Northern Beaches Hospital Inquiry: Final Report Links Rebuilding Trust to Concrete Reform - 11 Recommendations
On July 1 2026 the Final Report from the Northern Beaches Hospital Inquiry was released.
The committee stated 'Northern Beaches Hospital's challenges were not isolated failures but reflected structural flaws in the public private partnership model, the NSW Parliament's Public Accounts Committee found in its final report, which also sets out 11 recommendations directly targeting each of those failures as the hospital transitions to public operation.
Concerns about the Hospital were raised soon after it opened in 2018. In 2019, Legislative Council Portfolio Committee No. 2 – Health (PC2) commenced an inquiry into the operation and management of the Hospital. PC2 tabled its report in February 2020, making 23 recommendations across a range of issues. However, challenges with the Hospital and the public private partnership continued. In 2025, the Auditor-General for NSW published a performance audit report on the Hospital, making further recommendations for improvement.
See prior reports:
Residents to Protest Hospital Service Closures at Mona Vale Meeting - February 2019 includes news Brookfield acquires Healthscope
NSW Upper House to hold Inquiry into Northern Beaches Hospital - June 2019
Advocates Condemn Mona Vale Hospital Demolition Announcement as Inquiry into NBH and MVH commences - June 2019
Northern Beaches Hospital Inquiry: November 2019 Hearing
Hospital Inquiry Report Released: Recommends Looking after the people – not profiteers + ceasing demolition of MVH + returning an Emergency Department to Mona Vale Hospital - February/March 2020
Parliamentary inquiry into safety and quality of Northern Beaches Hospital services Announced - March 2025
The report, chaired by Jason Yat-sen Li MP, follows an extensive inquiry prompted by serious public concern about the hospital's performance and the public private partnership model under which it was established. The inquiry focused on systemic issues at the Hospital, rather than individual clinical incidents.
"Patients and families expect healthcare services that are safe, accountable and worthy of their trust," Mr Li said. "We heard from people who shared deeply personal and distressing experiences in the hope that lessons would be learned and future families spared similar pain. Their courage and generosity have shaped every recommendation in this report."
The inquiry was catalysed by the death of Master Joe Massa and the advocacy of his parents, Elouise and Danny, which led to the passage of Joe's Law - legislation now prohibiting new public private partnerships for acute hospital services in NSW.
Independent MP for Wakehurst Michael Regan was a Member of the Committee.
On Wednesday April 29 2026 the Minns Labor Government finalised the transition of the Northern Beaches Hospital to the public health system, bringing the facility into public hands and correcting one of the worst privatisation mistakes in NSW history.
Findings matched to reform
• The Project Deed did not support the hospital's long-term financial viability and was too rigid to adapt as operational realities changed. The Committee has recommended a comprehensive post-transition safety, quality and operational improvement framework, developed in consultation with staff, clinicians, unions and the community.
• The Project Deed's KPI regime was not an effective means of managing performance or risk, and quantitative measures alone are not a reliable indicator of healthcare quality. The Committee has recommended annual public reporting covering staffing, IT integration, incident management, clinical governance and unresolved risks, alongside performance measures that combine quantitative outcomes with qualitative feedback from staff and the community.
• NSW Health and the Northern Sydney Local Health District focused on upholding the risks allocated under the project deed rather than adopting new strategies for addressing emerging issues and risks.
• Formal enforcement mechanisms were available to Northern Sydney Local Health District under the project deed, however high thresholds for their use and practical consequences of invoking these may have limited their effectiveness for proactive risk management.
• The governance structures in the project deed, such as governance committees, did not provide Northern Sydney Local Health District with timely or effective tools to address emerging operational and clinical risks.
• Electronic medical record integration remained unresolved for years despite being identified in previous reviews. The Committee has recommended full integration into NSW Health's systems, backed by an independent clinical safety review.
• Workforce pressures reflected structural constraints within the partnership model rather than any lack of professionalism or commitment by hospital staff. The Committee has recommended staffing consistent with comparable NSW public hospitals, including Safe Staffing Levels and protection of staff pay and conditions.
For future public private partnerships, the Committee has recommended rigorously stress-tested financial assumptions, retained government intervention powers and public interest override mechanisms.
"Rebuilding public trust is essential," Mr Li said. "Transitioning to public operation is an opportunity, not a guarantee of improvement. It will take sustained effort, investment and engagement with staff and the community to deliver the safe, high-quality care that people deserve."
The full report is available on the Committee's webpage.
The government's response is due by January 1 2027.
11 Recommendations
Report 6/58 – July 2026. ''The safety and quality of health services provided by Northern Beaches Hospital'' records the 11 Recommendations:
Recommendation 1
That, within 6 months, Northern Sydney Local Health District should consult with staff, unions, the Medical Staff Council, consumer representatives, paramedics, the Clinical Excellence Commission and the Northern Beaches community to develop a post-transition safety, quality and operational improvement framework for Northern Beaches Hospital.
Recommendation 2
That, every 12 months, Northern Sydney Local Health District publicly report on the implementation of the post-transition safety, quality and operational improvement framework, and provide updates on IT integration, incident management, staffing levels, patient escalation systems, equipment replacement, clinical governance, complaints, and unresolved risks.
Recommendation 3
That Northern Sydney Local Health District resolve the integration issues between the Northern Beaches Hospital's electronic medical record system and the Northern Sydney Local Health Districts and NSW Health's systems, now that the Hospital has transitioned back to public management.
Recommendation 4
That Northern Sydney Local Health District commission an independent clinical safety review of the recent upgrades to improve the integration of the electronic medical record system (Telstra Health eMR) and the patient administration system (webPAS). This review should assess whether the system upgrades are fit for purpose and adequately resolve integration issues within the emergency department.
Recommendation 5
That Northern Sydney Local Health District should:
- provide Northern Beaches Hospital staff with ongoing training and resources on how to use ims+ effectively, and
- within 6 months, conduct a review of the Hospital's incident management and risk theme analysis processes, identify any ongoing weaknesses in incident management processes and implement strategies to resolve identified weaknesses.
Recommendation 6
That Northern Sydney Local Health District ensure that staffing levels at Northern Beaches Hospital are consistent with other public hospitals, including through the implementation of the Safe Staffing Levels initiative and recommendations of the Clinical Excellence Commission, now that the Northern Beaches Hospital has transitioned to public operation.
Recommendation 7
That Northern Sydney Local Health District ensure that employment, pay and conditions of Northern Beaches Hospital staff are protected and not reduced, now that the Northern Beaches Hospital has transitioned to public operation.
Recommendation 8
As part of the Hospital's transition to public operation, the Northern Sydney Local Health District should conduct an audit of equipment and supplies to ensure the Hospital is appropriately equipped to support safe and quality care.
Recommendation 9
The NSW Government should consult with staff and unions on the immediate steps necessary to improve the safety and working conditions of staff at Northern Beaches Hospital and to support the safety and quality of health care services.
Recommendation 10
That the Northern Sydney Local Health District should keep the Northern Beaches community informed of transition arrangements and updated on the resolution of key Hospital issues in order to re-build public trust in the Hospital. These updates should form part of a post transition plan to ensure improvements are sustainably embedded at the Hospital.
Recommendation 11
For any future public private partnerships, the NSW Government should:
- ensure financial assumptions are appropriately understood and stress tested to determine long-term financial viability, and that funding arrangements are sufficiently flexible to accommodate changing patterns of demand, patient complexity and workforce pressures over the life of the contract
- consider how the distribution of operational risk may impact government agencies' ability to maintain and enforce best practices
- ensure that public sector agencies retain sufficient operational visibility, oversight powers and practical intervention mechanisms to respond rapidly to emerging safety or quality risks
- ensure that contracts contain clear public-interest override mechanisms where safety, service continuity or workforce sustainability are at risk
- ensure that staffing frameworks, workforce conditions and governance arrangements align closely with broader public system standards
- ensure that governance arrangements promote integration with surrounding public sector networks rather than institutional isolation and require that IT systems appropriately integrate with existing public sector systems
- incorporate a range of quantitative and qualitative performance measures, including input from staff and impacted communities, and
- include robust and ongoing consultation processes with staff and key stakeholders.
The safety and quality of health services provided by Northern Beaches Hospital Inquiry Committee
Chair Mr Jason Yat-sen Li MP, Member for Strathfield, Labor
Deputy Chair Mr Clayton Barr MP, Member for Cessnock, Labor
Members
Dr David Saliba MP, Member for Fairfield, Labor
The Hon. Anthony Roberts MP, Member for Lane Cove, Liberal
Ms Jenny Leong MP, Member for Newtown, NSW Greens
Mr Michael Regan MP, Member for Wakehurst, Independent