South Australia's huge department takes on big challenge; confronts critics during and after Transforming Health
The headquarters of the state government's biggest department, SA Health, near Hindmarsh Square in Adelaide city.
South Australia’s biggest government department SA Health had the task of bringing in the state Labor government’s Transforming Health vision and then overseeing its dismantling as a concept under the Liberal government elected in 2018.
During both phases it had to face the criticism of of interest groups such as the South Australian Salaried Medical Officers Association (doctors working in hospitals), the Nursing and Midwifery Federation, the Australian Medical Association, individuals such as Warren Jones, an emeritus professor at Flinders Medical Centre, and, increasingly, South Australian Ambulance Service employees.
Vicki Kaminski was brought from Canada to lead Labor’s Transforming Health project. At her exit in 2018, Kaminski said about 70% of Transforming Health goals were achieved and the new Liberal government would have to do more, with South Australia having one of the most expensive cost-per-head health systems in Australia.
On the plus side, South Australians had the second highest availability and access to GP doctors in Australia. It also had the equal highest hospital beds in public hospitals per person of Australian states and territories, 8% more beds per person than the national average, and more nurses per capita than any other mainland state. But in 2016 South Australia was ranked sixth of all states and territories for the longest waiting times for emergency treatment.
The state Liberal government started its promised remedy by appointing a new head of SA Health, Chris McGowan, while five other senior executives were replaced. The new administration faced the same funding and demographic crunch with the state heading towards health taking up 50% of government spending in about 2030. Australia’s oldest population and mental health were among factors threatening to overwhelm resources.
SA Health had taken over from South Australian Health Commission, created in 1975, that replaced the hospitals department. SA Health, the name adopted in 2007, integrated the state government health department and all its networks and agencies. It had 26,942 medical staff and 13,590 administrative workers in 2015. It was concerned with health reform, public health, medical research, developing policy and focus on wellbeing, prevention, early intervention and quality care.
SA Health covered the state government ministries of health, mental health and substance abuse and ageing. Linked to the department of health and ageing were the Central Adelaide, Northern Adelaide, Southern Adelaide, Women’s and Children’s, Country Health SA local health networks and the South Australian Ambulance Service.
SA Health services included public hospitals, metropolitan and country health, environmental health, communicable disease control, epidemiology, health promotion, pathology services, drug and alcohol services, emergency and ambulance, and organ donation. South Australians also were not accessing primary health care such as general practitioners as much as previously. Chronic conditions also were a significant burden in health, social and economic costs.
Promoting healthier weights, reducing smoking and improving the health of people with chronic conditions were targets of South Australia’s strategy alsong with the health of Aboriginal. Wellbeing SA was started in 2020 as an agency attached to the South Australian government’s health and wellbeing department. It had a five-year goal to lead the system change, supporting health and wellbeing and embedding disease prevention.
