Proposed Health Restructure Creates Risks for Govt

Horn Report: Proposed Health Restructuring Creates Risks For Government

What is the ‘Horn Report’ The full title of the report is a mouthful - Meeting the Challenge: Enhancing Sustainability and the Patient and Consumer Experience within the Current Legislative Framework for Health and Disability Services in New Zealand.

It is the report of the ‘Ministerial Review Group’ convened by Murray Horn – banker, Business Roundtable member and former Treasury chief executive – which was set up by Tony Ryall, Minister of Health. Released last month, it contains 170 recommendations which are currently being considered by cabinet.

Much of the Report’s contents are welcome (large parts have been previously advocated by a number of organisations such as the ASMS). These include the emphasis of health professional led clinical networks, strengthening national and regional collaboration between DHBs, and rationalisation various support services.

Increased (avoidable) risks to Government But a closer examination reveals some serious concerns, including major restructuring and threatened privatisation, which risk derailing many of the laudable recommendations. The ASMS will comment on these in further issues of ASMS Parliamentary Briefing.

It recommends major restructuring by significantly downsizing of the Ministry of Health and creating a new less accountable National Health Board (NHB) with enhanced powers in the funding and running of DHBs.

The time spent on creating a new national bureaucracy and on the change in relationships between this new bureaucracy and the 21 DHBs will be considerable. The Horn Report greatly under-estimates the effect its recommended restructuring will have on those working in the health sector.

The risk to government is that so much time will be spent on getting the new structures up and running with benefits (if any) a long time down the track. Further, the risks of destabilisation, paralysis in decision-making and confusion will be high. No government would be keen to go into an election with controversial restructuring being largely all they have to show for their health policy.

The government went into the last election promising no major health sector restructuring. Accepting the Horn Report’s recommendation on establishing the NHB would represent an abandonment of this commitment.

The government should instead consider that the functions expected of the NHB could be achieved by a relatively minor re-jigging of the role and authority of the Ministry of Health.

The Association of Salaried Medical Specialists (ASMS) represents salaried senior doctors and dentists. The large majority of our members are employed by DHBs. Outside the College of GPs we are the largest organisation representing doctors in New Zealand. Central to our existence is to promote the right of equal access for all New Zealanders to high quality public health services.

The ASMS publishes the ASMS Parliamentary Briefing to provide considered advice to MPs of issues and concerns where we believe we have the experience and expertise.

ENDS

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