Health leaders set sights on fairer future

Doctors and nurses say equal access to healthcare will be NZ’s biggest challenge when population hits 5 million.

This Tuesday in Wellington, more than 50 of New Zealand’s top doctors, nurses, health researchers, campaigners and policy-makers will meet to discuss the urgency of health policy change that meets the needs of a fast-growing, aging population with rising rates of chronic illness.

Current StatsNZ estimates of population and population growth suggest numbers may hit 5 million in 2020. Health professionals say this rate of growth, with an aging population and increasing incidence of chronic conditions like diabetes and heart disease, means the government must consider wider health policy options, including public-private partnerships, and the new insourcing model.

DHBs trial new waiting list-cutting idea

DHBs have used various strategies to reduce waiting lists for many years. These include outsourcing to the private sector, employing locums (temporary doctors and nurses) and upskilling nurses. Insourcing is the newest option on the table.

Instead of reducing waiting lists for non-urgent operations or appointments by sending patients to private hospitals, or larger public hospitals, DHBs can bring staff or teams into their hospitals to treat patients using their own facilities and administration.

Insourced treatments happen at times when the hospital facility would otherwise be unused, for example, evenings and weekends. The results are:

reduced cost to DHBs
patients treated closer to home
often, treating patients at times that suit them better
freeing up time for permanent staff to upskill or work on longer-term issues.

What DHB staff and patients say

Lisa Rogerson, a specialist echocardiographer based in Hamilton, says, “Operations get put back because we can’t keep up with demand. And the situation is only going to get worse because of the population and the health problems in New Zealand.”

Clinical Nurse Specialist Jane Hawthorn, who has worked in ophthalmology across several DHBs, and says the problems are widespread, with many patients having to wait longer than expected, particularly for follow-up appointments.

Hawthorn thinks insourcing is the way to go. “I’ve worked in Wellington and Manukau doing injection clinics. They’ve been really successful. In one weekend, I did 103 injections. That’s a lot of people having their treatments who would have otherwise waited.”

Hawthorn adds, using facilities and equipment outside the working week also has the benefit of creating a less pressured environment. “During the week you might get locums in. You might have enough staff, but you don’t always have the facilities to work efficiently.”

Lisa Rogerson agrees. “Equipment and facilities are all paid for and just sitting there – it seems silly not to run seven days a week now.”

Rogerson says patients like the option of treatment on a weekend. “A lot of patients have an elderly relative that they have to bring to the hospital, and they don’t want to take time off work to attend appointments. They’re happy to come somewhere quiet with no problems parking on a Sunday morning.”

Rogerson is convinced the benefits outweigh the costs. “Initiatives like working weekends provide an extra 20 percent on top,” she says.

What leaders in healthcare think

The panel discussion on Tuesday 22 October is one of a series put on by HealthCentral.nz, NZME and SEQURE Health. The subject is, Future of New Zealand healthcare: how can we achieve a more productive, sustainable and equitable healthcare system?

The panel is:

Dr Janice Wilson, a psychiatrist by training, is now Chief Executive of the Health Quality & Safety Commission. Previously Deputy Director-General at Ministry of Health, specialising in mental health and population health.
Professor Gregor Coster CNZM is Dean of the Faculty of Health at Victoria University of Wellington. Previously Chair of Counties Manukau DHB, Deputy Chair of Pharmac, Chair of WorkSafe New Zealand and Professor of General Practice, University of Auckland.
Ian Powell has been Executive Director of the Association of Salaried Medical Specialists (ASMS) for 30 years. Powell has negotiated over 100 collective agreements for senior doctors and dentists in New Zealand public hospitals.
Gary Heath manages relationships between medical insourcing specialists SEQURE Health and their DHB clients. He tailors insourcing to individual DHB’s needs and monitors the staff involved.
John Tamihere, Director on the board of Hāpai te Hauora, Auckland regional Māori public health provider. Tamihere has served two terms as a Government Minister, been on many health and community boards, and has consistently advocated for the rights of urban Māori.
Sarah Fitt, Chief Executive, PHARMAC. Before joining PHARMAC, Fitt spent 12 years as Chief Pharmacist at Auckland DHB.

HealthCentral.nz will live-Tweet during the event. After the event, selected video clips and a summary of what was said will be available on the SEQURE Health website.

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