A conservative think tank has called for local health districts to be given total control of their budgets and greater privatisation.
Some hospitals need to be privatised and nurses and doctors should come under the control of health district managers, if NSW is to avoid a "financial catastrophe", a new report says.
The report, released by The Centre for Independent Studies last week, says that with health already consuming a third of the state budget the government needs to look to micro-economics to solve its financial woes.
Authors David Gadiel and Jeremy Sammut argue that control for hospital budgets and staffing should be stripped away from Macquarie Street and placed into the hands of local health district managers.
While Sammut said the current government had created 15 Local Health Districts across the state to "devolve management down to a local level", the changes were simply cosmetic.
"These 15 districts are virtually identical to the 15 Local Health Networks that the Keneally government created in 2010," he told AAP.
He said all plans by the government were "meaningless" unless district managers were made "totally financially accountable for what they do".
This includes the ability to close hospitals and hire and fire staff.
"We are aiming to give the local health districts full responsibility over the terms and condition over which they hire and fire clinical staff," he said.
Sammut said the privatisation of some hospitals should also be looked at.
"If we could have a system where there were some privatised facilities competing with public hospitals that remain in state hands ... that would encourage all hospitals to lift their game."
While he expected unions to be "vehemently opposed" to the report's proposal, he said they were necessary.
"These reforms are not only overdue but they are essential if we are not going to have a financial catastrophe and longer and longer queues and waiting times for treatment."
The centre is an Australian think tank which advocates for "a free society under limited government".
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