Friday, January 13, 2012

The problem with Queensland's Local Health and Hospital Networks

I was saddened to hear today about the death of a man I met only once but have known about for a long time. Before I was headed to Roma a couple of years ago, a friend from IBM days told me I simply had to meet his cousin. His cousin was a named John Young who my friend told me was involved in the Roma airport and later the hospital and health system.

By the time I got to Roma,his cousin had mostly retreated (retired is not the right word) to his property some 50km south of Roma where he worked the land. It was well over a year before I got to meet him and this fact was always discussed whenever I met his cousin in Brisbane. I finally got to meet John Young at a meeting of the local Health Community Council

HCCs were a sort of half way health house set up by State Labor in 1991. For 20 years, HCCs operated geographically at just-above-local council level (there were 36 in Queensland) dealing on the ground with patients and their hospitals. They were the eyes and ears of the health system becoming aware of, and fixing local problems. They talked to the patients and they talked to the staff but relied on their soft power with authorities to get things done rather than any legislation.

Last year the Queensland Government disbanded HCCs in a major revamp of Queensland Health. From 1 July 2012 they will be replaced by 17 Local Health and Hospital Networks (with the unfriendly acronym of LHHNs). These new agencies will be responsible for bigger areas and will have more powers.

The old Roma HCC represented the views of the communities of the Maranoa and Balonne regional councils. They also monitor the performance and quality of public health services in these regions. John was the chair of the Roma HCC and I finally met him at a public meeting at Wallumbilla Hospital in February 2011. Only one couple showed up from the general public, the rest were there from the general hospital but John showed no disappointment with the small turn-out. He diligently explained what their role was and what assistance he could provide. He carefully listened to the couple’s issues with the health system and gave them options on what they could do to improve their situation.

He also talked logistics with the hospital staff. He made whoever he spoke to feel important and he gave suggestions to solve issues. Everything was important and surmountable. At the end of the meeting, he and I shared a joke or two about our mutual friend/cousin before going our separate ways. I never saw him again.

The HCCs were disbanded in June 2011. By June 2012 the will be replaced by 17 Local Health and Hospital Networks (LHHNs) which will have a strong local decision-making and accountability function. There is a 12-month gap while Queensland Health rolls them out with five already established including ones in Brisbane and the Gold Coast. The Government said this was a major reform with profound implications for the quality of health care in Queensland.

The LHHNs will be statutory bodies with Governing Councils, accountable to the local community and Queensland Parliament. In August 2011, I editorialised in my paper the changes were good ones with more money, more beds, more doctors and nurses available at a local level to support an overburdened system. But I said finding the right local people to go on these volunteer boards would be tough. The board members will have the huge responsibility for managing the operation and performance of the hospitals within the network. While I didn’t mention him by name, I thought John Young would have been ideal for the local board.

It will never happen now. This morning I found out he had died of a heart attack in his paddock yesterday. I was shocked and immediately texted his cousin to offer my condolences. He rang back within minutes. I was worried he had not heard the news prior to my text but he had almost found out in real time. John’s wife had relayed the terrible news on the phone to the wider family in updates. John had a fall and it doesn’t look good, she reported. Then a few minutes later, “he’s gone”. He was just 59 years old.

John’s death was a tragedy for the family but it was also bad news for the wider community. I don’t know if he nominated to be part of the local LHHN, but they need people like him if they are going to work. I don't blame him if he didn't nominate. The LHHNs are a far bigger ask than the HCCs, they cover a wider area and have greater powers. Members need skills in business, finance, legal and human resources expertise wanted as well as the delivery of clinical services. All this in volunteer and most unpaid work. Reform is needed, but for these new LHHNs to work, we need people like John on them - people with knowledge, understanding and the ability to listen to and act on problems, in short, people with a vocation for health. Our wellbeing depends on it.

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