The 20 health boards have been replaced by one body, Te Whatu Ora. Photo / Sylvie Whinray
The 20 health boards have been replaced by one body, Te Whatu Ora. Photo / Sylvie Whinray
ANALYSIS:
A clear view of the inner workings of our health system has dramatically declined and there is cause for concern in comments about that from Rob Campbell, the chairman of our new national health authority Te Whatu Ora.
Our 20 district health boards had monthly meetings which were opento the public. That ended last month with the creation of Te Whatu Ora, which now concludes its monthly board meetings with a press conference.
Te Whatu Ora is the new organisation that merges the functions of the 20 district health boards into one. Unlike the health boards, it doesn't elect members and it doesn't hold meetings in public.
Today, Campbell appeared to describe the idea of Te Whatu Ora holding its meeting in public in this way: "Getting on with the work is more important than providing occupational therapy for journalists."
It wasn't "occupational therapy". It was an exercise in democracy.
Those old health board and committee meetings provided an extraordinary amount of information about our health system. They were preceded by agendas and recorded in minutes, which provided those interested in a real-time narrative of our health system and health-related events in our communities.
The 91-page agenda for the last Auckland District Health Board meeting is typical of its kind, containing details of operation of services and systems. Hospital Advisory Committee agendas, along with others, combined to tell a story of our health system that was rewarding and rich.
And each was deeply rooted in its own geographical patch. All the 20 health boards were an unwieldy construct, they were creatures of their own population and their particular health issues.
It's true not many attended health board meetings. And its probably also true the numbers of people who read the agendas and minutes were small. And yet, the few who do held such an interest it expressed a value across a far wider community, such as journalists producing stories read by thousands of taxpayers.
The documents and the meetings for which they were created served a dual purpose. Not only did they serve to impart information to a community, but it also compelled healthy authorities to go through the self-checking, self-monitoring process to produce the information. It required those health boards to look into their own organisations, and into their communities, lest they produce a document that overlooked either.
Now those vast volumes of accountability are gone, as are the meetings they served to forecast and record.
Rob Campbell, chairman of Te Whatu Ora. Photo / Michael Craig
When Campbell was quizzed about the absence of meetings on Radio NZ, he made a number of startling claims.
Those included that Te Whatu Ora does not have to because its legislation doesn't say it must. And, he says, other public bodies don't have to so why should it?
That's true but appears disingenuous. There are few government agencies which have the reach and critical importance to people's lives and well-being as Te Whatu Ora. In terms of transparency, our health system has gone from "drive" into "reverse" without slowing down.
Our ability to see inside the health machine has gone from a monthly warrant of fitness check to turning up to be told what the board wants to tell us.
Further, Campbell gave the rosiest possible glow to interaction with a large government department. He said: "We answer questions every day. We answer all the questions we get from journalists around the country which we do every day. I get a list of the ones we have answered. If we weren't providing information, I could understand the point."
It has increasingly become the case that communications staff at government agencies do not answer questions.
And one of the reasons for the reluctance to answer requests - or even allow its tremendous staff to be interviewed - is there in Campbell's comments.
In a promotional video for Te Whatu Ora's website, Campbell said the board's role was "looking after the reputation and health of the organisation".
From that lofty position, the Radio NZ interview with Campbell made it clear that it was Te Whatu Ora which made judgments as to what was worth knowing and what was not.
"If we were hiding anything," he said, "if we weren't answering queries, there would be a big issue but there's not.
"There is no information which is not readily available on request that is information that is useful or capable of being made public."
Campbell should seek out an independent review of the sort of information that was available through the agendas and minutes of health board meetings and assess whether Te Whatu Ora provides the same level of regular disclosure.
The review should also review media requests to Te Whatu Ora and see whether journalists consider questions to be satisfactorily answered and whether interviews with its staff would do so more effectively than information filtered through its communications team. Te Whatu Ora should also ask the public what it wanted to know.
Those in government should also ask the question: When we're in Opposition - whenever that might be - what do we want to know?
And they might also ask why they didn't legislate whatever the answer might be.
