‘Crisis’ label won’t cure problems
Every day is another day of bad news about the stress our healthcare sector is under. Whether it’s another medical profession claiming near-collapse, anecdotes of long waits for acute care or specialist appointments, or more evidence that our chronic GP shortage is no longer manageable, our healthcare system is, like so many of its patients, struggling to breathe.
Solutions are being suggested by many organisations working in the sector. Loosening migration restrictions, training more nurse practitioners, lifting Covid traffic light settings, and using pay parity to attract more nurses into the vital community clinics are just some of the many ideas being mooted.
Both the problems and the solutions reveal a system as complex and interwoven as a Gordian knot, with many parts that are interdependent, ever-changing and fragile.
When laboratories are inundated with Covid tests, for example, there is little resource left for diagnosing other deadly and debilitating diseases. When hospital emergency rooms and A & E departments have wait times of more than six hours, GP clinics will have more after-hours work and patients will present with more serious symptoms, making their care more complex and time-consuming.
I’m no health sector analyst, but my family has relied on an effective healthcare system for more than two decades. We’ve benefited from, and stayed alive because of, the expertise and thinking of a big group of professionals who have thought creatively to overcome our medical problems while functioning in a stressed and prescriptive system.
I have huge respect for this workforce and, as a regular healthcare consumer, have noticed a few things lately. First, many ordinary, everyday services are operating as they always have. Clinics are held, X-rays taken, babies born, prescriptions filled. A 95-year-old I spoke to had eye surgery go ahead as planned. A 75-year-old Cantabrian’s oncology treatment is continuing as scheduled with a new, previously unfunded drug. Despite the daily outpouring of bad news, many departments remain effective, life-saving and even pretty good places to work.
Second, what is happening here is happening everywhere. New Zealand is part of a much larger international system experiencing the same pressures. There are not enough nurses, hospital beds or aged care facilities across the world, Covid is wreaking havoc in countries used to world-class healthcare, and the cost of it all is hard for every government to keep up with.
Thanks to our Government’s initial response, we can now draw on the research and experiences of other countries during the peak of their pandemics. We know system failings, an overworked workforce and not enough equipment are part of how the pandemic plays out. I’m not saying this is fair or sustainable, but our problems are not unique or surprising. This must give us at least some relief.
Next, if we think about our healthcare sector as an integrated system rather than hundreds of individual services, we can better understand how small wins in specific areas can translate into important shifts in others.
The ‘‘back pocket prescriptions’’ announced last week, enabling pharmacists to dispense antiviral drugs to at-risk patients, will ease pressure on GP clinics, testing centres, community nurses, and those caring for at-risk patients at home.
Finally, the media’s focus on whether Health Minister Andrew Little is naming the system as in ‘‘crisis’’ is unhelpful. I often write communications for large, complex organisations and I understand there are good reasons alarmist terms should not be used when the pressure is on. It can make a bad situation seem worse, raise anxieties that are useless in solving problems, and prove detrimental to a workforce’s wellbeing.
It’s more productive to address the communications fallout between medical professionals who deserve more empathy and a Government starting to sound despondent.
There are many small but important steps being taken to ease pressures, and we need more. Is there a workaround for getting the hundreds of unvaccinated nurses safely back to work in noncontact roles? Would free paracetamol for two months empower more families to recover at home rather than visit a doctor? What fresh thinking can the new Mā ori Health Authority bring to address workforce shortages in rural areas? Is it time to consider employment bonds for migrant healthcare workers?
As my child’s oncologist once explained, it will be the steady, integrated steps we take – not a single treatment – that will bring a complex problem back to better health.
Our problems are not unique or surprising. This must give us at least some relief.