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Annette King: Health Conference Speech

Annette King
30 September 2004 Speech Notes

Joint conference of Royal Australasian College of Medical Administrators and NZ Institute of Health Management

Rotorua Convention Centre

It is an honour and privilege to have been invited to open this joint meeting of the New Zealand Institute of Health Managers, and the Royal Australasian College of Medical Administrators.

This is the first time, since it was founded 37 years ago, that the College has held its conference in New Zealand, and I want to warmly welcome you. I am sure this beautiful city of Rotorua will go out of its way in terms of the warmth of its hospitality, and I strongly hope that your college visits our shores more frequently than once in 37 years in the future.

Conferences such as these are invaluable in terms of the links they create, and the opportunities they provide to exchange ideas, skills, experiences. That is even more the case when so many notable delegates and speakers are here from New Zealand, Australia, China, Hong Kong and the United Kingdom. Congratulations and thank you to Dr David Rankin, his organising committee and everyone else who played a part for working so hard to make this importance conference happen.

In welcoming all our overseas visitors, I firstly want to acknowledge my counterpart from Hong Kong, Dr E K Yeoh, Hong Kong’s Secretary of Health, Welfare and Food.

Dr Yeoh is leading off tomorrow’s session on SARS --- Lessons from Hong Kong. I believe it is widely recognised that his selfless example has done much to help his region reach a state of emergency preparedness for any future outbreak of a communicable disease, and he will have much of great value to share with delegates tomorrow.

It is an honour to have the Secretary in New Zealand and I am looking forward to discussions with him later this morning. I have just returned from a meeting of the World Health Organisation’s Western Pacific Regional Office Committee in Shanghai, and the main item on the agenda there was, in fact, how countries in the region could work together to prepare for future communicable disease emergencies.

I am sure communicable diseases will also be one of the items on the agenda for my meeting with Dr Yeoh today, and it is vital to continue to explore ways in which countries can work together to combat whatever epidemics lie ahead.

There are a number of other individuals I particularly want to acknowledge, including, of course, Dr Shereen Denanish, the president of RACMA and Fiona Ritsma, president of NZIHM.

Welcome too to Professor Sian Griffith, professor of public health at Oxford University, and Dr William Ho, chief executive of the Hong Kong Hospital Authority, both of whom are also taking part in tomorrow’s session on SARS; to Dr S V Lo, from the Hong Kong College of Community Medicine; and to Professor Steven Boyages, chief executive of the Western Sydney Area Health Service, who has already spoken to you today on reconfiguring health services.

That is a subject I know quite a lot about too, and so do many of the prominent New Zealanders participating in the conference, including a number of District Health Board chairs and chief executives, New Zealand’s Health and Disability Commissioner Ron Paterson, and the chair of our Health Workforce Advisory Committee, Professor Andrew Hornblow.

The theme of this conference is Showcasing New Zealand – Innovations from Isolation. In terms of the people taking part, the conference is already more than living up to its name, because a showcase of New Zealand talent is taking part.

In another respect, however, I think the theme is mildly misleading. New Zealand was once an isolated nation, but this is no longer true. You don’t hear phrases like “the global village” anymore, because it’s taken for granted that our world is becoming more integrated.

That is something I become acutely aware of when I visit the World Health Assembly in Geneva each year. Some of our finest health professionals are working within the World Health Organisation, and it is impossible to take part in the Assembly without feeling a sense of pride in the lead New Zealand is showing in areas like tobacco control and the global strategy on diet and physical activity.

Because this Government has been a creative and innovative thinker in health terms since we came to power in 1999, there has also been much international attention paid to some of our health reforms, and I am no longer surprised at international forums like the Assembly when other countries approach me to discuss in depth a range of New Zealand policies, particularly in primary health care and health administration.

I think health professionals are the perfect illustration in New Zealand of how this country is no longer isolated. The links that NZIHM has with RACMA and the Australian College of Health Service Executives, for example, prove the point. Any New Zealand body of health professionals you care to name almost certainly has links overseas, often with an Australian counterpart.

Integration is occurring at a governmental level as well. In December last year I signed the Trans-Tasman Agreement for the Establishment of a Joint Scheme for the Regulation of Therapeutic Products, designed to ensure that New Zealanders have access to safe products.

Even if we discount the term isolation, there is certainly a great deal of innovation to showcase in New Zealand, and I am very proud of much of what is happening in our health system.

Throughout our health sector, people are working to develop better products, services and processes, and to improve the treatment, care and recovery of New Zealanders. And, before I leave the subject of isolation alone, I should mention that while New Zealanders are proud of their own innovative successes, as a nation we are certainly not too proud to copy the example of successful innovations overseas.

For the past two years our Ministry of Health, together with our Accident Compensation Corporation, have run national Health Innovation Awards to celebrate ways in which our professionals contribute to the treatment, care and recovery of New Zealanders in creative and novel ways.

These awards are important for a number of reasons, and one of the most important is that the innovations are quality initiatives that other providers need to learn about so that they too can apply them where they can see benefits for their patients.
They are also important because the ingenuity displayed by the awards entrants can act as a positive role model in encouraging other providers to think in fresh and innovative ways about the way they deliver health care themselves.

I am sure everyone in the health sector in New Zealand also wants to build a positive culture that facilitates and encourages quality health care and quality improvements. One way of doing so is to praise achievement, encourage innovation and recognise excellence. The Health Innovation Awards play an important role in this regard.

Entries for the 2005 awards are now open, although the 2004 awards were only held in June. The supreme winner was Auckland District Health Board and ProCare, an organisation providing management services to three of the country’s biggest Primary Health Organisations.

They investigated inappropriate referral rates for dyspepsia, and started a remedial training programme and an advertising campaign. Before the scheme began about a quarter of referrals from GPs for hospital treatment were unnecessary, while as many people again who actually did require treatment were not referred.

Because of this scheme, which only cost $70,000, referrals have dropped by ten per cent, the wasted time of patients and specialists has been reduced considerably, and $1.5 million has been saved. That surplus has been passed on to colonoscopy services, and waiting times have also been reduced in that area.

This is an excellent example of quality improvement in action, but it was but one of many examples of excellence highlighted at the Innovation Awards. The supreme award also shows that health managers can make a real difference. Through a range of these sort of measures, we can make our health and disability system better. The sum of small incremental changes can be a marked improvement in the overall system.

It never ceases to amaze me, however, that sometimes people still ask --- why should we work on improving quality?

The answer is straightforward. Health providers want to do the best they can for those who need care, so it is only natural that they are interested in quality improvement, and New Zealanders deserve services that are accessible and timely, as well as being of good quality.

Quality is identified as one of the cornerstones of a high-performing system in the New Zealand Health Strategy, and in September last year I launched Improving Quality (IQ): A Systems Approach for the New Zealand Health and Disability Sector. The work is leading the way in quality improvement, and represents a commitment to supporting continuous quality improvement by each person working within the health and disability system, and a commitment to the people affected by the system and the system itself.

This publication, along with the IQ Action Plan: Supporting the Improving Quality Approach, forms the basis for improving quality across the New Zealand health and disability sector. Action 2.2 of this plan required me to “establish a network of leaders in the health and disability sector with an interest in quality improvement.” The first IQ Network Forum took place in June, and was a great success.

Improvements in quality are necessary for our vision of New Zealanders receiving health services from a health and disability system that is people-centred, of a high standard, safe and culturally competent. One of the fundamental principles of the New Zealand Health Strategy is “a high-performing system in which people have confidence.”

Real quality improvement will only be achieved if it occurs at all levels and stages of the health sector. That requires vision and leadership throughout the sector. You are responsible, as we all are, for providing that vision and leadership.

Cooperation is what allows real quality improvement to occur. We need to share and exchange our techniques and information, learning what works to make our health and disability sector better, and, just as importantly, what does not work.

As the conference theme says, this meeting gives New Zealanders an opportunity for us to show off innovations and success stories, and I’m certain our visitors will all discover ideas and practices over the next two days that you can take home and use in your own work.

However, I am equally confident that New Zealanders attending this conference will learn much from what our visitors have to share with us from their own experiences. We all have everything to gain from working with our international peers and exchanging knowledge.
I mentioned earlier that other countries often approach me to talk about primary health care, and I would like to finish today by making some brief comments about New Zealand’s innovative approach to this area. As Minister of Health, I can say without doubt that I am prouder of the advances New Zealand has made in primary health care in the past three to four years than any of the other innovative approaches we have taken.

I have long been convinced that the best way to improve the health of all New Zealanders is to increase our investment in primary health care, and the Government has now committed a remarkable $1.7 billion over six years in new funding to implement the Primary Health Strategy I launched three years ago.

Most of this money is being directed through new groups of health professionals called Primary Health Organisations, which have been set up to provide affordable and accessible quality primary health care focusing on keeping people well in their communities and out of hospital for as long as possible.

In May I attended a forum of like-minded health ministers in Slovenia on access to health care, and was taken by an analogy drawn by noted health researcher Professor Martin McKee, of the London School of Hygiene and Tropical Medicine.

Dr McKee talked of a shifting balance internationally between treatment and prevention, as countries recognised the growing opportunities for early intervention. Countries needed to find ways to integrate treatment and prevention strategies, he said, and that meant reorienting health care to embed prevention at all stages.

Dr McKee likened a person’s lifelong journey through the health system to a traveller in need of a tailor-made holiday, visiting a sequence of destinations suited to his or her individual needs, and using a variety of travel modes.

For such a person, simply using the Internet or reading a book for information was not enough. They needed a navigator, or travel agent, to take them through the maze. In health terms, Dr McKee said, the travel agent is the primary health care team.

The analogy is a powerful one, particularly with our ageing population. Large numbers of people now have multiple chronic diseases that need careful management. This is often because we can keep people alive far longer by controlling rather than curing their conditions.

Primary Health Organisations are our health ‘travel agencies’ here in New Zealand, and will provide a more integrated, effective, and affordable guide for those who use the health system. As I said, I am very proud of them, and I hope you enjoy hearing more about them tomorrow.

I certainly believe that our health system is of an extremely high quality, and I believe that through innovation and the commitment of those who work in the health system, it’s becoming better all the time.

But I also believe we can never stop striving to make it better still, and that is why I am so pleased to open this ‘Innovations from Isolation’ conference. I hope you enjoy Rotorua and the other parts of New Zealand you manage to visit while you are here, and thank you again for inviting me to be at this historic meeting with you.


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