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After Garling – How to make it work?

MJA Media Release - After Garling – How to make it work?

18 Jan 2009
The report of the Garling inquiry into NSW’s public hospital system has made some excellent recommendations but there is a need for clear guidance on how to implement any changes, according to articles published in the latest Medical Journal of Australia.

An editorial by Dr Martin Van Der Weyden, Editor of the Journal, said the report’s recommendations were presented with no sense of priority and were not costed.

“The report is will require courage and political will … outstanding political, clinical and community leadership; open discussion; and community engagement to an extent not previously seen.”

In their assessment of the report, Professor Graeme Stewart from Westmead Hospital and his co-author Professor John Dwyer, Co-Chairs of the NSW Medical Staff Executive Council, said that clinicians should welcome most of the reforms recommended by Garling.

They added that implementation was feasible but would require substantial culture change to alter the manner in which health bureaucrats administered their responsibilities.

“The changes must re-engage clinicians and stem the flow of desertion to the private sector,” Prof Stewart said.

“They must also address the fundamental causes of the current crisis.

“Amongst these is the serious underfunding of the public hospital system for which the Commonwealth Government must take urgent responsibility and return the funds redirected to the private sector by its predecessor.”

“Without serious, new ‘pennies from Kevin’, it is unlikely that clinicians will find the energy and time to engage in a complex reform process and many of the excellent recommendations from Garling are not cost neutral,” Prof Dwyer said.

Prof Stewart and Prof Dwyer said a major omission from the Garling report was its failure to adequately address the loss of local accountability in hospitals since the abolition of area health service boards.

The Medical Journal of Australia is a publication of the Australian Medical Association.

Published: 18 Jan 2009