Moore / Health goes back to the future

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THE restructure of the ACT Health Directorate by Health Minister Meegan Fitzharris and Mental Health Minister Shane Rattenbury not only makes good sense for better management, it is also wily politics.

Michael Moore.

Kate Carnell implemented a similar model in her first term as chief minister when she was also minister for health.

This makes it awkward for Alistair Coe and the Liberal Opposition to attack the change in any substantive way. Good politics. This announcement came as the auditor-general made public the intention to inquire into breaches of the Public Sector Management Act including by senior ACT Health executives. Wily distraction politics.

All state departments of health along with the NT employ purchaser-provider models for managing health and hospital care. This does not mean that the ACT should follow suit. There have to be very good reasons for such a substantive departmental restructure.

The health ministers have given a six-month lead time to prepare for the implementation. The restructure will see two separate parts of the directorate. The oversight, or “purchaser”, will be responsible for “the strategic policy and planning stewardship of the health system”. The other part of the directorate will be responsible for service delivery, or as the ministers explained “the delivery of quality health services to our growing community”.

According to Minister Fitzharris: “This separation will enable a clearer focus on operational effectiveness and efficiency, and improve accountability for health service delivery.”

This is certainly what Canberrans should be expecting of the ACT government and its directorate. She identified a reason as Canberra’s changing needs and the ability to be more responsive and flexible.

The minister also attempted to reassure health staff working in the hospitals and across the directorate. As an example, she pointed out “the clinical and service planning underway through the territory-wide Health Service Framework will remain a key priority for government”.

However, the timing did coincide just too neatly with the auditor-general’s announcement. It is hard to believe that this is a coincidence. The announcement provided a clue, “critical to getting the reform right is continuing to talk to the community, ACT Health’s workforce and non-government partners”.

Of course, it is appropriate for both ministers to reach out to the community to have “conversations over the coming months to guide these new organisations”.

Opposition Leader Coe was quickly into attack mode with: “It’s pretty shoddy that on the same day as the auditor-general announced she is investigating very serious allegations in ACT Health, Minister Fitzharris comes out and makes what seems to be an ad hoc decision to split the directorate into two”.

He added: “I fail to see how creating two departments of health in a small jurisdiction will fix Canberra’s health woes.”

On the issue of the potential impact of the restructure, the Canberra Liberals are on thin ice considering how close this restructure is to the one Kate Carnell implemented in order to overcome some of the administrative issues that had been plaguing the system from the time of self-government. The approach allowed much more ministerial control, transparency and clarity on the priorities set by government and followed through by the “purchasing” area.

On the second issue, the Opposition Leader was on firmer ground with his comparison to the Land Development Agency.

“This decision is straight out of the LDA playbook: after a scathing auditor-general’s report, split the organisation in two, double the costs and claim the problem has been solved,” he said.

The ministers have assured the community that the restructure will be achieved within the Budget. However, in the meantime the current chief executive will be stepping aside with one of her deputies managing the transition.

In a nutshell, the restructure might just be the right tool for the ministers to handle the portfolio more efficiently and effectively. However, the timing does indicate that there is a fairly significant catalyst. Hopefully, the auditor-general’s report will shed light on what has been going on.

Michael Moore is a former member of the ACT Legislative Assembly and an independent minister for health in the Carnell government. He has been a political columnist with “CityNews” since 2006.

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Michael Moore
Michael Moore is a former member of the ACT Legislative Assembly and an independent minister for health in the Carnell government. He has been a political columnist with "CityNews" since 2006.

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