Autonomy for boards advocated

Waimarino Bulletin, Volume 5, Issue 21, 20 October 1987, Page 1

Autonomy for boards advocated

Decisions regarding the form and level of health services should be made by the boards providing those services says the Minister of Health, Mr David Caygill. Addressing the small and medium hospital and area health boards conference in Taumarunui last Thursday, Mr Caygill said he wants to see decisions taken by each individual board, not by central government. "Autonomy needs to be increased," he said. Mr Caygill told representatives from 15 boards including some from the South Island that he would like to see the strengthening of relevant domiciliary and community services. "In my view there is scope for more use of ambulatory services, especially surgical services. An increased level of day surgery has the advantage of providing surgical services to more people at less cost per patient and a reduction in waiting lists should flow from the increased throughput." Mr Caygill also suggested that a better liaison must be established between general practitioners and other health agencies. Mr Caygill reaffirmed that he is a strong supporter of area health boards but did not think that health care could be "standardised". There are already three area health boards in New Zealand - Northland, Wanganui and Nelson, with a fourth, Taranaki, to come into being on 1 November. However, Mr Caygill said he had no "magic" number of what the total number of boards should be, but thought it would be in double figures. "Maybe a total of between 15 and 20 boards," he said. He encouraged boards to take initiative now and plan, in consultation with neighbouring boards, to provide a comprehensive range of services in their area. "I am prepared to consider any proposal that lands on my desk," he said.

Three motions were passed by boards represented at the small and medium hospital board conference following the afternoon open forum session. Chairman of the Wairarapa Hospital Board, Mrs Trish Taylor, moved that "a letter be sent to the Minister of Health reiterating the desire of the boards present to participate in any discussion or alteration of the cross boundary funding formula. Other motions to be forwarded to Mr Caygill were: 1. That the Hospital Board Association be advised that the boards present wish prior consultation whenever practical when the executive considers major policy issues. 2. That the boards attending are concerned at the potential loss of representation, funding and services that could result from small to medium boards being absorbed into larger units. "We seek assurance that the Minister will address the issues via legislation." Chairman of the Taumarunui Hospital Board, Mr David Kydd, told boards when he opened the open forum section of the conference that the Minister's speech had changed things slightly. "Lines are much more flexible," he said. However, Mrs Betty Bourke, chairman of the Wanganui Area Health Board, warned boards Cont'd on p. 2

Board autonomy advocated

Cont'dfrom p. 1 against sinking into complacency following the Minister's speech. "Mr Caygill is new in this job (Minister of Health). To think that he is going to allow 20 area health boards is living in a fools paradise," she said. Mrs Bourke said that while Mr Caygill had not cut off their (the boards) heads he had cut off their hands. "Eventually the Govemment will have what they want - large regional boards," she said. Mr Bruce Beetham, Deputy chairman of the Wanganui Board, said it had been clearly indicated that the formation of area health boards will be followed by a "two-tier" structure, a structure that a number of boards are not happy with. "There is a possibility that boards are being lulled into a complacency," he said. "I am convinced that Government still want regional areas," Mr Beetham added.

Several board chairmen stated that they would be encouraging their boards to take immediate action and get the proposals onto the Minister's desk. "The Minister has indicated he will look at any proposal and I believe he is sincere," said Mr M. Mayman, chairman of the South Canterbury Board. Mr Ron Powell, deputy chairman of the Taumarunui Hospital Board, said that the biggest fear of small boards is of being drawn into a large organisation and "being lost". Mr Powell moved that the j small/medium boards ap- j proach the Minister and the Hospital Boards Asso ciation for guarantees thr I boards that do amalgamt 1 with neighbouring boards j do not receive "any less than existing funding." The motion was lost, however, when it was put to the vote. Mrs Trish Taylor, speaking against the motion, said that amalgamation will not work unless there is faith between all parties.