The Department of Health and Aged Care will have a new Secretary on 17 July when Blair Comley PSM replaces Professor Brendan Murphy, who is retiring after three years in the role.
Croakey asked key health experts and leaders for their views about the challenges ahead.
Jennifer Doggett writes:
Health sector leaders have responded positively to an announcement from Prime Minister, Anthony Albanese, that he will recommend the Governor-General appoint Mr Blair Comley PSM as Secretary of the Department of Health and Aged Care, replacing Professor Brendan Murphy who has been in the role since 2020.
Comley has worked across both the Commonwealth and NSW public sector, including as Secretary of the Department of Resources, Energy and Tourism and the Department of Climate Change and Energy Efficiency under the previous Labor Government.
After being sacked by the incoming Abbott Government in 2013, Comley worked briefly for PwC and then led the New South Wales Department of Premier and Cabinet as Secretary between 2014 and 2017. He is currently a director and partner at EY Port Jackson Partners.
Comley’s five-year appointment as Secretary will take effect on 17 July 2023.
“With his strong economic qualifications and proven leadership navigating complex issues, Mr Comley will bring innovation and policy rigour to addressing the challenges and opportunities within our health system,” the Prime Minister said.
Croakey has previously reported on the views of health leaders about the qualities they’d like to see in the next Secretary of the Department of Health and Aged Care, the type of expertise required, what their priorities should be, and the risks and opportunities ahead, as well as providing some advice for the interview panel.
They suggested the Department’s next Secretary should be Aboriginal or Torres Strait Islander, brave, evidence-informed, a systems thinker, and committed to equity, values-based healthcare and culturally safe workplaces. In addition, they wanted them to have the intellectual horsepower and aptitude to gain a quick understanding of the complexity of the health and aged care systems, and strong skills in guiding policy development.
The right stuff
Consumers Health Forum of Australia (CHF) welcomed Comley’s appointment, stating that his background in climate change, economics and public service leadership means he has “the right stuff” for the job ahead.
CHF CEO Elizabeth Deveny said that the impact of climate change on many aspects of health and wellbeing is often cited as a key issue for Australians.
Deveny said that Minister Butler’s public statements have given Australians high expectations of immediate and significant health reform.
“Health consumers tell us that they want healthcare services to be more accessible to everyone, more affordable, especially for those with significant health needs, and more equitably distributed across the nation. Reshaping the complex contraption that we call our health system will take a smart and kind person who is willing to lead,” Deveny said.
“Comley’s reputation suggests that he may just be that person. Now we wait to see. Health is everyone’s business – we fund it, we use it and we live it. CHF looks forward to bringing the diverse perspectives of everyday Australians to the table for conversations with Mr Comely and his team.”
The least serviced group
The National Rural Health Alliance (the Alliance) welcomed the announcement.
“We are pleased to see that a person of Mr Comley’s calibre, with his strong economic qualifications and experience, will lead the health and aged care sector,” said Alliance Chief Executive Susi Tegen in a media statement.
“We look forward to engaging with the Department of Health and Aged Care under Mr Comley’s leadership, to improve health outcomes for the more than seven million people living in rural and remote Australia.”
Tegen emphasised that the contribution of rural Australians, through varied industries, has helped keep Australia out of two global financial crises and reduced the economic impact of COVID-19. However, they are still the least serviced group when it comes to health care.
“Given the dire status of access to quality health care in rural Australia, the Alliance anticipates working closely with Mr Comley to increase preventive health care and further our vision of healthy and sustainable rural, regional and remote communities across Australia,” she said.
A renovator’s opportunity
Dr Stephen Duckett, Honorary Enterprise Professor at the University of Melbourne and former Secretary of the Department of Health, told Croakey that Comley, like every Departmental Secretary, will have to face the challenges associated with the Robodebt Royal commission.
He also mentioned the findings of the recent Australian National Audit Office report on the Community Health and Hospitals Program grants program as another key challenge facing the new Secretary.
Duckett also highlights both policy and program implementation as crucial for the Department to deliver on the government’s “ambitious” agenda, specifically mentioning the health workforce crisis and the “renovator’s opportunity” offered by the 2025 National Health Reform Agreements.
Keen understanding of market design
Peter Breadon, Health and Aged Care Program Director at Grattan Institute, described Comley as “a good appointment”, citing his extensive experience running public service departments and his work on complex and challenging reform in climate change.
Breadon said having an economist with a keen understanding of market design at the helm would be helpful, since a lot of pricing, subsidies, and quasi-markets in health are dysfunctional and need reform.
He referenced Comley’s combination of state and federal government experience as setting him up well for a focus on national reform over his five-year term.
“A range of urgent pressures and long-term challenges require national collaboration, including workforce shortages, hospital funding pressures, primary care reform and under-investment in prevention. The next funding deal between the federal and state governments will be agreed in 2025, and it’s a big opportunity for progress,” Breadon said.
In relation to comments that Comley lacks a background in health, Breadon noted that he was the head of the NSW public service, responsible for overseeing the state department of health, arguing that this will have given him insights into the challenges in the portfolio.
Breadon added that in his opinion being a health expert isn’t necessary, given that the department is full of experts who can provide support. “Management chops, reform ambition, and political acumen are more important in this role, and he seems well qualified in those areas,” Breadon concluded.
Strategic planning
Professor Andrew Wilson, Director of the NHMRC Australian Prevention Centre administered by the Sax Institute, said that his experience with the new secretary is limited to a strategy planning consultancy he led for a non-health entity.
Wilson said this was very well run exercise, and one of his more positive consultant run experiences.
“Comley demonstrated that he understood what strategic planning means in a government policy environment – realistic goals and targets, appreciation of broad stakeholder considerations, and of complexity when achieving change involves multiple players. This certainly reflects the health environment,” Wilson said.
Rebuilding policy capability
A former senior public servant, Charles Maskell-Knight, said that Comley’s greatest challenge will be rebuilding policy capability within the department.
“For a number of years the Department’s response to a policy problem has been to engage consultants, then consult the affected sector on what the consultants said, and then do whatever the sector convinces the Minister is best.
“The Department needs the capability to develop policy options itself and provide sound advice to the Minister. Not only does this require more staff, but it needs a change of culture to value training and expertise – which is where leadership from the Secretary matters,” Maskell-Knight said.
Navigation needed
President of the Royal Australian College of General Practitioners (RACGP), Dr Nicole Higgins, welcomed the appointment, saying that “Australians deserve a health system where general practice care is invested in as the centrepiece of healthcare”.
Higgins emphasised the need for major reform of the health system, in particular to help patients navigate the health system and also emphasised the lack of investment in general practice over a number of years.
“With an outstanding record in public service, policy development and design, and leading government organisations through change, Blair Comley is well-qualified to drive this kind of reform.
“On behalf of the RACGP and GPs in Australia, I welcome Mr Comley’s appointment to this prestigious position and look forward to working with him to build a health system that doesn’t just treat us when we are sick, but keeps Australians healthy at all stages of their lives, regardless of their postcode or income,” Higgins said.
Download Croakey’s report, Looking for fresh leadership in health and aged care
