Health restructuring not panacea, papers say

Press, 22 September 1987, Page 2

Health restructuring not panacea, papers say

By

OLIVER RIDDELL,

in Wellington Organisational restructuring alone will not be enough to support a modem approach to health management, according to briefing papers prepared for the new Minister of Health, Mr Caygill. The papers were published yesterday and said that two related issues had dominated the health scene in the last year, and could do so in the years Immediately ahead: First, the widely recognised and accepted need to make more equitable and efficient use of health resources.

Second, the need to cope with the growing problem of the disease

A.I.D.S. The Government had signalled its intention to reform the health sector, the papers said, and the momentum for change had speeded up In the last year.

Piecemeal change would no longer provide the required answers and more fundamental change was needed, the papers said.

While organisational change had been under way in the health services for more than a decade, until recently the pace of change had been too slow.

The movement towards area health boards was growing rapidly; most hospital boards had now given notice of their in-

tention to become area health boards.

The briefing papers said five hospital boards had prepared discussion documents to inform the public of the proposed changes. There was growing support for the formation of a smaller number of large regional health authorities.

After wide consultation, it had also been decided to restructure the Health Department's head office. Such large-scale change was not accomplished without considerable dislocation for both clients and staff, the papers said. Cuts in operational expenditure and staff ceilings had added greatly to the task. As well, expectations which had helped

sustain the early phase of reorganisation could not be fulfilled in the consolidation phase because of resource limitation.

Improvement was needed in the equitable allocation and efficient use of health resources. The papers said this improvement was needed across the spectrum of health services — from health protection and promotion at one end of the scale to hospice care at the other. The extent to which restructuring and efforts to improve the management of services succeeded was likely to be tested by the way the system responded to challenges from specific issues such aS A.I.D.S.