and business cases
- Monitoring the progress of all approved infrastructure projects
The HISC will achieve its responsibilities with support from corporate health functions, including the HRIT, Health Finance and the Licensing Unit. These functions will input into the infrastructure development process at various stages and:
- Provide support to clinical service planning
- Develop and monitor the capital expenditure plan and investment program
- Assist in the preparation, review and evaluation of business cases
- Liaise with the Department of Treasury and Finance
- Ensure operational and facility standards are met
Membership
The membership of the HISC consists of:
- Director General of Health
- Chief Finance Office of Health
- Area Chief Executive – North Metropolitan Area Health Service
- Area Chief Executive – South Metropolitan Area Health Service
- Executive Director –Child and Adolescent Health Service
- Area Chief Executive – WA Country Health Service
- Representative of the Health Infrastructure Unit
- Representative from Department of Treasury and Finance
Terms of reference
Operating procedures
Infrastructure Consultant
The Infrastructure Consultant is an advisory role to the Director General of Health, principally leading the revitalisation and progression of the infrastructure agenda.
This includes regular meetings with key stakeholders from within health and external to health, such as the Department of Housing and Works, Department of Planning and Infrastructure and the Department of Treasury and Finance.
Key roles provided by the Infrastructure Consultant include:
- Advice to the Director General of Health and the State Health Executive Forum
- Advice to Area Chief Executives, Area Infrastructure Steering Groups, Project Control Groups and Area Health Service Infrastructure Units
- Represent WA Health on key government committees including:
- Department of Planning and Infrastructure
– Infrastructure Coordinating Committee (ICC)
– State Infrastructure Strategy (SIS) - Department of Housing and Works
– Senior Officers Advisory Committee (SOAC)
– Client Council for New Building Works and Building Maintenance - Australian Health Jurisdictions
– Australian Health Capital Asset Management Consortium - Development and maintenance of the Capital Works Program with Health Finance
- Coordination of business cases
Support to the Infrastructure Consultant is provided by the Infrastructure Unit in the Health Reform Implementation Taskforce (HRIT) through the coordination of business case approvals and policy advice and development along with a number of administrative procedures.
Area Infrastructure Steering Groups
Purpose
The Area Infrastructure Steering Group is the peak decision-making body in the Area Health Service for all infrastructure development projects. The Area Chief Executive chairs the Infrastructure Steering Group and its role is to manage the infrastructure development program for the Area in accordance with the scope, time, cost and quality parameters agreed by the HISC.
The Area Infrastructure Steering Group is responsible for:
- Providing a decision-making forum with the authority to respond to requests for decisions, or recommendations received, from Project Control Groups supported by the Project Director.
- Ensuring appropriate infrastructure related input to the Health capital expenditure program and capital investment plans that reflect needs and priorities.
- Reviewing and approving the local health service plan within the context of the global framework/plan and recommend acceptance by the HISC.
- Reviewing and approving health facility master plans.
- Endorsing business cases prepared by the Project Director and Area stakeholders and recommend acceptance to the HISC.
- Monitoring overall progress on projects against the set time, cost and quality parameters.
- Approving all scope, cost and substantive time variations in accordance with delegation laid down by the HISC.
- Receiving and endorsing regular project reports from Project Control Groups, prepared by the Project Director.
- Ensuring that any organisational and/or working practice changes from the agreed business case are identified and achieved.
Membership
The Area Chief Executive is responsible for establishing the Area Infrastructure Steering Group and creating terms of reference.
The membership of the AISG will be:
- Chair - Area Chief Executive;
- Project Director for Area Health Service;
- Project Manager(s);
- Area Business Analyst;
- Project Transition Coordinator;
- Representative from Health Reform Implementation Taskforce (HRIT);
- Representative of various stakeholders groups within the area health service, for example chief facilities officer, chief medical officer, chief nursing officer, chief finance officer.
Terms of reference
Operating notes
Area Health Service infrastructure development and management organisation charts
- Department of Health Infrastructure Development and Management Organisation (PDF 12KB)
- North Metropolitan Area Health Service Infrastructure Development and Management Organisation (PDF 16KB)
- South Metropolitan Area Health Service Infrastructure Development and Management Organisation (PDF 13KB)
- Child and Adolescent Health Service Infrastructure Development and Management Organisation (PDF 12KB)
- WA Country Health Service Infrastructure Development and Management Organisation (PDF 15KB)
- Fiona Stanley Health Campus Development Infrastructure Development and Management Organisation (PDF 10KB)
Project Control Groups
Purpose
Project Control Groups should be established for each infrastructure project and are accountable to the Area Infrastructure Steering Group. The role of the Project Control Group is to focus on the detailed decision making for their specific project. The Project Control Group should ensure appropriate input into the development process and maintain a high level of communication with all stakeholders.
The Project Control Group is responsible for:
- Ensuring that the input from both the Program Control Group and user groups in the development process is effectively achieved and, when required, that any issues of dispute between relevant parties are resolved.
- Providing a discussion forum with the authority to respond to requests for decisions or recommendations received from the Project Director.
- Assisting the Project Director in the development of service plans, master plans, business cases, facility plans and contract documentation.
- Receiving and endorsing monthly project reports prepared by the Project Director.
- Ensuring the development of equipment schedules and associated costing.
- Ensuring that the organisational and / or work practice changes from the agreed business cases are identified and achieved.
- Providing direction and guidance to user groups about objectives and strategies.
Membership
The membership of the Project Control Group will include:
- Project Director and/or Manager
- Finance / Business Analyst
- Representatives of stakeholder groups, for example local community, Nursing Officer, Medical Officer, Facilities Officer
The Project Control Group or its Chair may co-opt temporary members onto the Group as required.
Terms of reference
Project Directors
The Project Director is accountable to the Chief Executive and is responsible for directing and coordinating all aspects of the infrastructure development process from project business planning through to health service operation.
The Project Director is responsible for the development and implementation of the systems, processes and resources required to deliver the Area’s infrastructure development program. They will develop and implement meeting and reporting structures and cost reporting systems. They will advise on the need for internal and external human resources, make the appropriate and necessary appointments and coordinate the performance of project staff and consultant contracts.
They will coordinate the development and implementation of all necessary information to support the production of business cases for new developments. This will include coordination of clinical service plans, project definition plans and outline procurement programs. They will work with the Area’s business analyst on the costing and funding aspects of the business case, ensuring a range of health service options are analysed from a recurrent cost perspective.
The Project Director will direct all aspects of the infrastructure procurement phase including schematic design, developed design and contract documentation. They will work with the Department of Housing and Works on the development of contract options and the review and evaluation of tenders, seeking feedback and formal approval from the relevant committees when required.
The Project Director will monitor the construction of the infrastructure program and work with their team to ensure the individual projects are delivered to approved scope, time, quality and cost. They will oversee the transition to new facilities and provide advice to Area Chief Executive on ongoing asset management and maintenance of new facilities.Project Managers (and other project team members)
The Project Manager supports the Project Director with the day-to-day management and coordination of specific infrastructure projects to the approved scope, time, quality and cost parameters.
The Project Manager will be responsible for the preparation of monthly progress reports, the coordination and flow of relevant information to stakeholders, the preparation of consultant briefs and the development of a detailed project program. They will manage the consultant team and work closely with key stakeholders and to build links with the project transition coordinator.
The Project Manager will work with the Project Director on the preparation and evaluation of tenders. They will establish and chair contractor site meetings and manage the performance of contractors. They will take responsibility for monitoring and reporting on progress to the Project Director and coordinate building commissioning activities and the approval to occupy. The Project Manager may be provided by the Department of Housing and Works or may be a specific area health service appointment.
Upon completion of construction of new developments, the Project Manager will coordinate all necessary information for effective asset management, coordinate post occupancy evaluation and manage the defect liability period. They will be responsible for reporting all post construction activities to the Project Director.
Project Consultant Team
Project Consultants will be appointed to work with the Project Director and Project Manager at various stages of the infrastructure development process. Consultants may be engaged to assist in the preparation of design documentation at the project business planning and facility planning stages. Consultants may also be used at the facility implementation stage to coordinate aspects of the tendering, construction and commissioning phases of infrastructure development and may work with the Project Manager to coordinate the necessary information for transition and ongoing asset management and maintenance.
Project Transition Coordinator
The Project Transition Coordinator is responsible for the final stages of the infrastructure development process. They will lead the health service transition process, in conjunction with the Project Director and Project Manager.
The Project Transition Coordinator will be required to develop and implement resourcing strategies, including staffing models, recurrent funding redistribution and training and development plans and will develop and implement the strategy for the operation of the new facility.
Department of Housing and Works
The Department of Housing and Works (DHW) will be engaged by the Area Health Service from business planning through to the facility implementation phase of the infrastructure development process.
The DHW will assist in project risk management by providing a whole of Government infrastructure perspective to the Area Chief Executive and Project Director. This will include advice on government policy, due process and statutory requirements.
They will provide advice to the Chief Executive on procurement policies and strategies and participate in ongoing risk management of the project from a construction perspective. They will assist in the appointment of consultants throughout the project and provide templates for tendering documentation where required. At the facility development stage, the DHW will undertake the role of Principal to contractors and the role of Building Superintendent, if required.
The DHW will meet with the Infrastructure Consultant fortnightly to discuss any issues arising from Health’s infrastructure program.
Department for Planning and Infrastructure
The Department for Planning and Infrastructure (DPI) will be engaged by the Area Health Service in a partnership approach to assist with the structure planning function.
Every site is required to develop a structure plan and gain approval from the WA Planning Commission (WAPC). The Project Director will work closely with the DPI to develop the structure plan in accordance with WAPC guidelines.
The DPI will also provide advice to the Area Chief Executive on structure planning policies and strategies to ensure appropriate protocols are adhered to.
The DPI will meet with the Infrastructure Consultant monthly to discuss any issues arising from Health’s infrastructure program.
Department of Treasury and Finance
Health Finance and the Infrastructure Unit throughout the business case development phase will engage the Department of Treasury and Finance (DTF). The DTF will provide advice on early drafts of business cases to enable a more streamlined approval process once the business case is formally submitted for approval.
In order to gain approval for business cases, they must be submitted to the Expenditure Review Committee (ERC) via the DTF.
The ERC is a standing committee of Cabinet and meets on an “as required” basis (but usually monthly on a Wednesday), and more regularly during the budget process. It primarily considers, approves, rejects or notes the financial components of all Cabinet or Ministerial submissions that have an impact upon the State’s finances. All proposals that have financial implications are required to be considered by the ERC. Voting members of the ERC include the Premier, the Treasurer and certain Government Ministers. Non‑voting members include the Premier and Treasurer’s Chiefs of Staff, senior officials from the Department of Treasury and Finance (DTF) and the ERC Secretariat. The ERC relies upon independent advice from the DTF in its consideration of financial issues.
The main functions of the ERC are:
- overseeing the annual budget process;
- ongoing monitoring of the approved budget estimates; and
- examination of other matters including:
- major policy proposals having expenditure or revenue implications;
- items referred to it by Cabinet;
- wage increases and associated industrial relations issues; and
- tariffs, fees and charges proposals.
The ERC is responsible for approving capital program funding and the initial funding allocation for each project based on the business case. The ERC approve any significant changes in scope, time, end total cost (ETC) and cost variations.
The DTF will meet with the Infrastructure Consultant fortnightly to discuss any issues arising from Health’s infrastructure program and are represented on the Health Infrastructure Steering Group and the Senior Officers Group.
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