Job cuts 'will benefit patients'

A National Health Board is to be established to oversee planning for new hospital facilities. Photo / Sarah Ivey

Thee Government promises patients will gain better access to health services because of a restructuring that will cut nearly 500 administrative jobs.

But Health Minister Tony Ryall is not calling it a restructuring, since National promised voters it would "not carry out another round of restructuring of the public health system".

Instead, he referred to the changes yesterday as an "administrative shake-up", one that would fulfil his promise to shift health dollars from bureaucracy to front-line services.

"This is about making the current system work better by filling in the missing links," he said.

His plans won wide support in the health sector, even from the senior doctor's union, which praised the Government for having "avoided the effects of a major restructuring" that had been recommended Mr Ryall's independent advisory group.

But there is scepticism whether the predicted savings of $700 million over five years will be achieved.

Two new bureaucracies will result:

- A National Health Board. To be a unit within the Ministry of Health, it will supervise the 21 district health boards; take over planning and funding of some national services, such as paediatric oncology, clinical genetics and major burns; and oversee planning for new hospital facilities, information technology and workforce development.

- A Shared Services Establishment Board. It will begin consolidation of functions like DHB payroll, purchasing hospital supplies and possibly human resources.

The ministry currently employs 1475 staff, and DHBs around 11,000 in administrative jobs. Under the restructuring, some 300 DHB jobs and 185 at the ministry are expected to be scrapped within three years.

A further 400 positions may shift from the ministry to the shared services agency, leaving 890. The National Health Board and the slimmed-down ministry will each employ 400-450.

The national board will have a general manager appointed by the ministry's director-general and a chairman responsible directly to the minister. Mr Ryall denied this was a recipe for conflict and said it was a model already in use.

Many details are yet to be worked out, like the full list of national services for which the national board will take over planning and funding; whether the cervical screening programme will be broken into regional schemes; and the shape of any legislation needed to provide greater regional collaboration between DHBs.

Otago University health policy specialist Associate Professor Robin Gauld, a critic of major health restructuring, said the Government was moving in the right direction with changes like trying to centralise back-office functions, but he had doubts about the savings.

"Whether 500 jobs will go or stay is an interesting question, and whether there are $700 million of savings."

Ian Powell, of the senior doctors' union, said the expected savings appeared to be "aspirational rather than based on practicality".

Labour's health spokeswoman, Ruth Dyson, said the back-office jobs Mr Ryall wanted to scrap included people who made hospital appointments and managed patients' records.

"If we are expecting doctors and nurses to do that, that's going to be a huge imposition on their time and on the costs to the health system."

* Costs and savings

Expected cost of changes $6 million.

Expected savings $700 million over 5 years.

Up to 500 fewer administrative jobs.