Perhaps not, observes Professor Gavin Mooney, a health economist with an interest in the use of citizen’s juries for informing health policy. He writes:
“Tony Abbott’s idea of local community boards for hospitals is really about who exercises power in our health care system. The idea of power to the people has a nice ring to it.
But Tony Abbott supporting power to the people? And the idea getting an overall positive welcome by the AMA President, Dr Andrew Pesce? Something amiss here…
Does this really mean people power?
No, this announcement is about two things. First it continues the obsession that politicians have with hospitals and their seeming inability to recognize that there are really rather a lot of health services outside of hospitals and indeed, on a day to day basis, the general public have much more contact with non hospital services.
This obsession applies to both sides of parliament. In the wake of the publication of the NHHRC Report last year, Kevin Rudd went on a national tour – not of health services – but of hospitals only.
Second, having small local boards plays into the hands of the powerful AMA who are then yet better placed to influence what goes on. Dr Pesce states: “It’s very, very fundamental that decision-making is returned back as close to the patient care delivery as possible, rather than being made at a very central [bureaucratic] level.”
So the AMA does not see this in terms of being community driven at all but of getting decision making “as close to patient care delivery as possible” i.e. into the hands of doctors.
So of course on these grounds the AMA welcomes Abbott’s plans.
Does Abbott really believe in the community voice in health care? Well he might now but he didn’t when he attacked the idea of citizens’ juries on the 7.30 Report in 2006.
A more fundamental question: are local community boards really the voice of the community?
No, they normally do not represent the community in any genuine sense but rather are selected from the great and the good. It is of note that in the South West of WA when efforts were being made to get to the voice of the community through citizens’ juries, those who were most vociferously opposed were the former members of local community boards who didn’t like the idea of their role being usurped by these ‘ignorant’ citizens!
Local voices to influence health care decision making is a good idea and it is a good idea for all health services and not just for hospitals.
But let’s have (as in citizens’ juries) the informed, randomly selected voices of the community. If we do have to have local boards, Mr Abbott, as a minimum require them to have to set up citizens’ juries – and require them to listen to them.”