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Legislative Assembly for the ACT: 1996 Week 8 Hansard (27 June) . . Page.. 2351 ..

MRS CARNELL (continuing):

Mr Speaker, I think that this is a much better management approach. Everybody in this Assembly has made it clear to me that they expect me to fix the health system or wear the consequences. From my perspective and from the Government's perspective, this is part of fixing the health system. Again, it is very interesting to look at what is happening in other parts of Australia. Mr Berry made the comment that this is a link to the past, basically going back to the past, that we should be sitting around the fire thinking about reinventing this old management structure. I do not suppose that Mr Berry would be very interested to know this, because I do not think he cares much; but right around Australia, even with the new management structures that have been put in place in other health systems, one thing that is really consistent is that, in all of these newer structures where health systems around the country are being rearranged, what they are all doing is maintaining the board structure at some level. So, it is not about going back to the past; it is about new structures - new and better ways of doing things.

It is not only happening in Australia, Mr Speaker; it is also happening in the UK, the US and Canada. It is seen that it is a good idea to separate the policy part of Health from the service provision part of Health. And that is what this is all about. We believe strongly that this approach will improve management in Health and will improve outcomes in Health. I was really interested to hear Mr Moore say that he thought that politicians should be involved in the day-to-day decision-making of Health. I disagree strongly. I believe that it is my responsibility, as Minister, to ensure that the systems in Health are right, that we do everything in our power to ensure that those day-to-day decisions are the right ones; but it is certainly not the role of the Minister to get involved in actually making those day-to-day decisions. The moment we start doing that - and it has certainly happened in the past, Mr Speaker - systems start falling over. It is interfering. It stops managers managing. It really does take the focus away from the patient.

Mr Speaker, the thing that is very different about this approach to a board from those approaches that have been taken in the past is that this approach really does clarify the roles and functions of our central office. That is something that simply has not happened before. Under the old board structure and under the board structures that have occurred in the past, that sort of split - that sort of very definite definition of the roles of central office versus the roles of the hospital and community care - has not happened, and it certainly will under this approach. Taking into account that this proposed board is very small, one of the things that we are going to have to do with this board is make sure that the people on it have the appropriate business and administrative acumen. It will be absolutely essential that the people who are on this board do not just understand how to run a hospital. They will certainly have to have a very good knowledge of businesses - how you run a business and how administration works - but they will also have to have a much broader approach. We must remember, Mr Speaker, that this board is not a hospital board; it is a board that will look after both community care and hospitals in the future for this city. We believe that that is important, because the future of health - not just in the ACT but, I think, worldwide - will be about continuity of care and about breaking down the barriers between our critical care institutions such as hospitals and the community part of our facility. That is the reason why we have one board looking after our whole continuum of health in the ACT.

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