Primary Health Networks and Local Health Districts

The report focused on the newly introduced primary health networks which are meant to replace the local medical care systems. The research looked at the coverage of the PHNs in the New Wales State and established that the new arrangements entirely covered the region. The study then looked at the comparison between the local health districts and the primary health networks on the basis on budget, functions, and accountability.

Running head: PRIMARY HEALTH NETWORKS AND LOCAL HEALTH DISTRICTS 1
Primary Health Networks and Local Health Districts
Student’s name
Professor’s name
Institutional affiliation

PRIMARY HEALTH NETWORKS AND LOCAL HEALTH DISTRICTS 2
CONTENT PAGE
Table of Contents
1.0 EXECUTIVE SUMMARY...........................................................................................................................3
1.1 Introduction...........................................................................................................................................4
2.0Primary Health Networks.......................................................................................................................4
3.0 comparison between PHNs and the local health districts.......................................................................5
1. The budget.......................................................................................................................................5
2. Functions.........................................................................................................................................6
3. Accountability.................................................................................................................................7
4.0 primary health networks vs. local health districts..................................................................................7
5.0 Possible challenges to face the primary health networks.......................................................................8
6.0 conclusion..............................................................................................................................................8
7.0 recommendations...................................................................................................................................9
8.0 References...........................................................................................................................................10

PRIMARY HEALTH NETWORKS AND LOCAL HEALTH DISTRICTS 3
1.0 EXECUTIVE SUMMARY
The report focused on the newly introduced primary health networks which are meant to replace
the local medical care systems. The research looked at the coverage of the PHNs in the New
Wales State and established that the new arrangements entirely covered the region. The study
then looked at the comparison between the local health districts and the primary health networks
on the basis on budget, functions, and accountability. The study found that the budget disparity
between the two systems is not significantly great but that the local health districts demand a
larger budget. The report also shows the contrast between the local health districts and the PHNs.
The difference is established to be regarding management, the scope of operations, community
involvement, and disease coverage. Furthermore, the report records the likely challenges that
may affect the PHNs in NSW which include corruption from the private organizations, inequality
in service delivery, and the ability to cater for the people living in the remote areas of the region.
The report ends by offering recommendations to improve the new regime which included; the
involvement of the NSW ministry of health, the formation of a management board composed of
individuals with managerial skills, a collaboration between the PHNs and the local health
districts, and an expansion on the disease coverage by the PHNs.

PRIMARY HEALTH NETWORKS AND LOCAL HEALTH DISTRICTS 4
1.1 Introduction
The New South Wales (NSW) government via the NSW ministry of health has for some
time provided health services to the people using the local health districts in the region. The
NSW ministry of health facilitates the delivery of healthcare through sixteen local health
districts. The districts offer services over a wide range of settings which include primary care
stations located in the remote regions and the metropolitan health centers. The system involves a
network of specialists who deal with children and pediatric services. Also, there are specialists in
forensic mental health and custodial fitness. However, the Australian government in 2015,
introduced Primary Health Networks (PHNs) to improve patient care and to ensure that the
health care system in the nation is efficient and effective ("Primary health networks (PHNs),"
2018). The introduction of the health networks calls for comparison and critique relative to the
local health districts. The report will compare and contrast the two health systems looking at
different aspects to determine which is better.also; the report will offer recommendations on how
to improve the two systems to ensure effective and efficient healthcare delivery.
2.0Primary Health Networks
There are 31 PHNs established across Australia. The aim of the health networks is to
improve medical care for patients especially those vulnerable to unfavorable health outcomes, to
ensure that government money is allocated where it is most needed and on health programs that
are more efficient, to enhance the connections between hospitals and local health services to
ensure that the patients receive health services at the right time and in the right place (Rørtveit,
2014). The primary health networks work hand in hand with local hospital networks and operate
under the same boundaries as the local hospital networks.

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New South Wales has the PHNs covering the entire region, from the central and eastern Sydney
to the western Sydney to the south-western Sydney and the north coast. The PHNs have replaced
the Medicare locals in the region, and there is likely hood of healthcare improvement. However,
there is a need to evaluate the differences between the primary health networks and the local
health district. Comparing and contrasting the two systems will show the potential benefits and
possible consequences of the primary health networks on the NSW government and the people.
3.0 comparison between PHNs and the local health districts
1. The budget
Like all government projects, the primary health networks and the local health districts
require money allocations to ensure that health care services are efficiently delivered to the
patients. The Australian government released the 2017-2018 health budget in which it provided
for the PHNs. The PHNs were allocated $80 M throughout four years to be utilized for
community mental health services. The service (psychosocial support) is aimed at assisting
people with various mental illnesses who do not qualify for insurance coverage. Furthermore, the
PHNs will receive over $145 M to facilitate after-hours primary health care. Also, about $8M is
allocated to the PHNs to be administered for about three years to cater for home-based palliative
care ("Summary of 2017-18 budget health announcements", 2017).
On the other hand, the NSW ministry records a $1.9B to cater for mental health in the
2017-2018 financial year. Also, an extra $20M was allocated to the local health districts to aid in
the implementation of the NSW reforms on mental health. Other budget additions for the local
district hospital included $23M to facilitate an increase in services for the admitted and non-
admitted psychiatric patients, $10.6M to ensure the continuity of Port Macquarie Hospital of
Mental Health. Furthermore, there is approximately $1B to enhance paramedics services who

PRIMARY HEALTH NETWORKS AND LOCAL HEALTH DISTRICTS 6
provide relief in NSW. The budget also caters for ambulance and helicopter retrieval services
that will incorporate doctors and paramedics in all flights ("Record $1.9 billion budget for mental
health - News", 2017).
2. Functions
The primary health networks focus on the needs of the local community as well as on
issues deemed by the government as important. They focus on cancer control, dementia, arthritis,
asthma, and diabetes. The PHNs conduct research on the health needs in a particular region. The
findings of the research help point out the vulnerable groups of people who require more
resources and services thereby aiding the PHNs to customize health services in line with the
people’s needs. Also, the PHNs implores the external health providers to offer extra services
such as; after-hours services, health promotion programs, collecting information regarding
children immunization, and mental health services (Booth & Boxall, 2016).
The Local health districts, on the other hand, have their share of responsibilities. They
are tasked with clinical governance which involves patient safety management, patients’
complaints management, and clinical risk management. Also, they provide nursing services and
ensure that nurses are deployed to all stations. The local health district also engages with the
community to find out more on the community health needs that require an immediate response.
They are also responsible for the transfer of patients to higher level care facilities, managing the
trauma centers as well as facilitating ICU retrieval("Key functions of each NSW Local Health
District - LHD Boards," 2017).

PRIMARY HEALTH NETWORKS AND LOCAL HEALTH DISTRICTS 7
3. Accountability
A board of medical professionals manages the PHNs. The board is advised and guided by
a clinical council together with the community-based advisory committee. The council of
clinicians is composed of nurses, general practitioners, indigenous health workers, and
specialists. The community committee is made up of patients, caregivers, and interested health
consumers. However, the board of medical professionals is accountable for the allocation of
funds and ensuring prompt and effective service delivery. On the other hand, the local health
districts are under the ministry of health. The NSW ministry of health manages all the 230
hospitals in the region ("Our structure - NSW Health," 2018). Therefore, the health minister is
accountable for the management, budgeting, and allocating funds in the local health districts.
4.0 primary health networks vs. local health districts
The primary health networks cover a broader scope of health care that the local health
districts. The PHNs provide essential services such as after-hours services which the local health
districts failed to consider. New Wales State (NSW) stands a better chance at improving health
services through the PHNs. The local health districts were more institutional oriented and thus
focused more on the development of the hospitals. Such orientation denies the health providers
the chance to engage the community and establish the groups that need more medical care. Also,
the PHNs focus on the health of the population in their regions thereby establishing the needs of
the regional level to decrease the poor health outcomes (Booth et al., 2016).
However, despite the community involvement in the PHNs, the system lacks proper
management. While the local health districts are managed by the ministry of health which is
composed of different personnel with management skills, the PHNs are governed by a board of

PRIMARY HEALTH NETWORKS AND LOCAL HEALTH DISTRICTS 8
health professionals. Such individuals lack management training and thus could lead to
misappropriation of funds. Furthermore, local health districts deal with a variety of ailments
compared to the primary health networks. The local hospitals in new wales state are equipped
with facilities to treat a broad range of diseases. PHNs on the other hand deal with limited
disorders and focus mainly on researching the needs of the community.
5.0 Possible challenges to face the primary health networks
The implementation of the PHNs is likely to have a few obstacles in the New Wales State. For
instance, the introduction of private firms into the primary health sector is bound to bring
transparency, governance, and policy issues which may impede positive changes for the people.
Problems relating to accountability and tender are likely to arise due to the involvement of the
private sector ("Primary Health Networks: key questions and challenges - Croakey," 2015).
The new arrangements also difficulties in ensuring that the new organizations deliver efficiency
and improved healthcare especially to the remote part of NSW where the people are more
vulnerable to disease (Perkins, 2015). Social inequality is a possible challenge for the new
regime. The PHNs involve working with a vast population characterized by poor people with
different needs. Such a condition may force the organizations involved to favor one group over
the other due to the varying needs.
6.0 conclusion.
Overall, the PHNs promise efficiency and improved healthcare to the community. Unlike the
local health districts, the PHNs are independent and are funded directly by the national
government. The New Wales State is likely to benefit from the new regime since the primary
networks engage the community and offer services to the remote areas of the region why the
local health districts failed to rich. However, the PHNs is likely to face accountability issues

PRIMARY HEALTH NETWORKS AND LOCAL HEALTH DISTRICTS 9
since the personnel charged with overseeing the new arrangements lack managerial skills. The
inclusion of the private sector offers an opportunity for improved service delivery but also
introduces the threat of corruption in tender allocations.
7.0 recommendations
The following recommendations could be applied to improve the efficiency of the PHNs
 Formation of a management board that oversees the distribution of funds.
 Invent strategies that link the PHNs to the local health districts to ensure
collaboration which would ensure efficiency in health care efficiency
 Collaboration efforts with the NSW ministry of health should be encouraged to
aid in research and medical facilities.
 There PHNs should expand on the range of diseases covered to ensure that the
networks cover all the community’s needs.

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References
Booth, M., & Boxall, A. (2016). Commissioning services and Primary Health
Networks. Australian Journal Of Primary Health, 22(1), 3. doi: 10.1071/py15167
Booth, M., Hill, G., Moore, M., Dalla, D., Moore, M., & Messenger, A. (2016). The new
Australian Primary Health Networks: how will they integrate public health and primary
care?. Retrieved from
http://www.phrp.com.au/issues/january-2016-volume-26-issue-1/the-new-australian-
primary-health-networks-how-will-they-integrate-public-health-and-primary-care/
Perkins, D. (2015). Primary Health Networks: Towards commissioning for outcomes. Australian
Journal Of Rural Health, 23(4), 193-194. doi: 10.1111/ajr.12226/
Primary health networks (PHNs). (2018). Retrieved from
https://www.healthdirect.gov.au/primary-health-networks-phns
Summary of 2017-18 budget health announcements. (2017). Retrieved from
https://www.ntphn.org.au/news/summary-of-2017-18-budget-health-announcements
Record $1.9 billion budget for mental health - News. (2017). Retrieved from
https://www.health.nsw.gov.au/news/Pages/20170620_04.aspx
Key functions of each NSW Local Health District - LHD Boards. (2017). Retrieved from
https://www.health.nsw.gov.au/lhd/boards/Pages/key_functions_of_lhdboards.aspx
Our structure - NSW Health. (2018). Retrieved from
https://www.health.nsw.gov.au/about/nswhealth/pages/structure.aspx

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Primary Health Networks: key questions and challenges - Croakey. (2015). Retrieved from
https://blogs.crikey.com.au/croakey/2015/03/02/primary-health-networks-key-questions-
and-challenges/
Rørtveit, G. (2014). Research networks in primary care: An answer to the call for better clinical
research. Scandinavian Journal Of Primary Health Care, 32(3), 107-109. doi:
10.3109/02813432.2014.943981