Governance of Local Health Districts

The main roles, responsibilities and relationships between Local Health Districts (LHDs), their Boards and the Ministry of Health are clear and understood, according to a report released today by the Auditor-General for New South Wales, Margaret Crawford. However, there are opportunities to achieve further maturity in the system of governance and the audit report recommended a series of actions to further strengthen governance arrangements.

LHDs were established to deliver greater local decision making, including better engagement with clinicians, consumers and local communities, as well as other stakeholders in the primary care and non-government sectors.

Clinician engagement has not met expectations and requires attention as a priority. A statement of principles to guide decision making in a devolved system is also needed.

Accountability and oversight mechanisms, including the Health Performance Framework and Service Agreements, have been effective in supporting a cultural shift that supports LHDs being held to account for meeting their obligations.  

Further information

Barry Underwood, Director, Office of the Auditor-General, on 0403 073 664 and email