MONEY continued to hold sway over discussion and debate in Tasmania's health system this year.
Two years after state government budget cuts, hospital staff still grappled with emergency department demand and elective surgery waiting lists.
According to an Australian Institute of Health and Welfare report released in October, Tasmania saw the biggest increase in emergency department presentations nationally between 2011 and 2013.
Launceston General Hospital reached record occupancy levels this year, and the elective surgery waiting list increased by 3.9 per cent in the 12 months to June 30.
There were positives to be found, with Health Minister Michelle O'Byrne pointing out the statewide elective surgery waiting list had fallen to its lowest point since 2009 last financial year - however, the state's median wait time was still longer than the national average.
Ms O'Byrne also said that emergency department performance and ambulance response times had improved, with Launceston ambulances taking an average 9.7 minutes to reach patients last financial year.
Tasmanian Health Organisation North chief executive John Kirwan said there was much to celebrate at the LGH as the hospital marked its 150th year, and upgrades to the WP Holman Clinic and the John L Grove rehabilitation unit were completed.
Mr Kirwan said work continued on the Flinders Island Multi-Purpose Centre, as well as LGH's operating theatre suite, intensive care unit, central sterilising department, department of surgery offices, medical staff common room and ambulatory care surgical unit, with all work due for completion next year.
Tasmania Medicare Local chief executive Phil Edmondson said his organisation had introduced programs to improve healthcare access for the disadvantaged, reduce smoking and drinking among young people, encourage exercise among Tasmanians with chronic conditions, and increase awareness of after-hours medical care.
Most of the programs were funded by the Tasmanian Health Assistance Program, which also funded Hobart's not-for- profit The District Nurses to develop a statewide home-based palliative care service.
Hospice in the home has just taken on its first clients, and is expected to be fully operational by March.
But it is not yet known if it will be able to meet the state's needs.
In the lead-up to the federal election, the University of Tasmania began pushing for funds for a proposed Northern Tasmanian health science active learning and sport precinct at the university's Newnham campus.
If it gets funding, $83.5million precinct would accommodate expanded programs in allied health, health technology, dementia care and active living.
In parliament, the state government pushed through a new Mental Health Act - though the rollout has been slightly delayed to February - as well as legislation decriminalising abortion.
Enterprise bargaining agreement negotiations saw two unions take industrial action in the health sector this year, with the Australian Nursing and Midwifery Federation working to rule after it couldn't reach an agreement with the state government on working conditions.
Nurses claimed meal breaks, overtime and other entitlements as part of the action, which started on October 23 and ended with a new offer on November 5.
Similarly, Health And Community Services Union ambulance and communications members started action over meal breaks and roster notice on November5, with members accepting a revised government offer on December 17.
It was a busy year on the East Coast, as residents fought ambulance changes, stepped up the campaign for a new hospital, and found some relief to a general practitioner shortage.
There was much controversy among residents when Ambulance Tasmania took away the Scamander branch station's Toyota Prado four-wheel-drive, which couldn't carry a stretcher, replacing it with a new Mercedes ambulance and a four-wheel-drive Toyota Land Cruiser.
Mayor Sarah Schmerl said at the time that the new arrangement, which would see the Mercedes respond to all call-outs unless a four-wheel-drive was specifically requested, did not take the East Coast's diverse and sometimes unpredictable geography into account.
But, Cr Schmerl was much happier a couple of months later when Break O'Day Council's campaign for a new St Helens hospital led to a memorandum of understanding between the council, the department of health and THO North in November.
Under the memorandum, the state government has committed to working with the council to find the right site for a new facility.