Download

The selection process should be set up to ensure that good quality candidates apply for the positions
and that the best person for the job is likely to be selected. This includes advertising the jobs in
media where good candidates will see the advertisements, personally approaching potential
candidates including people within the MOH and other health institutions who have high potential to
perform in the roles; and ensuring that the interview process and wider selection process will be able
to identify unsuitable from suitable candidates (e.g., use of well designed criteria, suitable selection
panel, thorough reference checking, work testing of key skills, etc.)
There may be legal issues with the proposed reforms. The rights of employees who lose their jobs or
are appointed to other positions of lower status or pay need to be considered. The legal situation
must be thoroughly assessed and well managed. Support should be set up for people who lose their
positions, including counselling, job seeking assistance, retraining and redundancy payments.
Employment contracts should be designed to encourage performance including fixed terms, probation
period, performance reviews with consequences for good performance and poor performance, and a
portion of pay linked to performance.
The communications around the reforms need to be carefully managed as there will be disgruntled
employees who may cause unnecessary media issues. The MOH should be proactive with the media
and present the reforms as an important step to improving health services.
The executive summary sets out suggested sequencing at a broad level for the changes covered by
this review. The information on the current staffing and detailed budgets related to this was not
available, so we have not been able to advance the advice on implementation to include more fully
developed suggestions on the changes and costs. This should be covered in the Institutional
Development Plan.
There are some changes that cannot be implemented at this stage unless the government changes
administrative instructions and some provisions of the law. The Institutional Development Plan can
identify these changes and sequence the reform in line with the likely timing of such changes.
Developing the purchasing/funding function
Appendix D sets out some suggestions about developing the purchasing/funding function in the
context of implementing a split between the purchasing/funding functions and the function of providing
services. The Ministry of Health could start implementing this split through developing the
purchasing/funding function and supporting the changes to improve the arrangements for the
hospitals and other health service providers suggested later in this appendix in relation to changes to
the Health Law.
Note that section 123 of the Health Law provides for the Health Care Commissioning Agency (HCCA)
to carry out functions in the absence of the Health Insurance Fund. This could be modified to say the
Ministry of Health and its agencies and institutions, so there is flexibility to allocate roles as sensible,
rather than doing everything through the HCCA, which at this stage is very under resourced. The
large range of work noted below supports the conclusion that many departments in the MOH would
need to get involved, even if it is led by one part of the MOH such as the HCCA.
The MOH would need to undertake the following work:
Designing and implementing the improved governance and accountability arrangements for
hospitals and other public sector health providers- see later section of this appendix on
possible legal changes
Strengthening the MOH planning, policy, funding, monitoring and regulation roles in all the
health areas including primary health, mental health, secondary and tertiary health services,
public health services and pharmaceuticals
28