The decentralisation of the State public sector health services through the establishment of a regional structure to administer public health services in Queensland was the most ---significant large-scale-reorganisation change in the history of the public health industry in the State. The major requirements of this reorganisation centred on the abolishment of the State's fifty-nine (59) Hospitals Boards with thirteen (13) Regional Health Authorities, having overall responsibility for all public sector health care service delivery at the regional level.
This new structure under the revamped Hospital Services Act 1991 represents a shift in focus away from Queensland Health's Central Office in Brisbane to decentralised and largely managerially autonomous regions. The adoption of the principles and practices of the State Government Treasury's Program Management Structure provided under the Public Finance Standard 310 has increased the accountability of the Regional Director.
The reorganisation of the forty-year old centralised public sector health care system involved a significant downsizing of the Brisbane Central Office, payment of voluntary redundancies, the establishment of Regional offices and the relocation of personnel to these offices. Transformative change was necessary to keep pace with the rapid changes in the business environment, spiralling health costs and the depressed Australian economy, and more importantly, for organisation's survival.
Some 33,000 employees, including Hospitals Boards' members were directly affected by this large scale organisational change in one form or another. This case study examines the impact of Regionalisation and the restructuring process of a public sector health organisation on its employers, employees and patients/clients. A critical analysis of the agency's restructuring process is undertaken from personal observations and insights using Kanter's Big Three Change model as a comparative tool.