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New South Wales regulation
What this Regulation does, mechanically
Key mechanical changes and rules (by topic)
Visiting practitioners (Part 2): Public health organisations that make a visiting-practitioner appointment available must advertise it in specified media (newspaper, affiliated employment website or the NSW Health jobs website) unless an exception applies (cl 5(1), (4)). Applications must be written, state the clinical privileges sought and authorise checks of past performance; applications are referred to the local medical and dental appointments advisory committee (cl 5(2)–(3)). Appointments must be by written agreement specifying conditions including clinical privileges (cl 6(1)–(2)). Appointments are for up to 5 years (cl 7(1)), with re-appointment eligible; teaching appointments and particular cases may have different terms and the Health Secretary can approve extensions up to 10 years (cl 7(3)–(4)). Resignation normally requires 3 months’ written notice (cl 8).
Transfer of accrued leave (Part 3): When employment moves directly between a non-declared affiliated health organisation (non-declared AHO) and the NSW Health Service (or vice versa) with continuity requirements, accrued leave balances transfer to the new employer (cl 10(1)–(2); cl 11(1)–(2)). Employees may instead elect to be paid the money value of accrued annual or long service leave (cl 10(3); cl 11(3)). There are caps on how much accrued annual leave may be retained (generally no more than 2 years’ entitlement unless approved) (cl 10(4); cl 11(4)). Liability for the cost of accrued annual or long service leave remains with the former employer: the non-declared AHO when the employee moves into NSW Health (cl 10(5)); the Government of New South Wales when the employee leaves NSW Health (cl 11(5)). Continuity rules do not apply where a section 64 order of the Act operates (cl 10(6)).
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Direct links to the current provisions in Health Services Regulation 2018.
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Ambulance Service staff conduct and reporting (Part 4): Applies to Ambulance Service staff (not the chief executive) and sets objects of protecting public health and safety (cl 12–13). Staff must report certain charges or convictions for serious sex or violence offences within 7 days and must report certain traffic offences or driving disqualifications immediately if driving is part of their duties (cl 16–17). Staff must report findings of professional misconduct under the national law within 7 days and provide a copy (cl 18). The chief executive must notify the Health Secretary within 30 days of a staff member’s conviction for a serious sex or violence offence; the Health Secretary must give the staff member an opportunity to make written submissions and may take disciplinary action having regard to clause 21 (cl 19(1)–(3)). The Health Secretary may transfer or reduce classification following misconduct (cl 20). The protection of patients, clients and children is the paramount consideration in disciplinary decisions under this Division (cl 21). The chief executive may delegate functions under this Part (cl 24).
Miscellaneous administrative provisions (Part 5): Maps certain Statistical Local Areas and Statistical Areas to local health district descriptions for Schedule 1 of the Act (cl 25). Sets appointment and removal processes for administrators (cl 26). Prescribes that certain newborn/paediatric transport services are exempt from s 67E for ambulance provision (cl 27). Prescribes specific concession cards that qualify for ambulance fee exemptions, with qualification limits for some DVA cards (cl 28). Declares quarantine services (as defined) to be a health service for the Act’s definition (cl 29). Provides for withdrawal of appeals under s 106 in an approved form (cl 30). Requires Samaritan Funds to be separately accounted for and restricts withdrawals to payments for patients in need (cl 31). Requires local health district boards to liaise with affiliated health organisations and Primary Health Networks (cl 32). Designates an outdoor public place at Albury Hospital as smoke-free (cl 33). Prescribes that government sector agency employees are a class of persons to whom local health districts may delegate functions (cl 34A). Repeals the 2013 Regulation and carries forward existing effects (cl 35).
Stated purposes and how they relate to mechanics
Who pays, who decides, and what behaviour changes
Who pays: liability for accrued leave costs stays with the former employer when staff transfer between non-declared AHOs and NSW Health: the non-declared AHO pays when the staff member moves to NSW Health (cl 10(5)); the NSW Government pays when the staff member leaves NSW Health for a non-declared AHO (cl 11(5)). Ambulance fee exemptions remove or limit fees for persons holding certain Commonwealth concession cards (cl 28), changing who bears ambulance costs in specified circumstances.
Who decides / exercises discretion: the Health Secretary has explicit discretion to exempt advertising/application requirements (cl 5(4)(c)), approve appointment periods beyond 5 years (cl 7(4)), receive notifications and determine disciplinary action (cl 19(1)–(3)), and local health districts may delegate functions to a prescribed class of public sector employees subject to the Act’s limits (cl 34A). Public health organisations decide appointment terms within the written-agreement requirement (cl 6(1)–(2)) and may waive resignation notice (cl 8(2)). The chief executive must act on reporting duties and may delegate functions under Part 4 (cl 16; cl 24).
Behaviour changes required: public health organisations must advertise visiting-practitioner vacancies in specified ways and process written applications through their advisory committee (cl 5). Staff in Ambulance Service roles must report charges/convictions and driving disqualifications promptly (cl 16–17). Employees moving between NSW Health and non-declared AHOs must meet continuity rules to transfer accrued leave (cl 10(1); cl 11(1)). Samaritan Funds must be separately accounted for and tightly controlled (cl 31).
Compliance burden, incentives, trade-offs and implementation risk (source-linked)
Administrative burden: advertising requirements for visiting practitioner vacancies and the written-application and referral process create ongoing administrative steps for public health organisations (cl 5(1)–(3)). Keeping separate Samaritan Fund accounts and meeting Ministerial directions on audits creates bookkeeping and potential audit costs (cl 31(2)–(3)). Mapping Statistical Areas to local health districts (cl 25) may require administrative updating where geographic classifications change.
Financial incentives and liabilities: the rule that the former employer bears accrued-leave liability concentrates the immediate cash cost on one party and reduces transitional fiscal exposure for the receiving employer (cl 10(5); cl 11(5)). The option to cash out accrued leave provides employees a liquidity choice but shifts fiscal payment timing (cl 10(3); cl 11(3)). The cap on retained accrued annual leave (2-year amount unless approved) limits large leave balances transferring without approval (cl 10(4); cl 11(4)).
Discretion and decision risk: several provisions give the Health Secretary or chief executive discretionary powers (exemptions, approvals, disciplinary decisions, delegations) which centralise decision-making and require internal procedures to manage consistency and review (cl 5(4)(c); cl 7(4); cl 19(3); cl 24; cl 34A). The requirement to afford a reasonable opportunity for written submissions (cl 19(2)) imposes a procedural step that may affect timing of disciplinary outcomes.
Effects on private choice and provider arrangements: the visiting practitioner rules impose conditions on how public health organisations recruit and appoint contractors/visiting clinicians (cl 5–7), and the leave-transfer rules influence employment mobility between NSW Health and AHOs by shaping financial consequences for employers and employees (cl 10–11). Prescribing certain concession cards for ambulance-fee exemptions changes out-of-pocket costs for beneficiaries holding those cards and changes who bears the cost of ambulance services in those cases (cl 28).
Concrete trade-offs and opportunity costs surfaced in the text
Public notification and advisory-committee referral (cl 5) increase transparency and may broaden candidate pools but impose recruiting costs on public health organisations.
The liability rule for accrued leave (cl 10(5); cl 11(5)) protects receiving employers from immediate leave liabilities but concentrates fiscal burden on the departing employer, which could affect bargaining over offers and hiring.
Centralised disciplinary authority for serious offences (cl 19) prioritises patient protection (cl 21) but concentrates discretion in the Health Secretary and requires administrative capacity for timely assessments and consideration of submissions.
Limitations and cross-references to other laws
Bottom line (source-grounded)