For immediate use

18 July 2018

Health Minister at the crossroads: which way to improve the public health system?

“The Minister of Health needs to avoid the easy but wrong-headed option of structural change in his review of New Zealand’s public health and disability sectors,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

“If David Clark wants to be effective in transforming our public health service, he needs to improve the ways communities and their hospitals work together, empower the health workforce further through comprehensive clinical leadership, address the crisis of hospital specialist shortages, and make DHBs more accountable for the health and wellbeing of their workforce.”

Mr Powell makes these points in a column in the latest issue of the ASMS magazine, The Specialist, which is available online at https://www.asms.org.nz/wp-content/uploads/2018/07/11950-The-Specialist-Issue-115-WEB.pdf. He says the review is off to a promising start with a highly-regarded chair in Heather Simpson, Dr Clark’s initiative in putting out draft terms of reference for consultation, and a wide-ranging brief - but he also sounds a note of caution.

“New Zealand’s public health service delivered through district health boards performs very well and regularly punches above its weight – but there are difficulties, mostly due to years of under-funding and lack of willpower to promote effective clinical leadership in DHBs. Senior doctors expect the Government to address this and in the process, make significant inroads into the long waiting times for treatments and high levels of unmet health need.

“While the Government can’t turn the ship around overnight, it does need to be visionary and far-sighted, and act to prevent New Zealand’s high quality public health service further eroding as a consequence of sustained neglect.”

Mr Powell says short-term structural changes, such as reducing the number of DHBs, are not necessarily a good long-term answer.

“The real solution lies in building effective relationships and cultures between community and hospital patient care especially and also between DHBs, in a workforce that is valued and empowered, and a sector that is properly resourced and accountable.

“The Health Minister is at a crossroads in determining the long-term sustainability of New Zealand’s public health service, and we want him to choose the things that will make a real difference to health care in this country.”

He says these are signposted in a cartoon by Chris Slane on the cover of The Specialist:

ENDS

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