After 15 hearings, 220 witnesses, 720 submissions and seven site visits across 21 months, the seven-member committee chaired by Labor's Greg Donnelly MLC yesterday filed its 322-page report.

As Mr Donnelly said yesterday in an accompanying statement, many of the issues raised are not new.

To clarify, Newcastle was regarded as metropolitan along with Sydney and Wollongong, putting it outside the committee's ambit.

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The rest of the Hunter New England Local Health District was, however, up for scrutiny. One of 15 such districts, it covers 131,000 square kilometres (16.5 per cent of the state) and 920,000 residents (11.2 per cent of the population).

The report describes it as the state's biggest local health district, population-wise, and its sprawling nature - a merger of the previously separate Hunter and New England local health areas - has long had its share of critics.

The Herald, Singleton Argus, the Manning River Times and other ACM titles have reported regularly on the trials facing staff and patients in our smaller hospitals and health centres - hardships compounded during the inquiry by the society-wide impacts of COVID.

The report makes 22 findings, starting with the long-established observation that people in regional, rural and remote areas tend to have significantly poorer health outcomes and more chronic disease and premature deaths than their metropolitan counterparts.

Although the committee heard localised evidence from place to place, the report's 44 recommendations do not single out individual hospitals or local health districts for attention.

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That said, the recommendations are detailed, and appear, at initial reading, to be practicable.

What the system does not need is change for change's sake, and so the recommendations, as well as the Perrottet government's responses to them, will need to be analysed in detail.

As Mr Donnelly notes in his foreword, healthcare is a joint responsibility in NSW (and other states), with Canberra paying for GPs and the states the hospitals.

Hard as it might prove, minimising the conflicts that flow from this divide would be a good starting point.

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