Health Benefits Limited: don't be fooled by the name
Article by Angela Belich - The Specialist, Issue 88, September 2011
Health Benefits Ltd (HBL) is an organisation whose activities are causing the ASMS (and several DHBs) concern.
The new shared services agency: Pharmac for services
In 2010 the new National government started to put in place the changes to the public health system that had been mooted in the Ministerial Reference Group (MRG or Horn) report. Essentially the MRG report proposed greater centralisation, co-ordination and collaboration through which the hope was the public health system could both improve the quality of health care and make savings.
The MRG group proposed to achieve this through clinical leadership and a number of new national entities: a national health board (now part of and roughly half of the Ministry of Health), a quality and safety organisation (now a separate crown entity, the Health Quality & Safety Commission), and a national shared services agency which was to be like a Pharmac for services.
Under the Radar
The shell of Health Benefits Limited was adapted to become the new national shared services agency and do this work in the same way that had been initially suggested for the National Health Board. They took the name of the crown entity that was responsible for primary care funding that had become a shell with the advance of capitation and its devolution to DHBs.
Like the new Health Quality & Safety Commission, HBL is separate from the Ministry of Health. It is a crown company (listed in schedule 4 of the Public Finance Act). It has its own board which reports directly to the Minister of Health (HBL also sits on the NHB).
The new shared services agency was set up with little fanfare to handle the rationalisation of so-called ‘back office’ functions of DHBs including procurement. Such ‘rationalisation’ might include regional consolidation, national consolidation and outsourcing (privatisation).
HBL’s ’Statement of Intent (SOI – a statutory annual document) makes it clear that though it regards individual DHBs as its customers ‘”where commercial considerations in support of the national interest outweigh individual DHB preference… HBL will request the Minister of Health to utilise his powers to direct.”
These are new powers given to the Minister of Health under the amendments to the New Zealand Public Health and Disabilities Act amendments passed in July 2010 and allow him to direct DHBs under certain circumstances.
What does Health Benefits Ltd do?
HBL has been required by the Minister of Health to make savings in DHBs of $700m (cumulative) over five years (over one year of which has already passed). In order to make these savings it will “make a quantum shift in the way management, administration and procurement support services are provided”.
A few weeks ago it submitted a business case to government, the contents of which are unknown. This is causing DHBs to fear that HBL may impose simplistic decisions that may be impractical or risky for financial, functional or clinical reasons....
The full article can be downloaded here
