The following appeared in the Australian a few days ago.
Federal health `riddled with conflict'
- David Uren, Economics correspondent
- From: The Australian
- January 15, 2010
THE commonwealth Health Department is an obstacle to reform and should be broken up, with its core staff numbers slashed by 95 per cent, a report presented to the Prime Minister's Department yesterday recommends.
The report, based on interviews with former commonwealth and state health ministers, treasurers and health administrators, says the department is riven with conflicts of interests and should be split, retaining its core function of specialist policy advice while a separate department would deliver services such as Medicare and aged care.
Ken Baxter, lead author of the report and formerly head of the premiers' departments of NSW and Victoria, said the Rudd government would not achieve its goal of improving health services delivery until the department's roles and responsibilities were sorted out.
"There appears to have been a long-standing culture of obfuscation and opposition to major reform from middle-level management," the report says, adding this was also true of state departments.
The department, with about 5000 staff, had become too broad for a single minister to handle effectively, Mr Baxter said. A pared-down policy advisory department would require no more than 250 specialist staff.
The report, funded by the private hospital and health fund body, the Australian Centre for Health Research, was based on interviews with 15 former ministers and health administrators.
Lots more here:
Coverage is also found here:
Report: Health Dept hindering reform
15-Jan-2010 
The Federal Health Department is rife with conflict of interests and is a serious obstacle to reform, a report by the Australian Centre for Health Research claims.
The report, which was presented to the Prime Minister’s Department this week, recommends that the department should specialise in providing specialist advice, while another department should be created to oversee the delivery of other services such as Medicare, according to an article in the Australian.
"There appears to have been a long-standing culture of obfuscation and opposition to major reform from middle-level management," the Australian quoted the report as saying, adding this was also true of state departments.
More here (registration required):
http://www.australiandoctor.com.au/articles/e4/0c0668e4.asp
It is interesting that this research has been, in part sponsored by Government – and must have been close to one of the last ministerial acts of the now Opposition Leader.
Press Release
Australian Centre for Health Research
17 October 2007
ABB135/07
Subject to successful contractual negotiations, the Commonwealth Government will provide funding of $500,000 to the Australian Centre for Health Research (ACHR) for its work.
Australia has a very good record in medical research. The Government wants health policy research to match our scientific and medical research in reputation and quality.
The ACHR will consider measures that could be taken to improve the delivery of health services and boost the quality of the performance of the health system.
It is headed by a former national president of the ALP, Neil Batt. A former federal Coalition health minister, Michael Wooldridge, is on its research committee.
The grant to the ACHR should help to establish a critical mass of practical heath policy that can subsequently be supported by competitive NHMRC grants.
The ACHR was established in 2005 as a research body that is representative of the entire health sector. It aims to produce independent, quality research to advance the effectiveness of health services in Australia.
The release is here:
http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr07-ta-abb135.htm
One really has to wonder that if these findings are indeed accurate then what sort of impact such division and dissention might be having on policy formation in e-Health. It sure can’t be helping.
Ken Baxter is no amateur assessor of bureaucracies and so his comments deserve, prima facie, to be taken quite seriously. It is a pity the report is not yet available from the ACHR website:
Maybe then we could all form our own views on the reported findings.
Heavens knows what impact all this might be having on the broader, and seemingly stuck, health reform agenda.
I look forward to comments from those on the inside of DoHA telling us all how this is just nonsense!
David.
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