Proposed DHB funding shake-up makes no sense

Proposed DHB funding shake-up makes no sense

“Changing the way public hospitals are funded without proper consideration risks fragmenting health funding, disrupting patient services and undermining innovation,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

He was commenting on a document leaked to Radio New Zealand that indicates the way district health boards (DHBs) are funded is for a major shake-up. A review ordered by the Director-General of Health suggests ending the bulk funding of DHBs and putting many health services out to tender. It advocates splitting DHB funding into four pools, introducing competitive tendering and opening the door to private health providers.

Mr Powell says the document has been developed in secrecy and its recommendations don’t make sense.

“For example, this idea of four pools of DHB funding doesn’t correspond at all to the way services are provided to patients. If we look at cancer treatment services, for instance, these are provided right across community-based and hospital-based services. It’s the same patient throughout, and to carve up the funding would seriously risk fragmenting the services and potentially causing patient harm.”

The review document also suggests making all specialist clinical hires employees of a region, and Mr Powell says it’s not clear what is intended by that.

“Senior doctors and dentists in public hospitals are employed on the same national collective agreement already, so there’s no employment impediment to medical specialists working in more than one district health board – and many of them already do.”

The leaked review document follows publication the day before of possible government plans to change the governance of DHBs, including the removal of control of DHBs from elected representatives.

“There’s a worrying message underpinning all of this,” says Mr Powell. “The Government appears to be increasing central government command and control over DHBs. One of the problems with that is that it risks undermining innovation within the health sector, as well as introducing rigidities and disrupting the provision of patient services, which are complex and integrated.

“If we had to score this funding report it would get a Z minus for commonsense.”

ENDS

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