By Henrietta Cook and Broede Carmody
Victorian hospitals would share staff, beds and radiology services under a proposed overhaul of the state’s health services being slammed as a backdoor form of hospital mergers.
A leaked Health Department document canvasses 41 new initiatives – mainly aimed at reducing costs and fixing workforce shortages – including “establishing expectations that large health services share workforce to meet minimum staffing requirements across the network”.
Victorian hospitals have been asked to consider sharing radiology services – among other things.Credit: Monique Westermann
The proposals, which were recently presented to regional hospitals as part of the state government’s contentious Health Services Plan, also detail a shared pharmacy network, human resources, administration and payroll functions, alongside moves to address “uneven” availability of beds.
The document – obtained by The Age – also confirmed that hospitals would use “workforce banks” of staff managed by a “core operations centre”. They would also “move towards consolidated radiology services”.
“Given the tight fiscal environment that health services are operating within, it is critical to maximise the proportion of funding and medical resources that are spent on patient care,” the document said.
In August, the state government ruled out forcibly merging the state’s 76 independently governed health services after a fierce backlash from regional communities and hospitals. It instead proposed grouping the services into 11 distinct networks.
The Age can reveal the Allan government hopes to have its new hospital network groupings and governance structures in place by July next year.
Each network will then be asked to develop a three-year business plan addressing health inequities, safety, better access to care and workforce shortages.
Victorian Allied Health Professionals Association secretary Craig McGregor described the proposals as a “backdoor way of achieving hospital mergers”.
“Instead of merging the hospitals, they are just merging parts of the hospital services,” he said.
McGregor said he was concerned that consolidating radiology services would lead to job losses, particularly among chief radiographers with local knowledge of the workforce and patient needs.
“It is potentially going to be a disaster,” he said.
The document said there may be some flexibility to tailor initiatives to local contexts.
A hospital executive, who did not want to be identified because it could jeopardise their employment, hit out at moves to centralise HR, radiology and pharmacy services.
“By consolidating all these services, it is an unofficial merger,” they said.
“So many services will be provided centrally that it will impact small health services through loss of jobs and visibility of staff.”
The executive said that while the workforce bank was “nice in theory”, it would not work because of the distances between hospitals.
“There are huge distances of up to two hours between health services in these proposed networks. Are people prepared to drive those distances to pick up those roster shortfalls?”
But two other hospital leaders, who also spoke to The Age on the condition of anonymity because they were not authorised to discuss the matter publicly, said they supported the reforms.
“Some things can be shared,” one said.
Association of Hospital Pharmacists secretary Matt Hammond said there was merit in a shared pharmacy network.
“Using purchasing power to provide value for the taxpayer is not unreasonable when we are talking about medication,” he said.
Opposition health spokeswoman Georgie Crozier said she was worried some patients would end up having to travel further to get basic care.
“It is extremely concerning that basic services such as radiology are being lost to local health services,” she said.
A Department of Health spokesperson said consultation with health services would begin next year and stressed that no final decisions had been made.
“A key driver in forming the networks is that it will enable health services to better utilise resources and support our workforce to deliver more seamless care for patients,” they said.
An Allan government spokesperson said residents would also be consulted.
“We have made it clear that we will not force services to amalgamate involuntarily because we believe that locals know their community’s health needs best and – together with their health service leaders – their voices will be listened to in the delivery of local healthcare,” the spokesperson said.
Australian Medical Association Victoria president Jill Tomlinson criticised the health department for not consulting unions.
“We call for greater transparency and clarity,” she said.
Tomlinson said while consolidating radiology services may deliver efficiencies, the government needed to ensure it did not impact patients’ access to imaging services.
She said hospital beds were rarely underutilised, and that bed capacity limitations were often due to staffing shortages.
While the May budget tipped a record $13 billion into Victoria’s health system, hospitals were told to shore up their budgets – for the first time since the pandemic– and to not expect any top-up funding.
At the time, Health Minister Mary-Anne Thomas said hospitals needed to reduce their marketing and travel spending. However, health insiders warned the belt-tightening could lead to bed closures and even the end of some kidney dialysis services. One health service encouraged employees to turn off the lights when they exited a room to save money.
The state government dropped its initial plan to end future hospital bailouts in August after a sustained backlash, instead pouring an extra $1.5 billion into the system.
This prompted a missive from Treasurer Tim Pallas that funding could not keep flowing like it had.
The Age last month scrutinised more than 60 hospital annual reports and found a growing number of hospitals went backwards financially across the 2023-24 financial year.
Victoria’s net debt is expected to peak at $187.8 billion by mid-2028.
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