Health Care Act

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Monitoring the implementation of Transforming Health

Transforming Health was a major South Australian state government change initiative to improve the metropolitan Adelaide public acute hospital system. It ran between 2015 and 2017, with the aim of aligning better models of health care delivery with new and upgraded hospital facilities.

Indicator reports

Our indicator reports monitor changes before and after the Transforming Health program implementation. We selected indicators to monitor changes in patient access and equity taken from the case for change stated in SA Health’s March 2015 document, Delivering Transforming Health – Our Next Steps:

  1. Too many deaths occur in our hospitals
  2. Long waiting times for discharge or placement
  3. Too many transfers between hospitals
  4. Senior clinicians unavailable.

We have prioritised monitoring indicators that may show whether system or policy changes are causing unwarranted widening of health outcomes gaps between specific populations, particularly vulnerable groups such as Aboriginal people, culturally and linguistically diverse communities, lower socio-economic areas, aged persons and rural and remote residents. We monitor hospitalisations (inpatient separations), average length of overnight stay, hospitalisations ending with death in hospital and hospitalisations ending with transfer to another hospital over time. Results are also presented by SA Health local health network.


How South Australian health system performance compares nationally

Every year the Productivity Commission releases its Report on Government Services (RoGS), providing information on the equity, effectiveness and efficiency of government services in Australia. RoGS includes a Health volume that covers primary and community health, ambulance, public hospitals and mental health.

We have produced two reports summarising how South Australian RoGS health system performance outcomes compare with the other states and territories, national averages, and previous reporting periods:


Our response to the Productivity Commission Reforms to Human Services inquiry (2016)

We responded to a Productivity Commission report from December 2016 that suggests key human services are in need of reform to offer more choice and competition. The Productivity Commission identify services such as public hospitals, public dental services and end of life care. While mentioning international examples of choice and competition policy, the report offers no explanation about how this might drive improvements in individual or population health outcomes or service delivery outcomes. HPC is concerned that if this inquiry recommends trialling any competition based reforms to human services, and particularly in public hospitals, that these preconditions should be met:

  • transparency of performance monitoring and reporting outcomes
  • service providers accountable for fostering consumer and community information literacy
  • government stewardship including sufficient funding and regulatory systems that take in consumer feedback and complaints management
  • recognition that a balanced and consumer-centred health system fosters better health outcomes and is most efficient when it integrates preventive and primary care with hospital services.

Our submission to the Productivity Commission – Reforms to Human Services: Issues Paper December 2016 expands on these points.


Health care for people from Culturally and Linguistically Diverse (CALD) backgrounds

In 2015, we commissioned a study to explore key issues in health care for Culturally and Linguistically Diverse (CALD) populations in South Australia. The scope of CALD populations for this study included new and emerging communities (new migrants and refugees) and established CALD communities, with a focus on older people from CALD backgrounds.

The study's report by Dr Iolanda Principe of IP Strategic Solutions, Issues in Health Care in South Australia for People from Culturally and Linguistically Diverse Backgrounds - A Scoping Study for the Heath Performance Council identifies current priority issues regarding appropriate care and quality of experience for people from CALD backgrounds through consultation with CALD peak bodies, advocacy groups and service providers, as well as a review of relevant information and research outcomes.


Aboriginal health in South Australia

At the seventh Aboriginal Leaders' Forum on 31 May 2017, we launched our 2017 Aboriginal Health Case Study report as a consultation draft for feedback. We invited stakeholders and interested parties in Aboriginal health to comment on consultation questions developed in conjunction with the case study.

Valued feedback to the consultation draft was provided by Aboriginal leaders, SA Health, expert independent bodies and other interested parties during the project's consultation phase and incorporated into our final report, Aboriginal health in South Australia: 2017 case study.

The 2017 case study formulates advice for health system reform to address disparities in health outcomes of Aboriginal people. Aboriginal leaders are clear. If better health outcomes are to be realised across the board, there must be an integrated, cross-discipline, cross-portfolio, and Aboriginal-led approach. This approach must take account of social, cultural, spiritual, economic and environmental determinants such as education, employment, safe housing, and culturally appropriate health practices and health promotion.

Four key areas for action emerged through consultation and research:

  1. Increase the numbers of Aboriginal people trained for and placed in the health workforce, particularly in senior and health professional roles.
  2. Expand culturally appropriate treatment to the entire health system, respecting Aboriginal people and drawing on their strength and endurance to support both individuals and communities to improve wellbeing.
  3. Remove barriers to the reporting and recording of Aboriginal identification in the health system, both as staff and consumers.
  4. Reduce and remove perceived and real institutional racism towards Aboriginal people within the health system through workplace audits, consumer feedback, safety and quality standards and personalised healthcare plans and by ensuring Aboriginal health consumers know their rights.

This 2017 case study is our second evaluation of Aboriginal health. It follows the HPC's 2014 report, Aboriginal Health in South Australia 2011-2014: A Case Study, our inaugural assessment of how the health system is performing for Aboriginal people.


Improving End of Life Care for South Australians

Quality end of life care is an important measure of a humane society and an essential element of heath care systems. Improving End of Life Care for South Australians reviews progress on the implementation of SA Health's Palliative Care Services Plan 2009-2016 and considers ways to improve the quality of life for South Australians at the end of life.


Mental Health in Rural and Remote South Australian Communities

We heard from country Health Advisory Councils that mental health was a very important issue for regional South Australia, so we looked at mental health outcomes and mental health services in country South Australia. Mental Health in Rural and Remote South Australian Communities details our findings.


Review of Country Health Advisory Councils' (HACs) Governance Arrangements

In 2016, five years after the first review of governance arrangements between Country Health SA and the Health Advisory Councils, we set out to revisit the 2011 review to comment on changes over time and highlight where improvement was possible.

Importantly, we acknowledge the great volume and variety of work that is done by Country HACs across South Australia. HPC commends all Country HAC members for their service, commitment and amazing achievements in contributing to stronger regional health services for all country South Australians, now and in the future. As part of this review, we invited Country HACs to submit case examples describing achievements, and these are all published in the report. HPC acknowledges all observations in the review and future expectations for HAC activities should be proportionate with the unpaid part-time role of HAC members.

Our report comments on promoting the interests of specific population groups; building health and health governance literacy; receiving relevant health system performance information from Country Health; supporting Governing Council and Country Health achieving key strategic directions for patient safety and quality health services; and building on the shared future vision for collaboration through the full implementation of the June 2017 Country Health Partnership Framework. 

In 2011, the first HPC review of the governance arrangements between Country Health SA and the Health Advisory Councils was undertaken in accordance with its mandate under the Health Care Act 2008. We submitted our report to the Minister for Health on 31 December 2011 and it was tabled in Parliament on 4 April 2012.