Las competencias en el EEES

Prior to their involvement, Steering Committee members understood that their commitment to the Committee would be in their “personal” time. Meetings were held in the evening at a committee member’s workplace. Resourcing of the Committee for stationery, printing, photocopying, postage, internet access and toll calls initially came from individual members or the goodwill of businesses and organisations with which committee members were associated. Steering Committee members travelled varying distances to the Steering Committee meetings, the greatest being 34 kilometres return.

The Steering Committee Chairperson highlighted the problems this created:

Because the Establishment Committee had no resources for eight months the committee members were constrained. Electronic communication precludes many from participating and the messages received via this route leave much to be desired, and difficulties arise, and there is a cost, disseminating the information to all committee members. The Chairperson, the only member of the Committee not in paid employment, was reluctant to make toll calls, although toll calls were reimbursed, for what was very basic information. We needed in our situation an administrative person based in our locality. Photocopying was done by MIPA in Palmerston North, but not all of it, and this created another stressor. The photocopier was free but the Chairperson had to travel 34 kilometres round trip to do it. There was little understanding of the frustration this caused.

From interview, 18 August 2004 The issue of personal financial cost was raised on a number of occasions at Steering Committee Meetings. The following statements made at various meetings by the Steering Committee Chairperson illustrates this:

The hall has been booked for next Monday. We got a bill for its hire. [Steering Committee Member identified] has sorted it out – there is no charge to us now.

20 January 2004 I’m sick of having to get [person identified] to pay me [reimburse]. I send the accounts to MIPA when I can and pay myself when I have to. The advertisement for the free local newspaper [advertising the promotion day] would not be accepted unless I paid for it then and there.

In April 2004, following Ministry of Health approval, the DHB paid an establishment grant of $75,000 to meet establishment costs of the Committee.

The Steering Committee Pharmacy Representative made an effort to acknowledge the personal contribution made by the Steering Committee Chairperson at the 3 May 2004 meeting:

Can we pay [Chairperson identified] for the work she’s done? Can we write a cheque? We need to be able to give proper compensation for getting it [the PHO] on the road - getting us here and keeping it going.

The MIPA Advisor replied:

$75,000 has gone through. MIPA has a contract with the DHB to get it going. We need to be sure that we have funds, for example, for legal fees. So $15,000 held for directors’ fees should be held till we are aware of all the establishment costs.

At a Steering Committee Meeting a fortnight later the Steering Committee Pharmacy Representative persisted:

Can I talk to the man that holds the money? Can we pay her [Chairperson identified] $3,000? She has put so much in …..

17 May 2004 To which the reply was:

We agreed to wait until we were aware of all our costs. We also agreed to ensure [Chairperson identified] and others would be compensated.

MIPA Representative

This was the only occasion when overt frustration and anger was expressed. The pharmacy representative was appreciative of the personal costs being experienced by the Chairperson in relation to time and incidental expenses. Importantly acknowledgement was also being made to the contribution the Chairperson had made to the success of the project. Timely

reimbursement which reflected actual costs incurred would have acknowledged this contribution.

While there was an understanding and acceptance that voluntary input into the PHO planning at the community level was required, the way in which the Steering Committee was resourced necessitated personal financial contribution from all members in order to conduct the Steering Committee business. This was a source of resentment throughout the PHO planning period.

At another level demands were also being made on volunteer input, specifically in the giving of time. By implication, the Funding Division - in securing the expertise of the Reference Group - required the Steering Committee Chairperson to make an additional personal contribution:

At the time [of receiving the Establishment Plans] I didn’t have a lot of resources but I was using the Primary Health Care Reference Group as the - to do some of the work around looking at the Establishment Plans and making sure that they were OK.

Funding Division Representative B from interview, 19 August 2004 The CPHAC Chairperson was an advocate for a level of resourcing for projects of this size:

Yes I would have said that money is needed up front, right at the beginning. So that - there is so much work to do that - for community volunteers to do it, it’s almost impossible. Its almost – it’s just a huge [emphasized] commitment in time and I think that there has to be seeding funding ahead of the establishment date. When they get their establishment money they need that up front – they need that early - so that they can do what [Otaki] did and employ somebody to get to the start date. Levin [Horowhenua] didn’t have that.

And so that is a real big tick for that community [the Horowhenua] that they actually have the volunteers prepared to put in the time. And it’s a really complex process. So that would be the big thing I would argue for – money up front. – right at the beginning.

From interview 18 August 2004

The enormity of the task for the Horowhenua PHO Steering Committee and the amount of volunteer input were further highlighted by Steering Committee GP Representative I:

So the community involvement and so on can’t just happen out of thin air – you have to actually have it organised in some way and you have to have someone who can do that as did happen in the other places. We didn’t really have someone who could do it apart from [Steering Committee member identified] who put in hundreds of hours and without her doing that, very much unfunded, there is simply no way we would have got off the ground in the time we did. We would have been delayed forever.

From interview, 19 August 2004 Simpson et al., (2003) contest that projects must be supported by adequate resourcing so that positive capacity building experiences can occur. Failure to do so can create a risk that new pressures on previously sound community networks become a “… catalyst for ‘cracks’ ……” in the community social infrastructures (ibid., p. 282). While there was no evidence of “cracks” some Steering Committee members were clearly frustrated about the personal time commitment required for this project.

6.8 WHAT SKILLS AND KNOWLEDGE WERE REQUIRED AND HOW WAS