Our own part in health overhaul
It is no surprise to anyone who has cause to use our hospitals that many of the buildings are in poor shape both in appearance and their ability to withstand an earthquake. Unfortunately they are unwitting metaphors for the system itself.
New Zealand’s health system is not delivering the results we want. We might be living longer but that’s not the same as saying we are healthier. A fresh paint job and re-gibbing of the operating theatres won’t be enough. We need to overhaul the system and create one that helps more of us live a good life.
The timing of the release of the government stocktake on the state of our hospital buildings is fortuitous. Having just beaten Covid-19 the country is proud both of itself and its health sector. There is political mileage to be gained in committing more money to make sure the buildings meet both the necessary physical requirements to operate safely and our own expectations for how our hospitals should look.
On the other hand our health system is a bureaucratic mess of 20 competing health boards with incompatible and highly complex systems that few patients can navigate successfully. Before Covid-19 there was widespread dissatisfaction that it was costing billions but still falling short, despite the goodwill and commitment of both its patients and its workforce.
Why pour more money into it when, for example, it has proved particularly disastrous for Ma¯ ori, whose health and wellbeing outcomes under the current system are significantly poorer than for non-Ma¯ ori.
It was this dissatisfaction that led to the 2019 Health and Disability System Review, the findings of which were available to the Government on
April 26 and have not yet been made public. However, the interim report released by chair Heather Simpson in September 2019 indicates the review is going to propose radical change. The current model of care that employs more and more medically qualified staff ‘‘focused on treating illness, rather than promoting wellness’’ is neither effective nor sustainable, both in cost and human resources, the interim report says.
It states the system needs to be more cohesive, collective and collaborative, that it needs stronger leadership at all levels and clearer, enforceable mandates and accountabilities. This would appear to pave the way for the abolition of district health boards, as has often been called for.
The interim report also states that if the system is to be equitable, Ma¯ ori need to be able to apply their Treaty rights to have authority within it, that more emphasis needs to be placed on preventative care and more urgency needs to be applied to making improvements in outcomes for Ma¯ ori, Pacific people and low-income and rural households.
Change, when it comes, will not be a mere tinkering around the edges. It will need to be a comprehensive overhaul.
The Government will be aware no change to the health services of New Zealand can be made quickly. For a start it employs 8.5 per cent of the country’s workforce and this is not the time to force through restructures that put people out of work.
But we can all make immediate changes to ensure better health. Our collective defeat of Covid19 showed us how much power we wield when taking individual responsibility for our own wellbeing. Our willingness and understanding of how to lead a healthy life will always be this country’s cheapest and most effective medicine.
This would appear to pave the way for the abolition of district health boards ...