Briefing for the 2026 Health Debate

Restoring Victoria's Patient Safety Capability: Briefing for the 2026 Health Debate (PDF, 4 pages)

I am not aligned with any party. This is to provide transparency about the challenges and opportunities to improve the safety and quality of care in the Victorian health system in the next term of government.

The detailed report, Bacchus Marsh Lessons Forgotten: The False Economy of Cuts to Victorian Patient Safety, references every factual claim to a public source. In short:

• Of 217 sentinel events in 2024–25, only 26% were notified within the required three business days, and reviews averaged 79 and 106 business days against standards of 50 and 75.
• Mandatory quality accounts, the main public report on each hospital's safety, have been permanently ceased.
• Safer Care Victoria can review and recommend, but cannot direct a health service. Since Djerriwarrh in 2015, I could find no public example of formal intervention because a hospital was an outlier on deaths or complications, yet budget requirements have been issued to every board in writing.
• The savings being sought from oversight and support functions are small beside the cost of avoidable harm. The public hospital medical indemnity premium alone has risen 26.4% to $380.9 million this year.

Both major parties have proposed restraint in "back-office" public service roles: the government through planned department staffing reductions, and the Coalition through a back-office hiring freeze. In health, many of those roles are the people who detect harm.

Questions for representatives in the next Victorian parliament

• 1. Acknowledging the problem
  • 1.1 Do you accept that, since the initial improvements resulting from Targeting Zero, successive restructures and budget cuts have weakened Victoria’s capacity to detect, investigate and respond to patient harm, and are reintroducing the patient risks identified in the Targeting Zero report?
  • 1.2 Will you recognise that safety and quality, clinical governance, incident review and clinical analytics staff are part of clinical care teams, not “back office”, in savings targets, VPS review implementation and “live within budget” directions to boards?
  • 1.3 Do you accept that further cuts to these functions risk repeating the failures found at Bacchus Marsh?
  • 1.4 An independent review of the implementation and long-term outcomes of Targeting Zero, incorporating the VAGO findings and taking account of the current health and fiscal environment and the VPS and health system structure, may be of benefit in identifying the challenges and opportunities to improve safety and quality for the community through improved detection, investigation and response capability across the health system. Would you initiate and/or support the commissioning and unconditional release of such a review?
• 2. Key issues and priorities
  • 2.1 Which of the identified issues would you prioritise, and what will be in your first budget?
  • 2.2 The national safety commission found departmental meetings “concerned themselves primarily with budget and activity data” (ACSQHC). Targeting Zero warned that a focus on financial targets can drive “critical understaffing and a neglect of safety and quality”, and told the department to “cease to aggregate quality and safety with the financial and access dimensions of performance” (Targeting Zero, p. 84). The Auditor-General found that the separate safety and quality performance framework Targeting Zero called for had not been enacted (VAGO). If health service boards’ statements of priorities and the Department of Health’s own actions do not prioritise safety and quality, health services are unlikely to do so either. How will you ensure safety and quality outcomes are given similar prioritisation to meeting financial and activity-based targets in the next term of government?
  • 2.3 Will you exempt statewide and health service safety and quality functions from further savings targets and separation packages?
• 3. Restoring, maintaining and increasing core capability
  • 3.1 Will you return the Chief Medical, Nursing and Midwifery, Allied Health, Mental Health Nursing and Paramedic officers to Safer Care Victoria, reporting to its CEO with direct safety oversight roles, as Targeting Zero recommended?
  • 3.2.1 Will you restore resources for the Data Request Hub to service government agencies external to the Department of Health, health services and researchers?
  • 3.2.2 Will you review the requirements of existing DH eHealth, shared government IT support providers and consultancies, to meet health system safety and quality monitoring and analytical requirements?
  • 3.2.3 Will you review the impact of the restructure on VPS epidemiological and health data analytical expertise within the Department of Health and the safety and quality agencies, and where recommended, restore resources to support in-house epidemiological and analytical expertise within safety and quality agencies?
  • 3.3 Will you fund linked, statewide surveillance of severe maternal morbidity, so that safety and quality teams and health services are resourced to learn from serious harm and improve care?
  • 3.4 Will you legislate Safer Care Victoria and the health information agency as statutory bodies independent of the department, with protected budgets and the power to publish?
  • 3.5 Will you ensure evidence-based funding for health service safety and quality teams, and reinstate public quality reporting, so that harm is found and acted on locally?

Any response from a party will be published here in full, word for word. I would welcome the chance to brief any party or its staff.

A/Prof J. Oliver Daly