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Chris Ford: Health Sector Report Signals Another Restructuring And Privatisation

Chris Ford
Chris Ford

Late last week, Tony Ryall released the report of the Ministerial Review Group 'Meeting the Challenge' on the cost and other structural issues facing the health sector.

The report seems to be a modern day revamp of the last National government's health reforms during the 1990s which saw whole parts of the sector largely privatised through the contracting out process and/or run on free market lines.

What seems eerily familiar is the recommendation to establish a National Health Board (NHB) which would oversee and fund the 21 District Health Boards (DHBs) around New Zealand. Meanwhile, the Ministry of Health would be scaled back to a policy advisory and ministerial servicing role and a whole range of health advisory committees would be disestablished with a view to 'streamlining' the decision making process (in other words, kill off dissenting advice from outside professionals on issues like drinking water quality and cancer control, for example).

But as critics have pointed out already, the proposed National Health Board is but a throwback to the bureaucracy enhancing and generating days of the old Regional Health Authorities (RHAs) which then evolved into the National Health Funding Authority (NHFA) and has more latterly morphed into the Crown Health Funding Authority (CHFA) that is now merely an autonomous division of the Ministry of Health.

It is true that while the public health sector is a complex beast to run even at the best of times, the creation of a new bureaucratic set up with the intention of replicating the old funder/provider split (which to an extent survived under the Labour-Alliance Government's reforms of the early 2000s as I have pointed out in a previous blog) will only test both the public and health sector's tolerance towards further sector restructuring, if indeed that is what the Government orders.

I fear though that after Cabinet deliberates on the report, that will be what the Government does, despite its election promises to the contrary. Under the imprimatur of Tony Ryall and with a big push from both the Act and United parties, the sector will be prepared for wholesale future privatisation at some point, especially if National wins a second term.

For now, the Government will think that the public will be receptive to any change that can deliver a better quality health system with more resources devoted, as they keep saying, 'to the front line (in other words doctors and nurses), even if it means a greater degree of private sector involvement. I would happen to think that the Government might be shocked at some point to find out how far the public will really want to go on this issue and that is nowhere near any 1990s-style free market driven reforms.

National be warned!

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