Area Health Boards Bill called ‘wet fish’

Press, 25 August 1983, Page 8

Area Health Boards Bill called ‘wet fish’

Parliamentary reporter The Opposition said yesterday that confusion would result from a “wet fish” Government bill providing for big changes in health administration.

The Minister of Health, Mr Malcolm, was introducing the Area Health Boards Bill, which provides for the forming of new bodies to combine the functions of hospital boards and offices of the Health Department. Mr Malcolm said the bill was an innovative and important step in health service organisation. It came to the House after detailed consultation, and reflected a broad consensus of the health community. Labour’s spokesman on health, Dr M. E. R. Bassett, said the bill was a timid effort that would cause confusion and make health administration problems worse.

The bill arose from recommendations made last year by the Special Advisory Committee on Health Services Organisation, formed in 1976 under the chairmanship of Sir Alan Danks.

It provides for the formation of area health boards. These would be formed only if requested by hospital boards, and would combine the functions of a board and

Health Department offices.

While some areas could retain hospital boards, others could decide to have area boards. Those wanting area boards would ask the Minister of Health, who would recommend that the Governor-General make an Order-in-Council. “An area health board with its comprehensive responsibilities will be able to address the issues of total health,” Mr Malcolm said.

“Its jurisdiction will cover both treatment and preventive health services.”

The bill set out the following as the board’s primary objectives: • To promote, protect, and conserve the public health and to provide health services.

• To provide for the effective co-ordination of the planning, provision, and evaluation of health services between the public, private, and voluntary sectors.

• To establish and maintain an appropriate balance in the provision and use of resources for health protection, promotion, education, and treatment services. In these the board would have to comply with the policy directives of the Minister or Director-General of Health.

The bill goes against the recommendations of Sir Alan Danks’s committee in opting for elected instead of appointed board members. Mr Malcolm said this was to ensure the “primacy of the elective process.” It provides for 12 elected members, and up to four members could be appointed by agreement between the elected members and the Minister. Dr Bassett said the bill was a “wet fish” because it proposed changes to hospital boards only on the board’s request. Some boards would opt for the change, but others would not, and the result would be confusion.

After 10 years of discussion, and forthcoming select committee work on the bill, the point should be reached where hospital boards had to give good reasons for not becoming area health boards, he said.

He questioned a provision that allowed discretion by the Minister or the Direc-tor-General in deciding what Health Department functions could be assumed by each board.

“What is the point of having an area health board if it is to take over only part of the responsibilities of the department?” he said.

The bill was referred to the Health and Welfare Select Committee. Also introduced and referred to that committee was the Health Service Personnel Bill which provides employment conditions for area health board employees. It also aims to encourage consistent personel policies and co-ordi-nated pay-fixing in the health service.

It provides for the formation of a health service personnel commission with the following jobs: • Deciding and promoting personnel policies for the health service.

• Deciding, in consultation with area health boards and hospital boards, suitable employer policies. • Promoting high personel standards in the health service.

The commission would be the employing authority for area health board employees and for hospital board employees subject to' the State Services Conditions of Employment Act.

It would be responsible to the Minister of Health, except in matters relating to individual employees.