Independent Governance Review of the Health Services Act 2016

On 17 January 2022, the Minister for Health has appointed an expert panel to conduct an independent governance review of the Health Services Act 2016 (the Act) (external site).

The purpose of the governance review was to examine the operational and practical effectiveness of governance structures set out in the Act and their impact on patient experience and outcomes.

The efficiency and effectiveness of the WA health system has a direct impact on the health of Western Australians. It is critical to investigate and understand whether the current governance arrangements and operational instruments specified within the Act are operating in a way that is optimal and enables the best possible outcomes for patients and their families now and into the future. 

The Independent Review of WA Health System Governance Report

The independent governance review of the Act has now been completed.

On 24 October 2022, the WA Government acknowledged the Independent Review of WA Health System Governance Report and approved the release of the report for further consultation.

The Panel made 55 recommendations for improvement, shaped by extensive engagement with stakeholders throughout Western Australia.

The successful implementation of recommendations made by the Panel will require collaboration with multiple government agencies. Therefore, the Government will further consult and seek feedback from relevant government and non-government agencies regarding the report where appropriate.

Government Response to the Independent Review of WA Health System Governance Report

On 14 March 2023, the WA Government welcomed the Report and accepted in-principle 49 of the 55 recommendations with 3 recommendations requiring further consideration and 3 recommendations not supported.  

Recommendation 9 regarding a changed approach to the appointment of Health Service Provider chief executives is not supported. Recommendations 14 and 15 on mental health governance are not supported as written at this time. Recommendations 29 – 31 on local commissioning will be further considered.  

The Government would like to thank and acknowledge the Panel for their insights and their important contribution to the future of our health system through their comprehensive review. 

The full Government Response (PDF 1892KB) and the Brief Ministerial Statement by Minister Sanderson, Minister for Health; Mental Health are now available.  

The Department of Health will commence implementation of the recommendations accepted in-principle in alignment with the refocused priorities of the sustainable health review. 

Background

The Health Services Act 2016 commenced on 1 July 2016 providing a legal framework for clear roles, responsibilities and accountabilities at all levels of the system and a devolved model of governance that enables decision-making closer to service delivery and patient care. The Act brought significant reform to the governance and structure of the WA health system:

  • The Department, led by the Director General, has been established as the System Manager responsible for the overall management, performance and strategic direction of the WA public health system to ensure the delivery of high-quality, safe and timely health services.
  • Health service providers (HSPs) have been established as separate legal entities, governed by either a chief executive or a board, legally responsible and accountable to the Minister for Health. HSPs have clear functions and powers under the Act relating to the provision of health services including preparing certain strategies, establishing procedures for dealing with complaints and monitoring and improving the quality of services provided.
Panel

A panel of highly skilled and experienced professionals will undertake the governance review. The panel is scheduled to meet formally from February 2022 and comprises:

Chair Ms Kym Peake, Partner, EY Port Jackson

Ms Peake has held senior roles in public administration as the former Secretary of the Victorian Department of Health and Human Services, and previous Deputy Secretary of the Victorian Department of Premier and Cabinet.

Ms Peake led significant governance changes within Victoria’s public health system, including the creation of state-wide quality and safety entities, amalgamation of regional health services and creation of a new public entity to manage the purchasing, supply and distribution of medical consumables.

Dr David Rosengren, Executive Director Royal Brisbane and Women’s Hospital

Dr Rosengren has considerable and current clinical skills and experience working within a devolved governance health system and is a former Chair of the Queensland Clinical Senate.

Ms Jo Gaines, GESB Chair

Ms Gaines has extensive experience as an organisational leader and strategic policy director having worked as Deputy Chief of Staff to Premier Mark McGowan. Prior to this she was the Branch Assistant Secretary for the Community and Public Sector Union/Civil Service Association for 10 years.

Mr Gary Smith, Co-Chair of Reconciliation WA and Chancellor of Murdoch University

Mr Smith has thirty-five years of experience in the professional services industry and has provided business improvement and management consulting services to key industry sectors. A retired State Chair, KPMG, he brings strong governance skills and experience to the panel and has supported clients in matters of strategy, leadership, culture and process implementation.

Terms of reference

In carrying out the review, the Panel will consider the governance of the WA Health System in relation to:

  • the efficiency and effectiveness of the devolved governance structure, the System Manager and Board-led Health Service Providers (HSPs)
  • the impact of the current governance structure on the culture of HSPs from the perspective of consumers and carers, staff and the community
  • whether the System Manager’s role in planning and commissioning services and ensuring accountability is adequately enabled through existing mechanisms, such as mandatory policies, directions and Service Agreements
  • whether the System Manager and the HSPs are fulfilling their respective roles as originally envisaged, including whether the System Manager is exercising available authority under the existing structure and the HSPs are responding accordingly
  • the system’s ability to manage, plan and implement key health reforms and workforce requirements
  • the system’s ability to respond to emergency situations
  • any other related matters.
Submissions

Over 30 detailed submissions were received in response to the public consultation. Of these, 17 contributors permitted their submission to be published with 4 electing for their submission to be published anonymously and 13 electing for the submissions to be published with their name and organisation.



More information 

If you have any queries, please contact the project team by emailing IndependentGovernanceReview@health.wa.gov.au