Reshaping health in NSW

29 MARCH 2010

A 'decade of chaos' is how rural health specialist Associate Professor Sue McAlpin from CSU has labelled health reforms experienced by regional Australia in the 1990s.

A 'decade of chaos’ is how rural health specialist Associate Professor Sue McAlpin from Charles Sturt University (CSU) has labelled health reforms experienced by regional Australia in the1990s.
 
As the health debate gains renewed momentum in Australia, Professor McAlpin will receive her PhD at the CSU graduation in Wagga Wagga on Friday 16 April for her research entitled, A Decade of Chaos – A History of Health Restructuring in Rural NSW in the 1990s.
 
Associate Professor Sue McAlpin.Professor McAlpin explored the experiences of senior executives working in the NSW public health system during the 1990s; a period in which rural service underwent three restructures.
 
“I found that moving to the geographic model of the area health care was supported by the participants in my study.  I examined the political rhetoric surrounding cost savings being redirected back to rural health services and themes related to the lack of regard for people and poor treatment of staff during the change management processes leading to loss of expertise from the rural workforce.
 
“The participants in my research also highlighted the cultural connection between rural people and their hospitals and health services have been shown to be something to which city-based bureaucrats and politicians are blind,” Professor McAlpin said.
 
“Without an awareness of this important part of rural life and connectivity, the long-standing loyalties can be inadvertently de-valued and demolished.
 
“The evidence from my study supports other local and international studies of the limited financial benefits achieved through organisational restructures in health. The high cost of the disruption and displacement for staff must be considered ahead of health reform.”
 
Implications for current Commonwealth health reforms
 
“The health inequities faced by people living in rural communities cannot be addressed alone by an improved hospital system,” the CSU academic said.
 
“The proposal to devolve decision making for local health service delivery from centralised bureaucracies will see a positive change from the city-centric models of healthcare being forced on rural areas. Metropolitan health departments fail to recognise the value rural people and communities place on their local health service.
 
“Policy makers must assess the management capacity of health services in planning any organisational reform. While clinical workforce issues have long dominated rural health policy, recognition must be given to the recruitment, retention and sustainability of skilled management.”
 
Graduation in Wagga Wagga
 
Professor McAlpin will graduate from 10.30am on Friday 16 April in Joyes Hall, Pine Gully Rd, CSU in Wagga Wagga. During the same ceremony, Professor McAlpin’s former students will be awarded their Bachelor of Health Science (Nutrition and Dietetics).
 
Professor McAlpin is Associate Head of the School of Dentistry and Health Sciences, Accredited Practicing Dietitian, Board member of the Riverina Division of General Practice and Primary Health, executive member of the NSW Institute of Rural Clinical Services and Teaching, Director of the International Rural Network, Chair of the National Rural Health Alliance from 2004 to 2006, Board member of the Australian College of Health Service Executives 2005 to 2009.

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