No quick fix from health reforms — Snee
Kevin Snee has started his new job as interim director of a freshly formed regional health group still smarting from a dose of Covid-19 – it ‘‘wiped me out for a few days’’ leaving him feeling ‘‘a bit tired’’.
The experience will no doubt further sharpen Snee’s empathy for those many New Zealanders under pressure due to a health service struggling to deliver fully in the face of Covid-19, winter illnesses and staff shortages.
The new regional group – Te Manawa Taki – takes in five old district health boards (DHBs), including Waikato where Snee had started as chief executive in 2019.
The others are Bay of Plenty, Lakes, Hauora Tairā whiti and Taranaki.
They are part of a new Health New Zealand and Mā ori Health Authority national structure launched yesterday.
Snee says, frankly, the reforms won’t be a magic wand that will promptly solve health problems and pressures within Waikato and elsewhere in Te Manawa Taki.
The most important immediate job was keeping the system stable.
‘‘It’s only . . . by keeping the system stable over what can be quite difficult winter months that we’ll get through to the kind of brave new world of Health New Zealand.’’
He expected it to be a tough time. ‘‘And it’s going to mean that quite a lot of planned care [like elective surgery] is going to get deferred and we’re going to have to catch up from that later in the year and into next year.’’
But Snee, unsure of his exact role after his short-term interim director’s job finishes, is confident the reforms will deliver benefits longer term.
He said the reforms were a significant attempt to address health inequities, particularly for Mā ori.
‘‘It’s a fundamental attempt to refocus and re-shape the health system to focus on Mā ori’’ and to address issues raised with the Waitangi Tribunal.
Waikato has a higher proportion of Mā ori than nationally – and other Te Manawa Taki districts have significant Mā ori populations – so this emphasis is clearly important to Snee.
He noted Waikato has tried to address inequities in his time as
CEO at the DHB.
‘‘It’s not something you can flick a switch and change overnight. So you’ve got deeply ingrained issues of inequality.’’
Making health organisations more inclusive of Mā ori staff and culture would help improve outcomes for Mā ori.
‘‘That’s precisely the point. It’s making sure that people see themselves in the service.’’
He noted Waikato was the only district under the new structure that had introduced a co-leadership model. It involves Riki Nia Nia (executive director Mā ori, equity and health improvement) and Chris Lowry (executive director hospital and community services).
‘‘That’s unique in New Zealand,’’ said Snee.
He also sees opportunities for greater intra and inter-regional cooperation under a national structure to help ensure resources are used more efficiently, and conversations on this were already happening. ‘‘You’ll probably appreciate the benefits of that in a year or so’s time.’’
Centralisation of decisionmaking on big projects could also improve efficiency and speed things up, like the new mental health facility sought for Waikato: ‘‘I’m hopeful that will be given approval and we’ll get on with it quite soon.’’
On making sure local communities could still input into health system decision-making with the scrapping of elected boards, Snee said a series of ‘‘localities’’ were being set up nationally and regionally. These would take account of community views in ways to be determined locally. Other bodies would also help with input. While people wait for eventual improvements under reforms, there’s of course always a risk of more stories of pain and frustration emerging.
In May, a Te Kuiti woman with severe stomach pains – and others – spoke of 10-hour plus delays waiting to be seen at Waikato Hospital’s emergency department. She eventually got a referral to a specialist.
But she emailed again last week saying she’d still not heard from a specialist and ended up going privately for treatment. She said she had potentially ‘‘deadly’’ appendicitis, endometriosis adhesions and a growth that had to be removed.
‘‘Due to being sent away from Te Kuiti hospital twice and Waikato twice, I knew the pain I was feeling wasn’t normal and knew the only option I had was to go private. I was fortunate that I am able to but I know many New Zealanders are not.’’
Asked for general comment on how he’s affected by the frustrations people have with the health system, Snee steers a careful course.
‘‘We don’t want to see people having to wait, particularly when they’re in pain.’’
But prioritising treatment meant some people feeling pain and distress had to wait for more urgent cases to be dealt with.
‘‘That’s really sad and really unfortunate.’’
Who got seen first was ‘‘a clinical decision and unfortunately it’s one that can’t be avoided at this stage’’.
‘‘Anybody who’s in a leader’s position feels the weight of expectation and the weight of not being able to do everything you want to do for the wider community.’’
‘‘We don’t want to see people having to wait, particularly when they’re in pain.’’
Kevin Snee, pictured