Health Minister Bent Høie (H) rejects opposite SCSCA that he instructed the health authorities’ boards of election of a new hospital in North Møre og Romsdal.
– In this specific case I have not instructed through corporate meeting on the selection of land for new hospital in North Møre og Romsdal. I have not attempted to instruct the boards outside corporate meeting regarding election of land, writes Høie in its response to the committee.
Here’s health minister letter to Control and Constitutional Committee in its entirety:
(Highlights in bold and between titles made by Rbnett.)
Many misunderstandings
“I have noted that from several sources are many misunderstandings related to how ownership management between the Ministry as the owner of the regional health authorities and the regional health authorities as the owner of the health trusts are anchored in legislation. There is also confusion as to how good corporate governance should be exercised. I would therefore initially go any further into this issue before I answer the specific questions from the committee.
The regional health authorities and health trusts are businesses that have sectoral policy and social objectives. It follows from the Specialist Act § 2-1 that the state has the overall responsibility for the population given the necessary specialist . Government overall responsibility entails that the state should put the regional health authorities are able to fulfill their duties to provide specialist to the population within their health regions. “
The state has responsibility
” State responsibility is limited but not to facilitate the regional health authorities to fulfill their obligations. The State has the overall responsibility as determined in 2-1, also a contextually responsibility for the regional health authorities to meet their obligations of legal, health professional and constitutional character. “
– Goals more political
“The goals and requirements that I as owner puts into these businesses are thus far more extensive and more political than in other types of state enterprises with business goals. boards of the regional health authorities are my “tools” to carry my and government policy within the limits and constraints imposed by Parliament’s decision.
This applies not only to me, but has been the case my predecessors and will apply to future health ministers. “
Natural dense dialogue
” It is completely natural and necessary that there is a close and continuous dialogue between both boards and me, and between the management of the regional health authorities and the administration of the Ministry. Practice shows that the well so often is the regional health authorities who apply to the Ministry of relevant clarifications difficult questions, which I need clarification from the regional health authorities. This has also been the case in this matter. It is obvious that in such meetings and contacts exchanged views and opinions from both levels. “
– Not legally binding
” The Health Trust Act clarifies that these meningsutvekslingene and views are not legally binding for the regional health authorities when they are not given in a corporate meeting.
The Health Trust Act § 16 subsection provides that “owners exercise executive authority in enterprises in corporate meeting” and that “the owner can not exercise ownership in enterprises except enterprises meet “.
Corporate thus occur in corporate meeting. This provision does not preclude that there is contact between the owner and the board outside corporate meeting. Given control signals, these will not be binding on the Board. “
– Lawful to give their views
” The Health Trust Act § 16 regulates how the minister and the ministry can act to the regional health authority in dialogue outside undertakings meetings. The law does not prohibit the Minister to give his views on matters of great importance for the owner also outside corporate meetings.
If the Minister does not agree with a decision by the board or see a need for a decision in a case that the Board has not taken a position, must minister to consider to make decisions in corporate meeting. “
– Viewpoint is not instruction
” That the board of a regional health made familiar with the minister’s vision does not imply that the Board is instructed about the outcome.
In the special notes til§ 16 Proposition. No.. 66 (2000-2001) on page 136 stated that:
“If the owner provides control signals by virtue of its own position outside the general meeting is not binding on the firm’s management.”
In a letter from the Ministry of 19. april2004 state the following:
“If the owner gives instructions except corporate meeting, this is not binding on the undertaking. It is of course nothing in the way of that the board makes decisions in accordance with the informal “signals” from the owner, but the Board is not obligated to do this and it does not relieve the board of the responsibilities required under the health law. “
Supported in ownership message
The legal basis is also supported in state ownership message, latest report. St 27 (2013-2014) which states:
“limits on owner not preclude the state, as other shareholders, in meetings raises issues that companies should consider in connection with its operations and development . The views expressed by the state in such meetings are considered as input to the company’s management and board. “
The Health Trust Act prohibits therefore not minister to give his views on matters of great importance for the owner also outside corporate meetings. Such signals outside corporate meeting will thus not be a violation of health law § 16. “
The Board must evaluate
” In cases where the board of the regional health authority be familiar with the minister’s view, it will not imply that the Board is legally obliged to make decisions in line with this vision. As mentioned above, the Board in such a situation even consider the case and make a decision based on their own convictions. If the Minister does not agree with the decision made by the board of the regional health authority, must minister to consider whether it should be made a decision with a different conclusion. It must then be made in corporate meeting. “
– Do not instructed
” In the specific case I have not instructed through annual meeting for the election of land for new hospital in North Møre og Romsdal . I have not attempted to instruct the boards outside corporate meeting regarding election of land. Both the control treatment in Health Møre og Romsdal HF and Health Central Norway Regional was clearly expressed that there were no instructions from the owner by the Minister on the selection of land for the new hospital. No directors stated that their voting was based on the existence of an instruction from the owner and not own perception of which election of land that was best suited.
Please see the attached memo dated 20 December 2014 to Health Møre og Romsdal HF vlstyret from the law firm Thommessen AS. The memorandum is based on information from The medical Møre og Romsdal. There has been no contact with the Central Norway Regional Health and Health and Care under utarbedelse of note. In particular one point I have a somewhat different view of the legal assessment than Thommessen AS, see page 9.
As to the questions:
l. In what way has Helsedepartementet- formally or uformelt- been involved in the process related to the choice of location for the new hospital for North og Romsdal?
I will here first mention the formal milestones by the Ministry as has affected plot choice:
In general meeting on the 8th June 2011 it was given constraints related to the preparation of a development for the new hospital. It was further given the requirement that development plan should include an option with a common hospital between the current hospitals in Northern Møre og Romsdal:
“Corporate meeting showed that the National health care plan stipulates that there should be close to emergency and maternity care. This also can be obtained either by maternity and emergency facility at both hospitals in Northern Møre og Romsdal, or by one common hospital located between the current hospitals, but with sufficient proximity to both byer.Utviklingsplanen for buildings should therefore contain these two options. “
This decision narrowed thus entering the geographical location of the new hospital. Board of Health Møre og Romsdal later defined this to be the axis of – and – Hjelset supply and – with ear part of Frei.
From the general meeting on 19 December 2014l heights decision:
“The General Meeting confirms Board of Health Central Norway Regional its decision a Board No. 83/14 that the new hospital in North Møre og Romsdal localized to Opdøl (at Molde).”
Ministry of Health in the entire period from 2011 to now held regular meetings with Central Norway and been updated and informed about plot selection. In some of these meetings have also administration and project management in Health Møre og Romsdal participated. Employees of the Ministry has also been visiting in Møre og Romsdal and erected between Kristiansund and Molde and been shown plot options. However, it has never been given any signals from the administration of the Ministry to some employees of the Board or the administration of Health Møre og Romsdal or Central Norway Regional Health to support some of the plot options that have been relevant.
2. What informations- formally or uformelt- has the Minister given to Health Central Norway and possibly Health Møre og Romsdal, if the minister and the government’s views on the localization of the new hospital in North og Romsdal?
I have had several meetings / contacts both with the administration in Central Norway and with the two chairmen of Central Norway. In these meetings / contacts I have not instructed anyone to add a solution basis for the work towards control treatments. I have always stressed that it is the professional advice that will be decisive for the final decision in the case. Various empty choice has of course been discussed in these meetings that I have not instructed in the empty choice.
Both the Ministry and I have regular contact with all the regional health authorities, both administratively and with the chairman. The chairman of the health region often need to discuss difficult issues with me. It may be to probe or to discuss political consequences of different issues, and it is in line with good corporate governance. At this contact occurs in confidence is important for the ability to exercise good leadership to the chairmen. But this contact deprives course not the boards responsible for assessing, treating and decide cases on an independent basis. This is the latest featured in ownership report, as reproduced above. This has been the practice since the hospital reform stranded in force. We would warn against this being changed.
However, there is a difference between when this question is asked by the press and the question posed by Standing Committee on Scrutiny and Constitutional Affairs in connection with their efforts to make sure I as minister follows laws and regulations. I will therefore now clarify when and to whom I have given express my reviews between the various plot options. I have not given express what I mean to the current Chairman of the conversations we’ve had about prosessen.Tidligere Chairman Marthe Styve Holte took empty election up with me, as we sat beside each other on a dinner we had on 24 March 2014 boards and leaders of the regional health authorities. She wanted it to know if I had any preferences in the choice between lots. I replied that she should know if I during the process got a clear preference. At that time it was not clear to me whether any of the sites designated clearly or disqualified themselves academically. I contacted her 26th August 2014 to be inf ormed about the status of the process so far. In the conversation I said that it was not working as one of the two sites near the towns clearly stood out or disqualified themselves academically, and that I from recruitment consideration enough when poured against plot near Molde. The academic assessment and quality assurance of this was not done at the time, and we agreed that Central Norway Regional Health should come to Oslo and submit this for me and bureaucracy when this was completed, but before the boards did matter. This as a basis for making up the final conclusion at a later date.
I chose, however, to hold this meeting because this could be perceived as if I would instruct the administrations of the two health authorities in the time between the the academic report was ready and setting should be written to the boards.
When it comes to my contact at Health Møre og Romsdal, I refer to my answer to question 8.
When it comes to the formal decisions, I refer to questions l.
3. What procedural and investigation undertaken / have been made by the government receives a recommendation from the Central Norway Regional Health on 18 December this year until the government eventually reaffirm its decision in general meeting which is convened til19. December.
As I have explained above, I and the Ministry followed this case closely over time. We have had access to the same material from studies that other makers had. The documentation for the board meeting in Health Møre og Romsdal were sent out on 10 December and the papers to the Board meeting in Central Norway were sent out on 11 December. My department and I have thus had an equally long time to put us into control issues that the boards have had. Caseworkers in the Ministry has also followed both meetings are broadcast live on TV in the case under discussion there should emerge new information relevant to my final decision. I also chose to travel to Nordmøre and Romsdal24. February 2014 as part of the preparation, when it was clear which three plots that should be further investigated. In addition to that I inspected the plot options, I also had a meeting with the representatives from the two hospitals and the mayors of the three municipalities in question. This case is not treated in government Solberg. I have clarified that this is a decision that has been assigned me as healthcare minister, and thus corporate meeting in Central Norway.
4. What information and analysis underlies that the minister could convene the general meeting before Central Norway had reached a decision.
As stated in the answer to question 3, had both I and the civil service in Ministry formed a good picture of the options before the Boards considered the matter. What remained before a final decision could be made was to know the outcome of the two meetings and what arguments that emerged there. Had one of the boards decided to postpone the matter, also had the general meeting has been postponed. It was also communicated publicly in advance of the boards handled the case.
5. How does the Minister that the administration and the Board of Health Møre og Romsdal may have been influenced by the owner (Central Norway) recommendation to Board decision was public before the board meeting in Health Møre og Romsdal took place?
The formal relations between a regional health and health is the same as between Ministry of Health and a regional health. Board of health trust is therefore not obliged to follow any signals it has received from the owner and it is bound to take independent decisions by health law.
As it transpired from the live board meeting in Health Møre og Romsdal had Board members exchanged between plot options over time as they, from many quarters and sources, got new knowledge and insight in the matter. About standpoint of administration in Central Norway has affected some directors of Health Møre og Romsdal however, I have no reason to have any idea about. For those who followed meetings so there is nothing that would indicate that no directors and board as a whole took independent decisions and responsibility for this as the law also requires. Boards also have a responsibility to consider that they have a sufficient basis for the decision, it was also considered in connection with the postponement proposal in Health Møre og Romsdal.
As long as the Board of Health og Romsdal not instructed through corporate meeting, it is incumbent upon the Board to make an independent assessment of the case. Any signals that are given outside corporate meeting, does not relieve the Board of Health Møre og Romsdal from the obligation to make an independent assessment of the case. As mentioned above also shows the vote that the Board may not have understood that there was a binding instruction from ether.
6. What was the reason why the chairman of Central Norway Regional Health resigned earlier this fall, and the communication has been between her, Central Norway Regional Health and Ministry of Health in connection with her departure?
Ministry of Health has received 2014 phone calls from representatives where it has been expressed strong concern about the CEO Andersen suitability as leader. These concerns were relayed to Chairman Styve Holte. This referred not questions about choice of land for new hospital in North Møre og Romsdal. On 9 October 2014 received the ministry a letter from ASUR Central (Academics Councils) who went on the chairman’s ability to handle the situation in Central Norway.
On the basis of this letter, I contacted the chairman on Friday 10 . October and had repeated conversations with her through the weekend. Through these conversations with the Chairman, it became clear that we were fundamental disagreement about both the current situation, serious situation and how it should be handled further. Chairman then chose also even to withdraw. Vice chairman of the board was then on the board acting head, and said later agreed to be appointed as the new chairman.
Otherwise I can not answer for what communication there has been between the previous chairman and administration in Health Central Norway area in this case.
It follows from health law § 36 that the authority to add and optionally terminate or dismiss an employee rests with the Board. It does not mean that the owner may have an idea about the daily management of the enterprise. Owner may not terminate or dismiss manager through corporate meeting. Owner must adhere to the board. If the owner believes that the management of the enterprise is not exercised in a good and proper manner, it is nothing legally wrong to convey this to the Board. It’s the board’s responsibility just to make a good and prudent management of the firm, see Health Enterprises Act. § 28. The Board must consider these control signals and draw their own conclusions about how these should be handled.
In the particular case selected chairman to withdraw on the basis of control signals from own outside corporate meeting as I have described initially under this question. This she gave also expressed in the media afterwards that she withdrew.
I see that some express that this was done in a strategy to “pave the way” for acting director Daniel Haga. This is obviously wrong. Firstly, it is the Board of Health Central Norway constitutes director of the entity. Secondly, I was at that time aware that Daniel Haga was sick. I would therefore could not foresee that the result of that Andersen resigned from the post would be that Haga was constituted.
7. How has Health and omsorgsdepartementet- formally or informally been involved in the selection of current directors of Health Møre og Romsdal.
I have neither formally or informally been involved in the selection of current directors Health Møre og Romsdal. In connection with the appointment of Stein Kinserdal new chairman, came a request from Health Central Norway to the ministry where Central Norway Regional Health requested an assessment of whether health law gave opening to appoint a chairman outside the region. This was the black affirmative. It is only in the regional health authority that according to health law § 21er a requirement that board members must have a sense of belonging in the region.
8. Director Eidsvik in Health Møre og Romsdal went recently from his position. By demise turned director to what she believed was the intervention of Central Norway: “I experience no in the final stages of the work that Health Central Norway intervene in the process locally before my recommendation to the board is ready.” The regional health enterprise management in line with the health law §16 and Minister has informed that it has been such contact.
I am informed that the Boards of Health Møre og Romsdal and Health Central Norway agreed that they should pray the two administrations to seek to identify a common set what came plot choices. This led notoriously not succeed. Acting CEO of Central Norway has maintained that even if they did not agree, it was constantly made clear that CEO og Romsdal stood free to promote its own recommendation on plot choice.
I will inform SCSCA that I met the chairman of Health Møre og Romsdal Stein Kinserdal on the way to a lecture I should keep for spectrum 4. December. This meeting is also discussed in the attached letter from Thommesen. We had a brief conversation in which I asked him how it went with them in the difficult process. He informed me then that there had been a meeting between the directors of Møre og Romsdal and Central Norway Regional Health where they had tried to agree on a common setting, so that they could put forward setting together on the same day. He believed that it would be an advantage, but that Eidsvik was determined Storbakken and Haga Opdøl. I said myself agree that setting would be stronger if they agreed, but noted that they would not be able to present a common setting if they did not come to an agreement.
He also expressed he poured against Opdøl. In his explanation to Thommesen he has shown that I nodded during the call. It is for me a way to actively listen, not to agree with the statement.
He finished by telling that he was afraid that Eidsvik experienced situation so difficult that she was considering withdrawing, and that he was now in regular contact with her. There I was surprised and expressed the view that I hoped it did not happen. I wished him good luck on this difficult issue and proceeded to keep my lecture. After the lecture I went straight into government conference. When the IGC was over, I got information from the Chairman of the Central Norway Regional Health that Eidsvik had resigned.
I feel therefore not left in the mail he sent to Eidsvik and notes that he himself has given clearly indicated that he had not a basis for drawing a conclusion that I let it shine through that I supported Opdøl.
The relationship between the CEO (CEO) and the board is not regulated by health Act § 16, but § 37. It follows av§ 37 first paragraph that “the CEO is responsible for the daily management of the company and shall follow the guidelines and instructions issued by the Board.” CEO of the health authority is not bound by any signals given by the regional health authority outside corporate meeting.
In this case it is the case that the CEO went voluntarily. Legally would CEO could have stood in the position and given a recommendation to the Board with a proposal for a conclusion in line with their own assessment of what was best suited as empty new hospital, as long as there was no legal binding instructions from the Board of health authority on the selection of land.
The same day asked Astrid Eidsvik about a conversation with Secretary of State Anne Grethe Erlandsen a few hours before she announced that she had resigned. In conversation, she confirmed that she was instructed by the Minister. She added that the only thing that could get her to go for Opdøl as empty choice, would have been a direct instruction from the Minister. Such instructions she never.
The fact that the CEO chose to go by, do not affect the question whether the proceedings are justifiable. The deciding factor for this question is whether the legal basis is justifiable. It is basically irrelevant whether the CEO submits recommendations with or without proposals for conclusion. It is the proposal itself which shall be responsible, not the proposed conclusion. That recommendation from the new CEO of the health authority contained a proposal for conclusion on the choice of plot is consequently not a procedural error and results nor that the proposal is indefensible.
However, I was not made aware of mail exchange between Chairman Stein Kinserdal and Astrid Eidsvik ahead of that she resigned. These emails are now publicly available. It could for me now seems as if Astrid Eidsvik perceived situation to mean that she was subjected to the control of own Health Mid-Norway. Generally, I believe that the owner must be entitled to express a preference about how issues like health authority shall determine, should be solved. If the owner in such situations nor expresses the firm is obliged to follow such a preference, there is in my opinion no (attempt) breach of health law § 16. Here it seems that the law firm Thommessen AS assumes a somewhat different understanding.
9. There were allegations of offenses under the board meeting in Health og Romsdal17. December 2014, including issues related to pressure against director Eidsvik. The minister must indicate around the content of these allegations.
I refer to that which appears in Section 8.
10. Has the Minister knowledge innblanding- outside foretaksmøte- from Health Central Norway in the process of Health og Romsdal?
I know that obviously has been much contact between Central Norway and Møre og Romsdal in the processes that have been since corporate meeting of Health Central Norway Regional in 2011 merged the two former health authorities in the county and asked the new hospital investigate a new hospital for Møre og Romsdal and until the attempt to arrive at a common setting few weeks ago. This I regard as absolutely necessary contacts in a demanding process, and not interference, if one adds a negative interpretation of the word used. I would add that the same principles of corporate which is accounted for initially applies between the regional health authorities and health trusts. The common understanding of the law is that the regional health authorities will naturally have an even closer monitoring of health authorities, than the Ministry and the regional health authorities. In intensive processes will also be such that the regional health authorities the competence and counsel ing available to health authorities.
Sincerely
Bent Høie “
No comments:
Post a Comment