Health proposals criticised

Press, 22 October 1983, Page 5

Health proposals criticised

Parliamentary reporter

Hospital boards have stronglv criticised Government legislation providing for big changes to health administration.

The Hospital Boards’ Association told a select committee considering the Area Health Boards BUI that it doubted the bill would solve health administration problems.

The Palmerston North Hospital Board said it doubted that the bUI was necessary, and the Auckland Hospital Board said the biU fell short of its original aims.

The bill provides for the forming of new bodies, called area health boards, to combine the functions of hospital boards and offices

of the Health Department These would be formed only if sought by hospital boards.

Criticism by the Hospital Boards’ Association focused on the bUl’s alleged failure to improve the planning and delivery of health care. “The changes proposed are, in our opinion, mostly of an administrative nature which would have only a marginal impact on the actual provision of health care,” the association said.

The bill would not overcome, or even substantially reduce, the problems of fragmentation, lack of coordination, overlaps, and unmet needs. The association said the bill would maintain the wide-ranging powers of control and direction possessed

by the Minister of Health and the Director-General of Health.

In so doing it achieved little of the decentralisation that was one of the main purposes of recent reorganisation proposals. The Palmerston North board said there was no evidence that area health boards would provide a better health service. The new bodies would encompass functions that lay beyond the provisions of present funding, and there was no evidence of there being adequate funds to achieve the bill’s aims. The board said that the legislation should be tested by pilot schemes before widespread conversion to area health boards was permitted.

Hospital boards also criticised a companion measure, the Health Service Personnel Bill.

The bill provides employment conditions for area health board employees, and provides for the formation of a health service personnel commission. The commission would decide and promote health service personnel policies and employer policies. The Hospital Boards’ Association said that the new personnel structures proposed by the bill would not improve the efficiency of the health services. It said the proposed commission would centralise decision making to an unacceptable extent, and would hinder normal administration of the service.

In the present climate of cost restraint, the association said that it could only support the bill if it would improve cost effectiveness in personnel administration. “Neither the bill nor the two discussion papers have shown this,” the association said.

The Hawke’s Bay Hospital Board said the bill would diminish the authority of area health boards and hospital boards in staffing matters. “The little autonomy that boards have today will be further abrogated. Boards will have another body that they must take instructions from, and it is disappointing that an expected decentralisation of control and power is not to materialise,” the board said.