Emerging Infectious Disease Forum

Health Minister Annette King opens a national forum and talks about developing a competent health workforce that is ready to manage any emerging infectious disease.

It is a privilege and a pleasure to have been invited to open this Emerging Infectious Disease Forum today. Thank you to Dr Frances Hughes, Chief Advisor Nursing at the Ministry of Health, for giving me the opportunity. Frances, I know you are not one to blow your own trumpet, but I believe you have been the guiding force behind this forum and deserve some recognition for all the hard work you and your dedicated team of helpers have put in to today.

I have been asked to talk to you about developing a competent health workforce that is ready to manage any emerging infectious disease. But first I want to acknowledge our distinguished overseas guest who will be speaking to you today.

Dr Judith Shamian has travelled all the way from Ottawa, Canada especially for this forum. Judith, who is from Health Canada, brings with her valuable information on the challenges Canada faced during the management of the SARS epidemic, organisational issues and the impact SARS had on the nursing workforce. I know everyone here is looking forward to hearing about the Canadian experience and what was learned from it, so thank you Judith for sharing this information with us.

I am told that today will be very interactive, with participation from Health and Disability Commissioner Ron Patterson and panel discussions involving professional colleges, unions and regulatory bodies, so I hope it is productive and informative.

I am sure I don't have to tell you all how important this forum is. Significantly, it is the first time the professional organizations of nursing and medicine have been brought together to discuss a key emerging health issue at a national level. Coming together in this environment to exchange ideas and experiences is vital because if our frontline health workers can not provide the diagnosis, care, treatments, and containment of an infectious disease when it emerges, then not only are they at risk, but the whole health service and the economy is at risk.

And, as most of you will know, the countries affected by the international SARS crisis last year had their economies turned upside down. This reinforces the importance of being ready to prepare for, prevent and isolate any future outbreaks.

We are fortunate that Dr Frances Hughes and Professor Jill White from Australia -- who are both key figures in helping us learn about the effect of SARS on the workforce -- attended the Western Regional Chief Nursing Officers Summit in Sydney two weeks ago. This involved over 20 countries, some of which are still experiencing the after-effects of the disease.

I congratulate the Ministry of Health for its involvement in the planning of the summit and its support of Frances' attendance. It shows leadership to the health sector and is a proactive step towards protecting the health of New Zealanders.

I know that both Frances and Jill found the summit extremely educational, and you will be hearing more about what they learnt in their presentations later today.

Just to recap on what happened last year, between February and July the world experienced an outbreak of severe respiratory illness related to a previously unidentified viral agent. SARS has been described by the World Health Organisation as "the first severe and readily transmissible disease of the 21st Century."

The SARS epidemic certainly showed how easy it is for infectious diseases to spread around the world. Originating in the Guandong province of south China, SARS spread rapidly into Southeast Asian countries and eventually to 32 countries or regions. About 8,500 people were diagnosed with probable SARS and there were about 900 deaths worldwide. Those countries at the centre of the outbreak found they were ill-prepared to deal with a health threat of such magnitude.

SARS also posed a challenge for New Zealand healthcare services to prepare for the impact on New Zealand. We were extremely lucky to be able to avoid importation and local transmission of SARS.

At the moment, we have a window of opportunity for planning at a time when we do not have to deal with an emerging infectious disease. We have an opportunity to:

• Learn from national and international experiences during the response to SARS

• Identify the known and potential gaps and barriers in the nursing and medical workforce capacity, flexibility, skills and resources

• Identify the impact on nursing and medical training, education and ongoing competencies

• Learn and discuss ways of managing professional ethical issues relating to care

• Identify related regulatory issues that impact on professional registration

• Improve our response to any new epidemic

• Set up structures that come into force in the event of an emerging infectious disease.

This forum has been organised so that the identified barriers relating to the health professional workforce -- competence, training, regulatory constraints and education -- can be addressed.

The Ministry of Health Clinical Services Directorate was tasked with developing a National Clinical Action Plan for Emerging Infectious Disease. The plan will provide a framework for the response of primary/secondary/tertiary services in the event of the return of SARS, or a crisis related to another emerging infectious disease. This document will be completed next month (in June) and will then be integrated in to the National Pandemic Plan, providing the clinical action component.

We learned many lessons from the preparation for SARS and in the review of the New Zealand response, including the need for consistency, effective and timely communication lines and information, and clarity around responsibility and accountability.

The response planning will identify barriers to a co-ordinated approach and develop communications systems. The feedback from this forum will contribute to the National Clinical Action Plan for Emerging Infectious Disease, which will fit in to the National Pandemic Plan.

Naturally, an emerging infectious disease becomes a national issue that can affect all spheres of life. The New Zealand healthcare system is charged with:

• Providing the greatest possible protection for the population at large, all health service workers and health service patients

• Protecting and maintaining business as usual at local, regional and national levels for as much of the health service as possible

• Providing the best available clinical care for emerging infectious disease patients.

In addition, we must plan for recovery from the effects of the disease on the health services and ensure that our health professionals and health care workers are supported and assisted in coping with the impact on their lives.

I think chief nurse Susie Lum, from Hong Kong, summed up how difficult it was for health workers to practice during the SARS outbreak. She described it as "like building a ship whilst sailing in it." In other words, you simply can not plan for a crisis like that when you're actually in the middle of it.

On that note, I'd like to officially declare this forum well and truly open. I'm sure it will be interesting and thought-provoking, and thank you again for inviting me to be part of it.

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