Address to Open the Auckland University Health Symposium
Hon Peter Dunne
Address to Open the Auckland University Health Symposium
Sunday, 17 February 2013
Thank you for hosting us here in beautiful Oman at this Symposium on collaboration and innovation in health.
New Zealand and Oman are both proud nations, with similar population demographics, including relatively small and highly distributed populations and both with a real commitment to health system developments in primary healthcare.
Both New Zealand and Oman consequently face similar demands on their health systems.
New Zealand strongly believes in the importance of international collaboration and we regularly engage internationally with the health and innovation community to increase New Zealanders’ wealth, health and wellbeing.
I would like to congratulate His Majesty Sultan Qaboos Bin Said on his superb leadership in achieving spectacular results in Oman’s health system at such an extraordinary pace.
Oman’s health system is a highly sophisticated one.
Your significant achievements are well recognised globally.
I would like to acknowledge the award you received in 2000 from the World Health Organisation, which recognised the Oman health system as the most efficient in the world.
The 2008 World Health Report on primary health care makes for impressive reading and highlights your achievements in increasing life expectancy and the staggering decrease in the mortality rate for under five-year-olds.
The Human Development Report for 2010 ranked Oman as number one mover – the country that moved the fastest to catch up with the quality of life enjoyed by other countries.
That in itself is a superb achievement of which Oman should rightly be proud.
There are many other achievements to celebrate including:
· the elimination of many communicable diseases;
· the development of a highly skilled workforce;
· and the range of sophisticated facilities and equipment available.
Each of these successes ensures that the people of Oman can lead healthier and happier lives.
I believe New Zealand and Oman can, and should, learn from each other through collaboration and co-operation to ensure our world class health systems continue to move from strength to strength.
New Zealand has also enjoyed successes in its health system over recent times.
Health outcomes and the quality of health services are continuing to improve in New Zealand.
New Zealanders are living longer lives and spending longer in good health.
Our life expectancy compares well to other countries, although the actual amount we spend on health in New Zealand is comparatively low.
The Government has set six health targets, which are a set of national performance measures designed to drive performance improvement in targeted service areas.
Our Minister of Health, Hon Tony Ryall, reviews these annually and they are adjusted to ensure they align with the Government’s priorities.
Significant progress has been made in these targets since they were introduced in 2008, including improvements in immunisation rates; decreases in smoking rates and shorter waits for surgery.
Over the past five years, New Zealand has gone from one of the lowest immunisation rates in the developed world to one of the highest.
Immunisation rates continue to increase with 93 per cent of all two-year-old children now fully immunised – the recent lift in rates is one of the most significant public health achievements in New Zealand in the past 10 years.
Our Government is now working to increase the number of eight-month-olds immunised to ensure that New Zealand children are protected from preventable diseases even sooner.
Another of our health targets looks at cancer treatment waiting times.
Across New Zealand, all district health boards have achieved the new target with every patient receiving their radiotherapy and chemotherapy cancer treatment within the four-week international gold standard.
Despite these achievements, we cannot rest on our laurels.
We aim to achieve much more in the coming years to further improve the health of all New Zealanders.
We know that Oman has similar goals and therefore I believe both countries are in an excellent position to work together and to learn from each other.
Along with our successes, New Zealand and Oman also share similar challenges.
Some of these include:
· the rise in non-communicable diseases, particularly diabetes and cardiovascular disease;
· health work force issues;
· and maintaining a sustainable health care system in a tight fiscal environment.
There is widespread agreement that current health services are not well-placed to deal with a world where non-communicable diseases account for most of the disease burden.
That is because our health services were developed for generations when communicable diseases, such as tuberculosis, accounted for most of the disease burdens – leading to systems based on episodic, disjointed and hospital-based care.
So, like the rest of the world, New Zealand’s health service is tackling the challenge of re-orienting care towards the ongoing support and treatment of patients with long-term conditions, in the community, closer to home.
This symposium provides an important opportunity to collaborate and look at how our knowledge and experience can come together to plan policies and strategies to address these challenges and reduce the impact of non-communicable disease on our population.
The New Zealand experience
It is an exciting and challenging time in New Zealand’s health sector: Exciting for the excellent progress in patient care we are seeing throughout practices and hospitals across the country – reduced wait times, more effective treatments and greater integration across services through information sharing, IT systems and so on. It is also challenging because we must achieve all this and more in a constrained financial environment with increasing pressures on our health system.
Let us look briefly some of the other specific challenges and the actions we have taken to address these:
Some groups in New Zealand share similar rates of diabetes with the rates in Oman.
The New Zealand Government gives diabetes a top priority as one of our six national health targets – 90 percent of the eligible population will have had their cardiovascular risk assessed, including diabetes checks, in the last five years to be achieved in stages by 1 July 2014.
New Zealand has introduced a number of preventive and therapeutic programmes to address the problem of rising diabetes rates.
For example, in 2011, Health Workforce New Zealand, in collaboration with the New Zealand Society for the Study of Diabetes, established the diabetes nurse specialist prescribing project to demonstrate the effectiveness and safety of diabetes nurse prescribing.
Diabetes nurse specialists are able to operate with a high degree of autonomy with significant responsibility for the delivery of diabetes services, and having responsibility for prescribing common medicines for people with diabetes, under supervision and in partnership with medical practitioners.
An evaluation of the project showed it to be a success.
Prescribing by diabetes nurse specialists resulted in improved continuity of care for patients, reduced the need for separate appointments for routine prescriptions and reduced pressure on medical staff.
The Government is continuing to support the managed national roll out of this project to ensure more New Zealanders can benefit from this new and exciting phase for diabetes care in our communities.
Tobacco is the leading cause of preventable death in New Zealand, accounting for approximately 4500 to 5000 deaths a year, including around 350 people killed by the effects of second-hand smoke.
The Government has set the long-term goal of making New Zealand a smokefree nation by 2025.
This is an aspirational goal to reduce smoking prevalence and tobacco availability to minimal levels.
The Government's national preventative health target, to provide better help for smokers to quit, means doctors and nurses at GP clinics and hospitals are supporting more patients than ever before to quit smoking.
By helping people to quit not only are we reducing the risk of a smoker having a smoking-related disease, such as lung cancer, we are also improving the health of everyone in the family.
Having non-smoking parents greatly reduces the likelihood of a child becoming a smoker.
The Government agrees that discouraging young people from taking up smoking, and encouraging those who already smoke to quit, is critical if we are to achieve a smokefree New Zealand by 2025.
Many of the current programmes and policies are aimed directly at youth, such as the 'Smoking Not Our Future' campaign, and removing tobacco displays from shops.
There has already been significant progress in lowering the number of young people who smoke.
In 1999, 16.6 percent of 15 and 16 year olds smoked.
By 2011, this had declined to 4.1 percent.
The Government has also committed to raising tobacco excise taxes by 10 percent each year, from 1 January 2013 until 1 January 2016.
And we are also funding more programmes to discourage people from starting smoking and helping more New Zealanders quit.
Currently, we are also considering plain packaging of tobacco products to further reduce the number of smokers in New Zealand.
These measures will help improve the health of New Zealanders, reduce the long-term burden on the health system, and contribute to the Government’s goal of making New Zealand an essentially smokefree nation by 2025.
Another thing that Oman and New Zealand have in common is that we are both small nations with bigger and richer nations next door.
This can mean that keeping our well-trained staff on our own shores can be a challenge.
Oman and New Zealand already collaborate in areas of workforce training and development and we hope this successful relationship continues to grow.
To overcome health workforce challenges in New Zealand, we have increased clinical input into decision making and we are enriching clinical workloads through research opportunities, and a more co-ordinated approach through Health Workforce New Zealand.
New Zealand and Oman both share the challenge of providing health services to rural and remote communities.
One way New Zealand is trying to meet this challenge is extending the roles of particular health professionals.
I have already touched on the expansion of the Diabetes Nurse Specialist role and the use of pharmacists is another good example.
In 2012, every pharmacy business in the country accepted a new community pharmacy service agreement.
This new agreement encourages pharmacists to make better use of their clinical skills and expertise, and rewards pharmacists for providing support and advice so patients can better manage their medicines and medical conditions.
This agreement marks a significant step forward in the delivery of pharmacy care for patients and pharmacists and is another example of New Zealand’s commitment to providing more convenient health services closer to home, as well as ensuring our health graduates see New Zealand as a rewarding place to work.
Using IT for a sustainable health care system
Early adoption of information technology solutions has helped create a health information environment that allows New Zealand to boast one of the most advanced healthcare systems in the world.
New Zealand’s National Health IT Plan has a clear vision – by 2014 New Zealanders will have a core set of personal health information available electronically to them and their treatment providers, regardless of where they access health services.
Good use of information technology brings clinical services closer to home for patients and allows for higher quality patient care as health professionals can be better informed when making decisions about their patients’ care.
There is much to learn from the approaches taken by different funders and providers in New Zealand and their significant use of IT to enable change.
There are many examples of IT initiatives resulting in better care for patients:
· work is underway to allow all New Zealanders to access their health information via patient portals – this tool will enable people to take more control of their own care and will save time for patients and practices
· After the disastrous February 2011 Canterbury earthquake in New Zealand, InterRAI, an electronic needs assessment tool for the elderly, was invaluable in identifying older people most in need of help, and made their medication information available to the facilities they were transferred to. Today, InterRAI is being used by all district health boards across New Zealand and in an increasing number of aged residential care facilities.
· GP2GP, is a system which allows patients’ records to be transferred between GPs. It is being used in 80% of all general practices throughout New Zealand resulting in better decision making for patients and clinicians.
Small nations such as New Zealand and Oman have some real advantages over the larger nations in responding to health challenges.
We are by virtue of our size, adaptable; we are able to try new ideas and learn from them and, if they work, incorporate them into practice and policy; we can effect change relatively quickly when we need to; our people are quick to learn and keen to try new approaches.
New Zealand continues to look at what is happening in other countries and continue to customise good ideas to suit the New Zealand health system and the culture of our country.
This symposium provides an opportunity for research leaders from our two nations to share what they are doing in their fields to respond to health challenges with innovative approaches
Our hope is that this will trigger opportunities to work together to develop mutually beneficial knowledge and expertise to tackle the emerging health challenges we both face, and ultimately help achieve better health outcomes for our people.