After the 1990s National Administration taught the sector that business-minded managers were in charge, terms like “clinical leadership” and “trusting nurses and doctors” have resonance. Mr Ryall’s speeches are rich with them, reflecting his leg-work in Opposition and the evolution of moves started by Labour. He has instructed health boards to give clinicians more decision-making power.
Overseas he found that “clinical networks” – doctors hooking up across boundaries – make health services more effective. Enhancing the prestige of health workers may also counteract the pull of higher salaries overseas, helping to solve the health workforce crisis without massive pay rises.
There are some risks with greater power for clinicians, but there was little doubt the managerial culture had gone overboard, and the secto was drowning in bureaucracy.
Surely this dream run can’t last for a man in a portfolio which traditionally involves nasty public scraps over strikes, treatment delays from under-funded hospitals, or deaths due to medical mistakes.
Perhaps he will be dragged into a messy pay dispute. Health boards are lining up for what Waitemata DHB has told Mr Ryall will be staff-cost growth “based on a zero per cent increase on all employment agreements expiring during 2009/10”.
The pressures will only get worse.
He has incurred the ire of public health practitioners over cut-backs to anti-obesity funding, but these are in line with National’s philosophy that what we eat and how much we exercise are matters of personal choice and not socially nor environmentally determined.
And National is still funding many public health programmes. What Tony stopped funding was lobby groups to lobby the very Government that funds them.
Tony should also be looking at the funding of Te Reo Marama, as detailed by Whale Oil. They’ve had $1.2 million since 2004 and most of what they do seems to be attend overseas conferences and write letters to the editor.