Academic journal article Australian Health Review

Let's Talk Governance

Academic journal article Australian Health Review

Let's Talk Governance

Article excerpt

AS THE Letters to the Editor illustrate, governance, both good and bad, can influence the effectiveness of the health care system. As reported by Dr Playford and her colleagues (page 6), the health workforce and educational leaders in Western Australia suggested our lack of effective interprofessional education required a "good" governance solution - the government needed to fund, plan, implement and monitor interprofessional education. On the other hand, Dr Ranmuthugala suggested that the continuing stream of health care crises was a direct result of our apparent inability to take a systems approach (page 5), which could be argued is a symptom of "bad" governance.

This issue launches a new section on Health Care Governance. According to Wikipedia, most simply put, "Governance consists of assuring, on behalf of those governed, a worthy pattern of good while avoiding an undesirable pattern of bad". Therefore by definition, health system governance would focus on planning, implementing and evaluating the necessary structures and processes to maximise good health outcomes and minimise the bad or adverse outcomes. But for some reason in health care our governance of the system, the organisations and the individual providers was not seen to be effective in promoting good clinical outcomes and limiting bad clinical outcomes. This necessitated the introduction of "clinical governance" in the 1990s. Braithwaite and Travaglia track the progression of clinical governance in the first Health Care Governance paper (page 10). In addition, Johnstone and Geelen-Baass present a paper on business continuity - an important concern of all governing bodies (page 16J).

We know that the Australian states and territories have taken different approaches to health system governance. We have centralised governance with direct lines of accountability to the health department and Minister. We have population-based area health governance models. …

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