The clinical structures within state hospitals are actively being allowed to “decay” as the Tasmanian Health Service moves toward implementing a new clinical service structure, The Australian Medical Association Tasmania says.
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AMA Tasmania president Dr Stuart Day said the association had “significant concerns” that factors, including failure to replace vacant key positions, were leading to internal dysfunction.
“The on-the-ground clinical delivery structures of the hospitals are vital for patient care on a day-to-day basis,” Dr Day said.
The THS released its Building a Statewide Clinical Service Delivery Structure, First Steps plan on Friday.
The restructure will see clinical services grouped into six streams, each managed by a dedicated statewide clinician management team. Health Minister Michael Ferguson said statewide structures would “cut duplication and maximise frontline care.”
Dr Day said there was broad agreement from the AMA with a single statewide health service. But the plan gave limited detail about how clinical streams would be operational, Dr Day said.
“Some of our concerns could be allayed if we had an overall plan … we’ve yet to see that,” he said.
A letter sent to THS staff from chief executive Dr David Alcorn said statewide specialty directors would be appointed. The plan said “all existing clinical management positions will be retained until each new stream comes on line”.
“[The THS’s] primary task in implementing the new structure is to ensure that on-the-ground operational structures across the THS are not jeopardised,” the plan said. Dr Alcorn wrote that implementing reforms to address “long-standing issues” was a “complex and necessary process” which took time, planning and consideration.
“It also means that we are unable for now to answer all your questions … I acknowledge this can be frustrating … however, I can assure you that as we further develop and implement the new structure we will provide additional information,” Dr Alcorn wrote.
Mr Ferguson said there were no plans or intentions to “downgrade” clinical leadership and said no clinical capacity would be lost under the restructure.
He said the THS would continue to consult. The plan outlined that implementation of the clinical streams would allow for early progression of the Surgical and Perioperative Services, Women's and Children’s Services and Mental Health Services streams, with their clinical executive directors recruitment expected to commence in March.
A discussion paper on operationalising the delivery structure will be released in March, the plan said.