Return of the Empire by stealth

Return of the Empire by stealth – market forces driving health policy

“It is increasingly difficult to avoid the conclusion that the Government is returning to the market approach to health that was tried and failed in the 1990s,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

“Back then, public hospitals were turned into state-owned companies governed by competition law, and were expected to compete with each other and with the private sector. The consequences of this were disastrous for the health sector, setting workforce planning back a number of years, eroding the culture that health professionals worked in, and prioritising short-term decision-making over more sustainable longer-term thinking.

“For some reason, the Government appears to be looking fondly back at those times and trying to drag the health sector back into the 1990s.”

Mr Powell discusses this “return of the Empire by stealth” further in an article in the latest issue of the ASMS magazine, The Specialist, which is available online at http://www.asms.org.nz/wp-content/uploads/2016/03/10985-The-Specialist-Mar16-WEB-1.pdf.

In the article, he notes the Ministry of Health’s restructure and points to an increased emphasis on market mechanisms such as tendering through commissioning, and the language of the market – clients and customers. He also comments on the Government’s health funding reviews, which he says clearly point to a competitive model of health service provision.

“Proposals currently being considered by the Government include opening up DHB services to competitive tendering, with indications that funding will be dispensed only if planned milestones are achieved. If they are not, then funding will go to another public or private provider.”

He says the changes being planned, apparently behind the scenes, seem to be about creating a structure more suitable for market mechanisms.

“It’s not about providing the best care for patients and a decent clinically-led working environment for people employed by DHBs. It’s about awarding contracts to the lowest bidder.”

ENDS

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