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Editor Barbara Fountain is calling for the new national health agencies to be transparent
Confidentiality and commercial sensitivity will be protected, as they are now, by official information legislation
Omicron rules our world for now, no matter how hard we try to shift our focus.
But, elsewhere, cogs still turn and, all going to plan, on 2 February I will make an oral submission on the Pae Ora (Healthy Futures) Bill to the Pae Ora legislation committee.
I’m a first-timer at a select committee; as a journalist I usually report on submissions rather than make them. But in my allotted five minutes, I’ll be riffing on my journalistic passion for democracy and an informed public, and their role in ensuring an equitable, fair and patient-centred health system.
It’s a big bill and my focus is small. I want the Government to include provision for meetings of the Māori Health Authority and Health New Zealand boards to be open to the public.
Because when the new law comes into effect on 1 July, the 20 DHBs, which now routinely supply information on their activity, will cease to exist. Thus will end the regular information drop that comes with the requirement to hold board and committee meetings open to the public.
That’s a huge blow, not just for the public at large but also for the media who act as their proxy.
But it doesn’t have to be this way. The lack of elected members on these boards is not a reason to close the doors.
In the spirit of the legislation – seeking huge change in the health sector’s culture, values and Te Tiriti o Waitangi partnerships – I say we need a system that encourages transparency and values the free flow of information.
The system’s current risk-averse culture needs to be purged amid an acceptance by all that, in the making of something better, there will be mistakes along the way.
Energy needs to be expended on improving the system, not on hiding its flaws. This may sound naive but, unless, and until, health leaders have the courage to set a transparency agenda, the sector will remain accosted by political whims – with all the attendant political grief. And we just can’t afford that.
The biggest benefit of open board meetings is not sitting through the event, but accessing the agendas, minutes and associated reports.
This information keeps the public connected with what is happening in their health system and is a valuable tool for journalists who cover that activity.
For the most part, getting information from health agencies these days comes with a 20-day waiting period, the routinely cited time period of the Official Information Act.
New Zealand has a long history of public board meetings for its health agencies – interrupted only by National’s market-style reforms in the 1990s.
I’ll be the first to concede that, to date, elected board members and public meetings have not necessarily delivered on the promise of accountability and transparency.
But much of the blame for that can be laid with the boards, which have failed to adapt and make it easy for the public to “attend” meetings.
Livestreaming technology well pre-dated the current pandemic and has been used widely by council and select committees, but not by DHBs.
There has also been a circular problem with democracy at DHB board level.
In the first place, the complexity of the board member role makes it difficult for the average community representative to take part.
Then, when they do, it is only to find their hands are pretty much tied by decisions made by central government. Also, the DHBs make frequent use of closed-door meetings, and they run Cabinet-style decision-making, where all must support the final outcome, whether they voted for it or not.
This lack of ability to influence significant change at the local level means communities remain disconnected from their boards and do not attend meetings, which are, in any event, held at times that make attendance difficult.
Cuts in the media industry mean many media outlets do not have the resources to send reporters to meetings; DHBs have done nothing to counter this loss of regular media coverage.
At a minimum, a rundown of key issues covered in a meeting could have been released to the public by the communications staff employed by all DHBs. But instead, the public is required to await the delayed publication of meeting minutes. Accessing these on DHB websites is not for the faint-hearted.
If anything, board members feel a sense of relief at the absence of media, rather than concern that a key element of the accountability process is missing.
The media are seen, at best, as a chore, at worst, as the enemy, not as a key stakeholder able to help the system stay accountable to patients and taxpayers.
To be fair, not everyone hinders public and media access to information in the health system, but the system itself does not encourage a free flow. Those working from within trying to ensure transparency are as likely to strike problems as those on the outside.
Ultimately, the leaders of the new agencies need to ask themselves: “What is the worst thing that could happen if meetings were open?”
After all, confidentiality and commercial sensitivity will be protected, as they are now, by official information legislation.
The worst that could happen is no one will show up or tune in, which should then lead us to ask who these reforms are for.
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