Dialogue: Health sector embarks on cure for secrecy disease

By KEVIN TAYLOR in Hamilton

Back in the good old days - when hospital boards were elected and meetings were open - the public used to get real news about what was going on in their local hospitals.

The meetings may have been a bit boring and the turnout every three years to vote for new board members may have been low, but at least the system was relatively open.

Now the wheel has gone full circle as the country's new district health boards hold their first round of meetings.

So there is nothing really new in the Coalition Government's district health boards, which came into being on January 1. Sure, they may have some new roles and the new system won't be perfect, but the point is that the public will be able once again to scrutinise openly the operations of their region's health and disability services.

In the late 1980s, the days of open meetings were numbered. The boards were shortly to become area health boards and then crown health enterprises and regional health authorities.

As one could have predicted under a corporate health structure, public relations staff came to the fore. Their role: to present their employer in the most favourable light. The real stories became that much harder to get to.

The system is to blame for letting public relations staff have so much control over the messages that came out of the health sector. The result was predictable. A picture of gloom and disarray emerged, a lot of it well-founded.

And none of the gloom obviously came from the spin doctors.

Traditional news sources dried up for journalists. There were no more hospital board agendas which - dull as they might have been - at least showed some effort at openness.

Relying on press releases was hardly a satisfactory alternative.

Under the old system, officials were more accessible and journalists got to know them well.

There was also the accountability mechanism inherent in any governance system that relied on the public casting its votes.

Sure, it was politicised, but nothing has changed. Health has always been a hot potato.

The sector is the subject of intense public scrutiny. Health officials are dealing with people's lives and wellbeing and they are big spenders from the public purse. To have the system effectively run as a closed shop for 10 years was unacceptable.

Last week, the Waikato District Health Board released a report which was commissioned last year by Waikato Hospital's former general manager on the "health" of the hospital.

It said staff performance had reached a plateau, and workers had to cope with outdated facilities and a perceived lack of leadership and direction.

Board chairman Ian Wilson simply decided to release the report "warts and all." Good on him, but he also said it contained no surprises.

Not to him maybe, but to the public there were.

Before, when the crown health enterprises were run like companies, nobody knew what was going on. Now, even if a board goes behind closed doors, the media and public at least know the general nature of what will be discussed, and can work at finding out what is going on.

Before, they didn't even know what was on the agenda.

The Government hopes the new openness will make boards more accountable and help people to understand where their money goes.

The information stream is beginning to flow again, but obstacles remain. The district health boards still have their secrets.

This is clearly the case with the LabPlus debacle, in which the Auckland District Health Board refused to release to the Herald the results of a report by International Accreditation New Zealand showing the laboratory failed an international grade inspection within three weeks of opening.

A spokeswoman took the view that the board was not obliged to respond to this newspaper's Official Information Act request until the maximum 20 working days allowable had passed.

This view shows the secrecy disease still lingers.

But the public has been given a leg-up back into the system through open meetings and board elections this year. That can only be good news.