Mulgan on health reforms

Roderick Mulgan writes:

Ideology is different. The imperative is not what works but what is philosophically anointed. The Health and Disability System Review does not advocate abolishing the DHBs. It proposes collapsing some into larger ones, and giving them more central direction about what they should be achieving. Which is actually all the postcode argument calls for: a tilt towards more centrally directed co-ordination, not a new monolith.

The review was a substantial sounding of opinion and experience, and contained numerous interesting initiatives, many centred around local solutions for local needs. It did not recommend the Government’s creed of central control.

It is far from obvious that monoliths deliver the best public services, and no rationale for having one arises from the process to date. If there is any rationale beyond socialistic worship of state health hegemony, the Government would do well to identify it.

Labour certainly loves centralisation – polytechs, water, hospitals, national awards etc. The one thing in common is greater power to the centre.