 The announcement came after the State Government had commissioned La Trobe University's Health Management Group to prepare a report entitled A Review of Victorian Paediatric Services.
This was one of a number of studies the Government commissioned to coordinate and integrate services to give children the best possible start in life.
'The appointment of such a minister was totally consistent with the recommendations we made in the review advocating more coordination and a whole of government approach to child health,' says one of its principal authors, La Trobe senior lecturer in Health Services Management, Dr Sandra Leggat.
The Cluster Leader for La Trobe University Health Services Management, Associate Professor Judith Dwyer, Dr Tony Cull, who since publication of the review has become executive director of the Royal Children's Hospital, and Dr Leggat prepared the review for the Department of Human Services.
Its purpose was to provide information on which the Metropolitan Health Strategy and the Victorian Rural Human Service Strategy could be based. Dr Leggat said that the most important finding in the review was the lack of a co-ordinated system for child health in Victoria.
'We found that Victoria is far behind other States in thinking about child health and for this reason we recommended that the Government adopt a total child health focus,' Dr Leggat said.
The review found that Victoria had a range of appropriate, quality services for children and adolescents, particularly in acute hospital and community-based early childhood services. But it pointed out that there were major gaps in service coordination, rehabilitation and chronic care services for children and adolescents.
'Victoria has a rather old fashioned outlook on child health in that it spends resources looking for people who may have problems rather than developing coordinated services covering the whole spectrum of child health. This results in many gaps in our health service system for children,' Dr Leggat said.
'There is limited focus on community paediatrics. This gap appears to have limited the ability of the system to develop coordinated services to respond to the kinds of illnesses now more prevalent.
'Although we have known about the 'new morbidity' in child health for many years, with a change from infectious diseases to conditions more associated with early childhood and lifestyle, our system has been slow to respond. This is because our system is hospital rather than community based,' Dr Leggat said.
In one of its major criticisms, the review said that in the acute sector, service development was focused on inpatient beds. Today child health required refocusing on outpatient and ambulatory services and a broad capacity in paediatrics.
It appears these funding constraints have limited the development of a comprehensive package of care for children and adolescents throughout Victoria.
Another major problem discussed in the report is the transition from adolescent to adult services. For example there are 21-year-old patients with chronic diseases still being treated at the Royal Children's Hospital. 'The system needs to ensure transition is available when required,' it said.
Another is the lack of differentiation in emergency care between adults and children. Emergency departments of major hospitals have staff and facilities often unsuitable for the needs of children.
The review found that many children's health services were fragmented and uncoordinated, suggesting lack of planning and service integration needed for a responsive child care health system.
It also pointed to a significant shortage of paediatric-trained allied health practitioners and a possible future shortage of paediatricians and nurses specialised in paediatrics.
The authors of the review applauded the appointment of Sherryl Garbutt as the new Minister for Children, with an Office for Children to be established in the Department of Human Services.
They say the evidence has been clear, that children are given the best start in life through a focused, coordinated approach to service planning and delivery.
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