In an 8-1 vote, the House Health Committee endorsed the idea of setting up a hospital system for Maui that would take over management from the Hawaii Health Systems Corporation, which claims to be the fourth-largest public hospital system in the nation, overseeing 12 facilities.

The bill already passed by the Senate originally would have designated regional management of hospitals on all the islands, but the bill was amended today so that it only covers Maui. The Hawaii Health Systems Corporation unified the state's public hospitals when it was established in 1996.

The movement for more local control of hospitals has been building in recent years on Maui because of concerns that patients weren't getting quick and specialized care. Last year, an effort to build the 150-bed Malulani Health and Medical Center was rejected by state officials.

The legislation would not change the approval process for building new hospitals.

Maui hospitals need more community-based leadership because they don't get enough equipment, staff or medical assistance from other hospitals within the Hawaii Health Systems Corporation, said Dr. Pedro Giron, who works in the emergency room at Maui Memorial Medical Center.

"This is the way we have to go. We need a group that responds quickly to patients," Giron said. "People have painted Maui Memorial in such a bad way. We need to convince our community that we're a new and different organism."

But opponents of the plan say all the state's public hospitals should remain connected so they can save money, leverage purchasing power and prevent redundant services.

"Why not share resources, space and medical professionals rather than compete for them?" said Nona Wilson, director of nursing at the 21-bed Kau Hospital on the Big Island. "We small guys need the big guys ... for our survival."

The amended bill would allow Maui's hospitals — Maui Memorial, Kula Hospital and Lana'i Community Hospital — to control their equipment and decision-making without having to deal with the bureaucracy of the Hawaii Health Systems Corporation, Giron said.

Maui's independence would be a pilot project set to expire in 2012. The bill now advances to the House Finance Committee.

"Community involvement has to be served. At the end of the day, let's make sure that gets done," said Rep. Josh Green, D-6th (N. Kona, Keauhou, Kailua, Kona), who is also a Big Island doctor. He chairs the health committee but excused himself from the hearing before a vote was taken.

Even if the bill fails to get passed into law, the board of the Hawaii Health Systems Corporation has already decided to give more authority to the hospitals, said CEO Tom Driskill.

"I hope we can find a balance here," he said. "Going too far will spiral the cost of healthcare. ... Please, let's think of the needs of the people."

Lynda Dolan, a family physician at Hilo Medical Center, said patient care will improve when community hospitals are given more responsibility for their operations.

"The ownership and ability to function as a community hospital needs to come back home," said Dolan, who is also chief of staff at the hospital. "We can't get things approved. It takes forever. ... We're very limited in our services."

Most of those who testified Tuesday agreed that hospitals in Hawai'i need to find ways to efficiently coordinate their specialties so that patients can get the treatments they need.

But doctors, lawmakers and hospital directors differed over whether medical services are better provided through a centralized or local system.

———

On the Web:

Hawaii Health Systems Corporation: www.hhsc.org