Health system reform must be profound
It’s pretty clear what’s wrong with our health system – long waits for treatment, staff under pressure and a bureaucracy that can get in the way of doctors, nurses and other health workers caring for patients.
And all this despite recordspending on healthcare.
This year the Government is putting more than $20 billion into health, with the lion’s share – $15.3b – going to the 20 district health boards that manage our hospitals.
Healthcare consumes 20 cents in every dollar the Government spends, yet official statistics and our own eyes tell us that the system is struggling. Too many of us aren’t getting the treatment we need, when we need it.
Three years ago, the Government commissioned a report to find out what’s going wrong.
The Health and Disability System Review reported back in June last year.
It told us that that by world standards, New Zealand has a very good public health system.
And we have. I have huge admiration for the nearly quarter of a million people who work in our public health system, from the doctors and nurses at the front line to the cleaners and clerks who keep the system running.
But the report also said our public health system is under serious stress and needs to change.
One of the most important things we need to do, it said, is to put people – consumers, wha¯ nau and communities – at the heart of the system.
I agree with that. Our health system should not be about structures but about people.
If someone in Whanga¯ rei can’t get an operation in a reasonable time, that person should, with appropriate support, go to an Auckland hospital.
We do it when ACC is paying for treatment, and we should be able to do it in the public system too.
Just as importantly, we know some people end up going to hospital when it could have been avoided through better access to local healthcare. Better support for primary and community healthcare must be a priority for any revamped system.
I also agree with the review’s criticism of the way the system is fragmented and its failure to properly engage with Ma¯ ori as required under Te Tiriti o Waitangi. We need a system in which Ma¯ ori have effective leadership and partnership – with shared responsibility for health.
The good results we have on some health metrics disguise poor results for some parts of our community, in particular for Ma¯ ori and Pacific peoples, people with disabilities and rural communities.
Communities should have a greater say in planning for the services they need, working together so everyone has access to the support they need to stay well.
There are people who will ask why are we doing this now, when we are still battling the global Covid-19 pandemic.
If there is one thing Covid has shown us it’s the benefit of having a health system that works together.
And the pressure on healthcare is only going to get worse. With an ageing population and a growing burden of chronic disease, we know that within the next 15 years, the demand for health services is going to grow substantially.
That is why it is so important that we start fixing it now.
When we were re-elected with a clear mandate for change, our Government made three promises – to keep New Zealanders safe from Covid-19, to accelerate our economic recovery and to lay the foundations for a better future.
On Wednesday, I will announce the future shape and structure of our health and disability system. The changes are bold, but will allow us to build a modern, efficient, effective and innovative health system that works for everyone, no matter where you live or who you are.
Healthcare consumes 20 cents in every dollar the Government spends, yet official statistics and our own eyes tell us that the system is struggling.