ALLOWING hospitals to administrate community healthcare services is ``a bit like parking an ambulance at the bottom of the cliff'', Rouse Hill health administrator Darren Carr says.

The Hawkesbury-Hills Division of General Practice chief executive officer said last week that if the local hospital networks, proposed as part of the Rudd government's health service reform, were left to co-ordinate general practitioner services, the effect would be ``terrible''.

Mr Carr said the performance of the networks would depend on their role.

However, he and colleagues were concerned when Mr Rudd let slip during a health debate last week that the proposed local hospital boards may co-ordinate both aged care and GP services.

``NSW Health doesn't do a great job of running hospitals and in terms of co-ordinating general practice services,'' Mr Carr said. ``What we see in the hospital system is that resources are sucked into hospitals rather than going out into community based care.

``Community based care is more effective and more cost effective.

``The international evidence shows increasing the number of GPs to surgeons leads to lower morbidity and lower mortality rates.''

Eight area health services are now responsible for the administration of hospital and some community health services in NSW.

The federal government's health changes would see about 150 local hospital networks (LHNs) formed to run small groups of hospitals, in the belief this would improve health services at the community level.

But Mr Carr said that allowing hospitals to administrate community healthcare services is ``a bit like parking an ambulance at the bottom of the cliff''.

``Yes, we could pick up every body at the bottom of the cliff, but far better to stop them falling off the cliff,'' he said.

``It is community based services and general practice, community health nurses and even simple things like Meals on Wheels that help keep people out in the community and out of hospital beds.''