Health move risk for Govt

The National Party risks being accused of breaking an election promise if it accepts recommendations that would bring back health structures buried a decade ago.

The cost-cutting committee appointed by Health Minister Tony Ryall is understood to have recommended setting up a National Health Board to fund, monitor and direct New Zealand's 21 district health boards.

Mr Ryall refused to be interviewed by the Weekend Herald yesterday, but he is expected to make a television appearance tomorrow to discuss his policies.

Before last year's election, his party's policy said: "National will not carry out another round of restructuring of the public health system."

Sources say the committee, chaired by former Treasury Secretary Murray Horn, has recommended returning the Ministry of Health mainly to the policy advice and regulatory roles it had in the 1990s, before Labour scrapped the Health Funding Authority.

Under the Horn proposals, the new national board would pick up the ministry's role of funding and overseeing the 21 district health boards and a new role of directing them.

Other new national bodies are proposed for purchasing health materials for health boards, and to oversee the funding and planning agencies that were set up by regional groupings of boards when the Health Funding Authority disappeared.

The Horn report is also said to call for debate about which health services the state should provide - effectively a re-run of the last National Administration's 1992 core health services committee.

The Horn committee was set up to help reduce bureaucracy.

Its terms of reference included running a ruler over "the ministry's role as a manager of a range of national operational functions".

National has been explicit about wanting to force greater collaboration between district health boards but, led by feedback from a health sector weary of the instability of change, had sworn off the kinds of big-bang health restructuring undertaken by Labour in 1989, National in 1993 and Labour in 2000.

"It should not be assumed Tony Ryall will endorse the recommendations," said one source.

"Although those who are proposing this will say it's not the Health Funding Authority, I would say it is - without the rhetoric, without the name, and with strengthened powers."