Health bureaucrat blow-out under fire

The Health Ministry has more than doubled in size since the creation of district health boards in 2001.

Opposition politicians say the expansion is sucking money from frontline healthcare and are calling for reductions in all health bureaucracy.

The ministry, answering Herald questions, said its number of full-time equivalent staff had increased from 481 in December 2000, during the start-up phase of district health boards, to 1060 in March this year.

The restructuring was supposed to mean fewer staff in central health agencies, as the ministry absorbed the Health Funding Authority and some funding staff transferred to health boards, which have progressively taken on much of the financing role.

Some boards have set up a new agency to handle specified funding tasks.

The ministry's director-general of health, Karen Poutasi, said yesterday the basic figures did not tell the whole story.

In 2000, she said the combined staff total in the ministry and the HFA was 900 before the restructuring and would stay at about that level afterwards.

Yesterday, she said that figure did not include HealthPAC, the agency which pays out health subsidies.

HealthPAC is now a ministry unit employing the equivalent of 194 full-timers, who are included in the ministry's latest staff figures.

The Government is yet to decide if it will stay there or become an agency of the health boards.

Dr Poutasi acknowledged that after the restructuring the ministry had said it would shrink 20 per cent. Some reductions had occurred, but they had been offset by the Government adding new tasks.

"We've been reasonably constant around the 1000 mark," she said. "I think we've done pretty well, given the workload and the functions that we've needed to take up."

These included the meningococcal B vaccination campaign, which was short-term, the tripling in size, to 40 staff, of the National Screening Unit following the Gisborne cancer inquiry, problem gambling, and support for the formation of Primary Health Organisations.

The ministry had also lost roles, such as funding services for the elderly devolving to health boards, and food safety. Most of its medicines safety authority staff would shift to the planned transtasman therapeutic goods agency.

The health spokeswomen of Act, Heather Roy, and National, Judith Collins, said the Labour-led Government had indicated the HFA's absorption into the ministry would shrink the central bureaucracy.

Mrs Roy said that in her two years as an MP, health select committee reviews of the ministry had found steady growth in staff numbers.

National has not yet released its health policy for the next election, but Mrs Collins said the party was committed to reducing the size of the health bureaucracy.

She said excessive bureaucracy had led to a reduction, based on Treasury figures, in public hospital surgery.

The ministry disputes the Treasury figures and says operations increased in the last year.