Oliver Frank wrote: > Tom Bowden wrote: > >> I have been expecting NEHTA to bowl in and take overall responsibility >> for making things change, Robert says (and I have heard other NEHTA >> staff echo this), that they take no responsibility for actual change >> happening or the lack of any change to date and that they exist >> therefore to develop technical specifications and architectures in the >> hope that they will be implemented. If this is the case, who does >> have responsibility for leading the transition? > > I notice that in the replies so far to your message, Tom, that none of > us has yet been able to provide an answer to this important question of > yours. I wonder whether there is any answer to it out there in > governmentland or bureaucratland.
I can't answer on behalf of government or bureaucracy, but it is worth remembering that, to quote the "About NEHTA" web page: "On 5 July 2005, the National E-Health Transition Authority team became NEHTA Limited, a not-for-profit company limited by guarantee, with continuing responsibility for developing national health IM&ICT standards and specifications. NEHTA Limited is jointly funded by Australian state, territorial and national governments, and the Board of NEHTA Limited is comprised of chief executives from health departments within these jurisdictions." Also worth looking at the governance structure: http://www.nehta.gov.au/content/view/83/102/ You will notice that NEHTA governs nothing except itself. Thus NEHTA is an organisation set up, funded and governed by Australian state, territorial and national governments to provide better co-ordination of the health IT efforts of those government bodies. That necessarily means better co-ordination of the IT intersection between federal, State and Territory health organisations and private sector health services. But NEHTA has no governance powers at all, and relies entirely on the willingness of its jurisdictional members to actually follow and implement the standards, specifications and plans it puts forward. The same applies to its relationship with the private sector. There is no compulsion to follow NEHTA recommendations, just like there is no compulsion to adhere to Standards Australia standards if they don't suit or are not worth the compliance effort, unless there is specific legislation or government regulation which mandates such adherence. There is no such legislation or regulation that I am aware of with respect to any NEHTA specifications, standards or plans, nor are there any announced plans for such legislation or regulations. Thus, NEHTA's role is to lead the herd of horses to the water, but not to make them drink. >> I still cannot believe that such ambiguity exists. > > For some reason Australia, by contrast with New Zealand, seems often to > suffer from a dreadful paralysis. I have often wondered whether this is > caused mainly by the even larger geography than New Zealand's, our > ridiculous State/Federal disjunctions and jurisdictional fights or by > something in the Australian character. Whatever the cause, I have often > admired New Zealand's ability to just get on and implement changes in > its health system (acknowledging that some of them have turned out to be > experiments that failed). Compared to many other English-speaking countries, the Australian approach to government over the last decade or so has become very supine. I think this is informed by a lingering belief here in Oz and in the US, whose lead we are following, in "the power of the market" and in laissez-faire economics (and in "free trade"), beliefs which other countries merely give lip service to, rather than actually rely upon to deliver socially useful outcomes. Tim C _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
