One complex diagram, buried in evidence to the hotels inquiry, reveals why the Department of Health and Human Services needs a total restructure, writes Lindsay Grayson, professor of infectious disease at the University of Melbourne | COMMENT
Second, the recent and begrudging call for help by DHHS in which a number of senior infectious diseases clinicians have volunteered to be seconded from their hospitals into Lonsdale Street has shown the value of medical knowledge and expertise in a structure dominated by non-medical career bureaucrats.Pre-COVID-19, Victoria had only seven doctors working at DHHS – for a population of 6.7 million – roughly one doctor per million.
At a minimum, it needs to be divided into two – health and, separately, human services. The health structure should look to NSW for a robust, well-funded, hub-and-spoke model where regional public health units can rapidly respond to local outbreaks, recognising they have enhanced local “on-the-ground” knowledge , but where they are guided by standardised statewide policies and procedures.
In this model the CMO commands over an integrated health team that includes the chief health officer , plus separate experts in key areas such as hospital-based healthcare, quality and safety activities, HIV, vaccination policy and insect vector control. By incorporating these two structural changes, Victoria would have a system far better able to respond to outbreaks in a coordinated, effective manner than has been evident with COVID-19.
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