Department of Health and Aged Care must show leadership regardless of 'minister of the day': Australian Public Service Commission capability review

The findings come from an independent capability review of the department, released on Friday morning.

The first capability review of the agency in almost a decade, the report was commissioned by the Australian Public Service Commission, as part of a pilot program.

The report cards, discontinued in 2016 after causing some controversy, have returned as an opportunity "to talk frankly about areas for improvement", Public Service Commissioner Gordon de Brouwer wrote in his foreword.

Former senior public servants Andrew Tongue and Larry Kamener conducted the review alongside Infrastructure deputy secretary David Hallinan.

The reviewers commended staff at the federal government agency for "extraordinary efforts" throughout the pandemic, noting a strong culture and an overall commitment by staff to making it a "good place to work".

But the health agency had failed to consistently play a leading role in major system reform of the health and aged care sectors, the report card continued.

It lacks capability in integrated policy development, which addresses the interactions between various parts of the health and aged care systems.

"This may be because previous ministers have not asked the department for this advice, and capability in this area may have declined," the reviewers wrote.

"However, the department should maintain system reform policy capabilities regardless of the needs of the minister of the day."

The review pointed to work on the National Medical Workforce Strategy, the Primary Care Reform Strategy and the reforms coming out of the Aged Care royal commission, as successful examples of this kind of leadership.

The agency must also develop its relationships with the five ministers it supports, with the review noting it "has been somewhat slow to respond to the new government's priorities".

"Ministers want the department to provide more forward-looking policy options and strategic advice," the report reads.

Reviewers impressed that the department had proven its ability to "get the job done" and react to emerging situations during the pandemic, but that it was now time to look ahead and focus on strategic policy development.

The review also noted findings published by the Australian National Audit Office in June that the Department of Health's administration of the Morrison government's $2 billion local health and hospitals grants was inappropriate and ineffective.

As the largest granting agency in the Commonwealth in terms of volume (distributing 17,934 grants in 2022-23, valued at $9.7 billion) "there is an opportunity for the department to improve its evaluation of grants".

"We heard commentary on the large number of grants, the challenges in maintaining relationships when different parts are managed by different people in different organisations, risks around automation and fraud, and the difficulty in evaluating grants and having ownership of the outcomes when not involved in all stages of the grant."

The reviewers noted steps already being enacted by the department to improve its grants program, including updating guidelines.

The review was conducted during the term of former secretary Professor Brendan Murphy, who retired in July. Blair Comley has since commenced in the role.

In his response, Professor Murphy expressed pride over staff's contribution to "Australia's world leading health outcomes".

"The department now has the opportunity to consider the government's ambitious reform agenda, and closely examine how to integrate policy and delivery in the acute care, primary care and aged care systems, and carer systems more broadly," he wrote.

"To achieve this, the department must work closely with state and territory governments."

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