24 February 2000

Ms Tracey Slatter
Manager, Community Health
Aged, Community and Mental Health Division
Level 2, 555 Collins Street
MELBOURNE VIC 3000

Dear Ms Slatter,

I represented the Geelong Community Forum at the Geelong Health Governance Forum on Wednesday February 23. The short time line has prevented us from consulting our members, however, our committee has given due consideration to your consultation paper. Our committee agrees that participatory democracy was severely set back during the tenure of the previous government and for this reason it might not be possible to immediately fill the community health boards through full elections. We also believe that this can be ameliorated by the following suggestions which mostly echo the views of the meeting with some minor differences and elaborations:

Composition of the Community Health Boards

• There should be nine members, with six elected members and three appointed members.
• No more than three members of the board to be health professionals.
• Clear guidelines will be established for applicants and elected board members.
• Expressions of interest for nomination to a health board will be advertised through the local media with a reasonable time frame for people to respond.
• Applicants are to be rank ordered, according to suitability, by the chairperson, another elected member of the board, and an independent adviser, during a formal interview process.
• This full rank ordered list is to be ratified by a meeting of the board and then forwarded to the Minister for final selection.
• The Minister must select from applicants towards the top of the list and advise the board of the reason for the preferred applicant.
• Board members and unsuccessful applicants will be notified immediately after a decision is made.
• The need for appointments will be reviewed after four years.
• It will be made clear to all members of the board that no one is more or less legitimate as a board member whether they are elected or appointed, or on the basis of qualification.
• Board members will be given a fair stipend to meet ancillary expenses such as telephone and travel.

Public Awareness

• The government should immediately embark on a public awareness campaign to encourage people to stand for election.
• This campaign should have an affirmative action component which addresses equity issues surrounding gender, ethnicity, disability, age and other subtle forms of marginalisation.
• There will be an education program in place to ensure that all board members have a minimum skill base and therefore do not feel precluded from joining these boards because of lack of experience.

Elections

• 3 year staggered terms, with one third of the positions being replaced each year.
• All members of the community health centres will be eligible to vote.
• Membership of community health centres will be open to local residents or their families, and workers within the health centres.
• Others may be considered for membership if they are able to establish to the board’s satisfaction that they have a genuine tie to the community of that area.
• In time, eligibility to be elected to a board will require a minimum attendance record at general meetings.

Ensuring Widespread Participation

We note that the consultation paper focuses primarily upon the boards, rather than the membership of the community health centres. We hope that any decisions taken about the community health centres reverses this priority which is a carry over in thinking from the previous government. We regard this as crucial to the good governance of any community boards

Broad stakeholder representation at general meetings will facilitate communication between the board, community health centre members and the general public. We recommend that the constitution of the community health centres includes a membership category for delegates from community associations and other stakeholder groups. This would require the identification of all known stakeholder organisations (residents’ associations, neighbourhood houses, nursing homes etc.) through personal contact and advertisement in the local newspapers. These delegates or a proxy from their organisation should have the same voting rights as all other members but would have the additional role of reporting back to their organisations.

Improving participation rates through the identification of stakeholder organisations and interested individuals is a form of community building. This will not take place overnight and almost certainly needs the full time resources of a community liaison officer. Once high participation rates are established this person would have valuable skills to bring to a role as a community health ombudsman.

Democratising Integrated Health Networks

We believe that the integrated health network systems are in even more dire need of democratisation. Even if these health networks are not dismantled, the suggestions noted above for the community health centres could apply. Member ‘service providers’ could have their equivalents to the community health centre boards. The board of the central body could be elected on a collegiate basis from a pool of delegates nominated by the local boards. Once again this could involve a 6/3 split of elected versus appointed members. Because the commitment to a network board is more demanding upon time and resources these people should be paid a fair wage as well as a stipend for ancillary expenses.

We believe that all board meetings should be open to the public with a formal question time allowed at the start of each meeting. In the long term this will improve participation rates and the accountability of boards.

We hope these suggestions are of some assistance.

Yours sincerely,

Serena O’Meley
on behalf of
the Geelong Community Forum

cc: Stephen Vaughan, John Kranz, Mike Hill