Small Green victory on Health and Disability Bill

by Kevin Hague

Had an intersting experience today – got my first Supplementary Order Paper (amendment to a Bill) passed.

The NZ Public Health and Disability Amendment Bill generally does sensible things. It establishes the framework for the Minister to require DHBs to collaborate, and it establishes the Health Quality and Safety Commission, which will oversee projects to improve, well, quality and safety. This is important from many perspectives.

The problems are that along the way the Government has introduced objectionable detail. In establishing the machinery for enhanced collaboration the Government has also weakened the requirement for DHBs to consult their communities, clinicians and other service providers, removing the requirement from the Act, but saying they will establish something in Minister-made regulations. We are still fighting that one.

With the HQSC they have snuck in a requirement for it to endeavour to be self-funding. The theory is this will ensure it has buy-in from the sector. That’s a good thing. But it is outweighed by risk of perverse incentives. The self-funding requirement will lead the Commission to focus on revenue-generating projects rather than the most important projects. And service provider behaviour will also change if there is a price tag. I’m not against the Commission having the ability to charge for some programmes, but this cannot be allowed to overshadow prioritisation by need.

Progress in the House was very rapid this afternoon, and many of us were caught out doing other things. So much so that I missed the Committee stage of the Bill because I was at a celebratory event for Celia Wade-Brown, confident that the Bill wouldn’t come up until after dinner. When I got back to the House we had already moved to the next Bill. The Government had adopted a strategy of not speaking on the Bill and it had flashed through at lightning speed, including my amendment to remove the self-funding requirement, which passed on voices.

Government faces were all a little strained when I arrived in the House. They do have the option of sending the Bill back to the Committee stage when the third reading is called, but this would highlight their inept handling of the legislative process, and their determination to foist an inappropriate commercial model on the HQSC, so it’s by no means clear that they will.

So right now I’m enjoying my first successful SOP – even if its lifetime turns out to be less than 24 hours!