Health and hospital reform in Australia--a local health district's perspective.

Health and hospital reform is not new on the international stage. Increasing demand for health care services due to aging populations and the increased burden of chronic disease, continued advances in medical technology (including the rapid expansion of information systems) and ever growing community expectations mean that the health care expenditure of most health systems is growing at a rate greater than GDP (OECD 2008). Most countries appear to be grappling with how they can create a sustainable health system for the future. This article provides an overview of reform occurring within the Australian and New South Wales (NSW) Public Healthcare Systems, which includes devolution to Local Health Districts, a smaller and more focused Ministry of Health, increased transparency and funding reform. The article examines the challenges this reform presents for Local Health Districts and how these challenges are being addressed locally. This reform has also highlights the competencies that are required of chief executives and other senior executives in health in managing and leading these complex health organizations.