December 7, 2017 2:00pm by David Farrar

Ministry of Health’s scathing report

A damning new report card into the performance of the Health Ministry has found the agency wanting across a number of areas, including financial sustainability, behaviour and culture and the management of its people.

The high level performance review, led by Dame Paula Rebstock on behalf of the State Services Commission, painted a picture of a ministry that was striving to reduce health inequities across New Zealand, but hamstrung by poor relationships and funding models across a highly devolved system.

The release of the report comes days after Director-General of Health Chai Chuah announced his resignation, halfway through a five-year term. He said a change of direction was needed for the ministry, meanwhile Health Minister David Clark has branded the review as a “damning indictment” of the direction of the last Government.

I agree a change of direction is needed for the Ministry. Its performance has been woeful, including getting the DHB allocation figures wrong for the Budget.

But the Ministry is not the entire health system (thanks God). In terms of actual outcomes, we’ve seen the following:

From 70% to 94% of ED patients seen within six hours
From 65% to 100% of cancer patients staring treatment within four weeks
Immunization rates from 76% to 92%
Elective surgery procedures from 118,000 to 162,000

The Performance Infrastructure Framework review, or PIF, gave the ministry a “weak” rating for its financial sustainability, and its overall governance.

It was also weak on “values, behaviour and culture”. The ministry scored well on “vision” but it needed to “shift from aspirational statements to bringing the vision, purpose and strategy to life. The strategy needs to move from being thematic to directional”.

“Significant resources” needed to be committed to delivering on the Health Strategy, and that would require “re-prioritisation and decisions to stop some things”.

And the executive leadership team itself, under Chuah, while it “worked together initially”, it had reverted to a “group of individuals”.

“They are technically competent, but do not lead in a systemic way at an enterprise level.”

It is a scathing report, and shows change is needed at the Ministry. If David Clark can successfully institute that change, then that will be a very good thing.