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Some countries have combined health and social functions in one ministry, for example Finland and
many states in Australia. Some countries combine health and disability functions, but not other
social functions. At this stage the option to enlarge the scope of the MOH has not been considered
given the large challenges the MOH faces; weaknesses in key policy, planning and monitoring areas;
the legacy of having had many changes in ministers and PSs; and the considerable capacity
problems. Adding to this ministry’s functions or transporting this ministry’s functions into another
ministry, is likely to create an agenda of issues that would overload any PS and senior management
team.
SECTION XIII: New structure and current structure
The process to develop a new structure reflecting the functions of the MOH needs to be determined.
The Working Group on the Structure has not been able to resolve differences and is not a suitable
forum for this work, given that it is comprised of directors who will be affected by the restructuring. An
alternative process could be to have strong leadership supported by the ministers. A small team
could work with the group to develop and test the proposals before making recommendations to the
PS and ministers. The team could be made up of people skilled in this work with many coming from
outside the MOH. The process should involve gathering the necessary information. This draft report
could be a partial contribution to that work, but it needs to be thoroughly tested. The option that is
most strongly supported by the analysis should be fully costed and refined to make sure it is
financially realistic and sustainable in the medium term.
The main changes suggested for further testing have been set out in the executive summary. Table
4 maps these changes to the current structure. While this table presents one option, note that
variations on this option have been discussed in the report for many areas. Further work should test
the variations in this report and other variations that emerge from the process outlined above. The
mapping table below is not intended to suggest that staff members from the current structure are
automatically transferred to the new structure. The restructuring should involve new job descriptions
with suitable person specifications for all positions and a process for staff selection that might result
in jobs for existing staff, or might involve recruiting new people with the required skills.
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