NSW Health faces major overhaul as Inquiry set to deliver final report

After more than 200 submissions from various stakeholders, the Special Commission of Inquiry into Healthcare Funding in NSW is set to hand down its final report to the Governor on or before 24 April 2025 – a development that could have significant ramifications for the state’s healthcare system.

Established in 2023 by NSW Premier Chris Minns as a central plank of his election platform, the Inquiry was largely driven by calls from the Health Services Union (HSU) to address alleged waste within the public health system. At the forefront of these demands was the controversial push to limit or entirely end the use of Visiting Medical Officers (VMOs), a position that has sparked heated debate across the sector.

Richard Beasley SC, appointed as Commissioner, was granted an extension to deliver the final report, which is expected to reveal much about the future direction of healthcare funding in the state.

The Inquiry’s scope is sweeping, with a close examination of the structure of Local Health Districts, the governance and accountability frameworks within NSW Health, and the distribution of funding to both public hospitals and primary care services.

Rising costs and waste within the system are also under intense scrutiny. However, a significant focus has been whether the current funding model places too much reliance on hospital-based emergency departments, potentially leaving primary care services underfunded and overstretched.

Former AMA NSW president and GP Dr Michael Bonning has been vocal in his criticism of the Inquiry, claiming that the real driving force behind it is the HSU’s own agenda that is “specifically about taking money out of the parts of the health system where clinical care is delivered and moving it into other parts of the system”.

In December, final submissions and recommendations were published, with responses from major players like NSW Health and the Australian Medical Association (AMA NSW) filing in reply. The Commission then held its final hearings, during which NSW Health Secretary Susan Pearce and Deputy Secretaries Alfa D’Amato and Phil Minns provided evidence.

The AMA (NSW) has expressed cautious optimism about the Inquiry’s progress, with the organisation noting that “many of the inquiry’s draft recommendations address matters raised by AMA (NSW), such as the need for reform of VMO and employed doctor arrangements, the need for greater doctor involvement in decision-making, a review of the Model By-Laws and the role of Medical Staff Councils, a recommendation for an avenue of external review of workplace investigations and greater Ministry of Health oversight of complaints processes.”

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