‘Devolved responsibility’ is a sad fact of the public/private partnership says Northern Sydney LHD executive director of clinical governance.
Northern Beaches Hospital’s clinical governance procedures are different to those observed across the rest of Northern Sydney LHD, according to Mark Zacka, the district’s executive director of clinical governance.
The hospital was established in 2018 as a public/private partnership between the NSW Ministry of Health and national private hospital provider Healthscope. The company is currently undergoing auditing via the NSW Audit Office over its pledge to establish a four-bed acute paediatric mental health unit, with $7.5 million in funding provided by NSW Health for the project.
Appearing before the NSW Special Commission into Healthcare Funding today, Mr Zacka said organisations such as Healthscope were not automatically required to comply with the district’s clinical governance policies and procedures.
“It would be specific to the contract, and in the absence of seeing those I can’t tell you confidently [that compliance is required],” Mr Zacka told the commission.
“It might be that they wouldn’t observe our policies and procedures, without referring to Northern Beaches, that certainly is the case with Northern Beaches.”
With regards to the district’s role in overseeing clinical governance and quality performance adherence at Northern Beaches Hospital, Mr Zacka said governance was a “devolved responsibility” shared across several stakeholders, including the LHD, with governance and improvement initiatives largely led at a more “local” level.
“[Regarding Northern Beaches], our executive team meets with their executive team on a monthly basis specifically to look at all the performance elements, be they operational, financial, people and culture,” he said.
“Like all our facilities, it’s a devolved responsibility, and things go wrong sadly, over time, varying in severity, so a lot of their business in managing things happens locally.
“When things have really harmed somebody or they’ve really harmed somebody, that would be more of an instance where [the LHD’s clinical governance team] might get involved.
“Sometimes the patient may have been managed, as an example, both [at] Northern Beaches and somewhere else within our health service. In that circumstance it might require a joint investigation.”