Social service reshaping urged

Press, 4 August 1987, Page 11

Social service reshaping urged

PA Wellington Social services need a radical restructuring similar to that sustained by other sectors of the economy, according to the business consultant, Mr Derek Quigley. Health, education and social welfare together take up 25 per cent of gross domestic product, yet have no accountability or requirement to respond to consumer demand, he told a Planning Council conference in Wellington. He predicted big changes in the health system after the election. Later, in an interview on Radio New Zealand’s "Checkpoint” programme, Mr Quigley said that after the election health boards could be introduced. The former National Cabinet Minister thought some services would be contracted out and doctors would be paid a capitation sum plus a fee for services.

These changes would trigger innovation and flexibility.

Judging by American trends, there would be more emphasis on out patient facilities, day surgeries and home help agencies, catering to the needs of the consumer. He said the integration of the health system with the accident compensa-

tion system would bring big changes too.

Because of reforms, the Accident Compensation Corporation was unlikely to have continued free-of-charge access to public hospitals for accident victims. This would cost the corporation about $2OO million annually, which should result in a tradeoff for employers who would no longer have to pay for non-work accidents, now about 44 per cent of total claims paid. Most A.C.C. lump payments were also likely to stop, which would save about 22 per cent of costs.

He foresaw the introduction of a minimum compulsory employeremployee accident and sickness premium payment plus a taxpayer contribution sufficient to guarantee access for all to good-quality health care.

A series of social disability funds administered by a combination of revamped medical insurance companies, disability insurance schemes and State-Owned Enterprises, would replace the present accident compensation cover provided by the corporation, he said. “The final stage would be to turn the public health system into a State Owned Enterprise so that it could compete in man-

agement and efficiency with private health interests,” Mr Quigley said.