Progress in reinstating clinical leadership to New Zealand
hospitals will be gauged with the release of a health worker
survey next week.
Dunedin health policy specialist Robin Gauld, of the
University of Otago's Centre for Health Systems, led the
"exhaustive" national project which involved 19 district
health boards, the National Health Board and the Health
Quality and Safety Commission.
Health Minister Tony Ryall will speak at the launch next
Thursday in Wellington of the Clinical Governance Assessment
Prof Gauld said yesterday the survey was the biggest of its
kind attempted in New Zealand.
Of the 19 boards that participated, 25% of staff responded,
equating to about 10,300 respondents.
The survey gauged progress implementing In Good Hands, a 2009
report on clinical leadership Mr Ryall instructed boards to
While not high profile, it was "explicit behind-the-scenes"
Government policy, Prof Gauld said.
He could not give too much away about the survey, but said it
showed improvements and revealed variability between district
In 2010, Prof Gauld surveyed health specialists through the
Association of Salaried Medical Specialists, which raised
concern there was too little progress.
Taking nearly two years, the clinical governance assessment
project involved face-to-face interviews with more than 160
clinical leaders and managers, as well as the survey.
New Zealand was playing "catch-up" in terms of clinical
leadership. It went further than most countries when it
brought in "generic" managers to run hospitals.
Both the National and Labour parties favoured corporate
managers in health, believing they alone made "proper
decisions", Prof Gauld said.
Education did not go down the same route and, as a
consequence, universities and schools were run by educators,
not corporate managers.
Prof Gauld has a book out this month looking at the
effectiveness of elected district health boards. He
co-authored Democratic Governance in Health: Hospitals,
Politics and Health Policy in New Zealand with Miriam
Laugesen, of Columbia University in New York.
In an "unusual arrangement", health board members were
elected, but accountable to the Government rather than the
Prof Gauld's book suggests the public should only elect two
or three health board members, who could then advocate for
the public interest, but be voted down by the board.
At present, elected members form the majority, but are bound
by government dictate.