Interim Report Summary
The Health and Disability System Review Panel is today
releasing its interim report, having delivered it to the
Minister of Health last week, consistent with the timeline
in its Terms of Reference (TOR).
The report reflects the submissions the Panel has received, the feedback from the many meetings attended around the country, and the analysis undertaken over the past several months. But it is still very much a work in progress.
“We have identified the likely reform themes and directions but significantly more discussion and evaluation is needed before we will be in a position to bring our thinking to recommendation stage,” says Panel Chair Heather Simpson.
Recommendations will be made in the Panel’s final report, due by 30 March 2020.
New Zealand’s health service delivery and per capita costs are in line with other OECD countries. Health systems around the world are under intense pressure and New Zealand is no different. The Panel’s TOR are wide, reflecting the scope of the challenges that we are facing now and will face in the foreseeable future.
These include rapidly increasing demand, an ageing population, the health effects of climate change, the potential created by advances in clinical practice and digital technologies, and persistent inequities of outcomes, in particular among Māori, low income and rural communities.
The Panel is taking a broad view, encompassing issues of culture and structure, governance and the Treaty of Waitangi, strategy and procurement.
Key messages from the report are that:
• a more collaborative and cooperative approach is
needed, requiring changes in attitude and culture. These
need to be led from the centre and applied consistently
throughout the system. Mandates need to be clarified and
accountabilities clearly defined
• the focus must be on
the consumer, and what consumers value and need most, with
more choice about how needs are met
• if future demand
is to be manageable, the emphasis must be on preventing ill
health and promoting wellbeing. This means more focus on
population health and much faster progress on the vision set
out almost 20 years ago in the Primary Health Care
Strategy
• an effective Treaty/Tiriti based partnership
must be developed with Māori to improve Māori health
outcomes and to embrace a Māori world view
• a
clearer decision-making framework is required, that allows
decisions to be made in a timely manner, at the appropriate
level and enforced effectively
• hospital and
specialist services need to operate as a cohesive
network
• funding streams, particularly within
community and primary care, need to be simplified and more
emphasis put on teamwork and maintaining health and
wellbeing rather than on simply treating
illness
• disability services planning needs to be more
visible in the system with more flexibility in the way
services are funded and delivered
• there needs to be a
long term, nationwide health and disability service plan and
more effective strategic planning throughout the
system
• implementation of data standards, data
stewardship, identity management and interoperability must
be accelerated
• workforce strategies need to
anticipate and address projected shortages, and
• the
current distributed model for the design and delivery of
capital projects is expensive and may not be sufficient to
meet the scale of investment required.
The other Panel
members are: Shelley Campbell, Professor Peter Crampton, Dr
Lloyd McCann, Dr Margaret Southwick, Dr Winfield Bennett and
Sir Brian Roche. The Panel is working with a Māori Expert
Advisory Group to assist the review.
The interim report
and an executive overview are available at: https://systemreview.health.govt.nz/interim-report