There was no consultation between the National Health Services and Ministry of Health prior to submitting the merge proposal to Cabinet for their review.
That is what the Director General of the Ministry of Health, Leausa Dr. Take Naseri told the Commission of Inquiry appointed by Cabinet to consider the proposed organisational structure for the re-merge of the National Health Services and Ministry of Health.
Chaired by prominent lawyer and former Attorney General, Taulapapa Brenda Heather-Latu, the Inquiry started last week. The Commission members include Professor Fui Asofou So’o and Fa’amausili Dr. Matagialofi Lu’aiufi.
The lawyers assisting the Commission are Sefo Junior Ainu’u, the Assistant Attorney General and Chief Public Solicitor, and Shalon Time, a State Solicitor.
During his presentation, Leausa pointed out the creation of the N.H.S. in 2006 does not appear to have led to the improvements in transparency and accountability in the governance and delivery of health services that were originally envisaged.
“There is the duplication of services and functions; the top heavy corporate structure which is costly for the Government; the increase in sharing of non-directly service related activities; the complex reporting and communication lines; lack of output based financial reporting; the difficult in monitoring results and assess value for money.”
He explained the principle for the merger was for the people-centered health care and also revitalizes and prioritize integrated public health services using the District hospital and health care centers.
“Also to ensure integrated health care services provision in hospitals, foster teamwork among health professionals with clear lines of communication and reporting."
“We are also looking at a robust health system that is efficient and cost-effective to respond to health needs of the people."
“Furthermore, to encourage career pathways for health professionals through strategic professional development in prior healthcare and lastly to remove duplication of services,” explained Leausa.
Taulapapa pointed out that in the establishment of the N.H.S. in 2005; it was very clear the separation of roles and administrators.
“But it seems to me that was not adhered to because the roles are very clear and while we make sure that they were clearly defined and separated provision of services or nurses, monitoring policies, exercises and oversight of services performances,” pointed out Taulapapa.
Leausa explained that was in 2006, however fast forward to 2015 in the new N.H.S. Act, they were now under the Ministry of Public Enterprises and they would no longer report to the Chairman of the Health Board.
He said in 2016 was when the N.H.S. was moving forward with the new reorganizational structure which was stopped by the Minister of Health and eventually led to the merge.
Taulapapa asked who prepared the Cabinet paper recommending the merge and Leausa responded that it was him.
He was further asked whether other stakeholders were consulted, Leausa said no.
Taulapapa put it to Leausa that it would’ve been helpful for a consultation, but in response Leausa said: “the obvious body language by the parties is why there was no consultation.”