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The Future of the Repatriation General Hospital
Should RGH remain a small stand-alone hospital or merge with the SAHS?

The purpose of this paper is to provide a basis for Ex-Service Organisations to conduct their own examination of the present and future status of Repatriation General Hospital, Daw Park.

The Federal Government, through the Repatriation Commission/DVA, has a clear responsibility to care for serving soldiers and veterans. Since DVA ceased funding and became a purchaser of community-based services, it is the States' who administer the means of delivery.

The Government of South Australia has indicated its intent to change governance arrangements in order to achieve a more integrated health service by moving to a 'departmental' model where the Chief Executive (CE) of the Department of Health will be accountable to the Minister and hospital CEOs report direct to the CE.

In 1995, the Repatriation General Hospital was transferred from the control of the Repatriation Commission to become a public hospital administered by the State Government, although it retained its special relationship with the veteran community. Some years later, the Repatriation Commission severed its exclusive relationship with the former Repatriation Hospitals across Australia when it issued most veterans with the Gold Cards that allowed them a wide choice of service providers. The choice of Private Hospitals has recently been widened.

RGH remains a stand-alone hospital administered by a Board of Management, which includes a Veterans' Representative appointed by the Minister. Although, in theory, the present governance model provides for the Board to manage independently, latitude for independent action is severely limited by requirements to conform with government and departmental policy and financial strictures.

The Draft Health Care Bill 2007 provides an opportunity for veterans to participate in a Veterans' Health Advisory Council (HAC) that will enable them to advocate for and advise on services to veterans wherever they may be delivered in the health system, not just RGH. The composition, charter and resources for the VHAC have yet to be determined. Generic rules for HAC are at: www.health.sa.gov.au

Given the SA Government intent to integrate health service delivery and change hospital governance, under present arrangements RGH as a small stand-alone hospital will become increasingly isolated from professional forums, mutual cooperation and shared assets. RGH, FMC and Noarlunga Hospital have already found an operational necessity to share assets, services, human resources, and dual professional staff appointments vide an MOU.

Although the Minister has made it clear that RGH is not expected to migrate to the new governance structure unless the veteran community supports such a change, the time has come for veterans to review their position. Many more important improvements to structure, governance, collaboration and consultation will soon be announced. It is very important that veterans are represented on various forums within the new broader SA Health, MH and Aged Care structure. The Minister has provided opportunities for veteran participation by provision for a VHAC. The Government's intent and opportunities for veteran participation should not be ignored.

Detailed points, together with professional medical and managerial advice are available in the CC of ESO Discussion Paper 2006. 'The Future of the Repatriation General Hospital'.

The Consultative Council of ESO is working hard to address Health, MH and Aged Care issues. We have consulted with Ministers and their advisors to ensure that veterans' needs are included in planning at all levels as SA develops Health, MH and Ages Care Service Delivery on a State-wide integrated basis. We are presently working to progress two major proposals for veterans' Social Inclusion. They are:

. that serving soldiers, veterans and their families living in SA should be considered as and included as a
'special needs group' because their conditions of service and the effects of their active service on war and
war-like deployments set them apart from members of the general community and cause special needs
among them; and

. that the Government SA create a Portfolio of Veterans' Affairs under the auspices of the Premier of SA.

During future negotiations with SA Ministers and their advisors, questions related to the future of RGH will be considered along with a list of issues of concern to the veteran community. Our side will put a case for the following:

. An SA Veterans' Act, similar to the Victorian Veterans' Act tailored to SA conditions;

. Appointment of a SA Minister for Veterans' Affairs;

. Establish SA Veterans' Council to work direct to the SA Minister for Veterans' Affairs;

. Establish SA Veterans' Patriotic Fund;

. Development of SA Health, MH and Aged Care Plans to include provision for veterans' special
and specific needs, including specific targets for Aboriginal Ex-Servicemen and their families;

. Establish SA Veterans' Health Advisory Council (VHAC) as part of SA Health Plan;

. A Capital Funding Program over 5 years for RGH; and

. Veteran participation in any SA/DVA negotiations over funding.

The RGH Board has already indicated a strategic intent for RGH to merge with the Southern Adelaide Health Service (SAHS). The consequence of merging with SAHS under new governance arrangements is that RGH will move into the new 'Departmental' model and the Board will be dissolved.

Should RGH remain a small stand-alone hospital or merge with the SAHS?

Approach to Consensus

The Consultative Council, as the peak body, intends to apply the following process:
. Issue of this paper to Ex-Service Organisations for their consideration and to allow time for them to formulate their positions;
. Meeting of Ex-Service Organisations' representatives, to be sponsored by the Consultative Council;
. Consultative Council to begin negotiation with State Government (with advice to DVA and RGH);
. Report back to Ex-Service Organisations on outcome of negotiations and formulate final veteran position
(March/April 2008).

Enquiries and comments from ESOs are welcome.

Contact Norm Bell, Project Officer on 8322 2438.

Laurie Lewis



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Last modified: Tuesday October 23, 2007  DISCLAIMER