Hon Tony Ryall
Minister of Health

9 October 2009 Speech

Health Minister Tony Ryall launches Rotorua Hospital redevelopment

Parliamentary colleagues Todd McClay MP Rotorua , Hon Steve Chadwick List MP and former Health Minister. Your Worship the Mayor. Members of the District Health Board. Ladies and gentlemen.

Thank you for the opportunity to join you at this soil-turning ceremony for the redevelopment of Rotorua Public Hospital. The redevelopment will be welcomed by patients and clinical staff alike.

Today, I'd like to touch on the vital role of clinical leadership in improving our health service, the need to improve productivity and the opportunities ahead.

Globally, clinical leadership - the active engagement of doctors and nurses in how health services are provided -- is recognised as the fundamental driver for better health outcomes. Yet here in New Zealand over the past decade, the influence of clinicians on patient outcomes has been less than ever before.

This failure to engage the very people with the right expertise – doctors and nurses who know the patients' needs best – is seriously eroding our ability to provide patients with the care they need.

Recent research by McKinsey and Company based on 126 hospitals across the UK found a clear link between strong clinical leadership and hospital performance.

The researchers found that best practice operational approaches in hospitals had a positive impact on productivity, infection rates, readmission rates, and patient satisfaction. And finance.

But the real key to this success was the level of involvement of clinicians in running their hospital services. Stronger and more direct clinician involvement means more service and better quality.

And that is why the National-led government considers clinical leadership and the re-engagement of doctors and nurses in the running of healthcare as so important.

We all know that finances are tight. Even if the economy is on the way up again, it will take years before that flows into the Government’s books. Right now, the Government is borrowing $400 million a week to protect and support priorities like health services, schools and welfare entitlements.

The next few years mean we have to use our resources smarter, to deliver more and better services for our patients.

Around the country we have hundreds of superbly qualified and motivated clinicians who can – and do -- take responsibility for redesigning and improving their services. Many of our hospitals and their teams are thinking about new ways to improve safety and quality, and productivity.

Here at the Rotorua Public Hospital you’ve been using Lean Thinking to improve productivity and service.

And you’ve achieved real successes. Here in Rotorua, the time it takes to transfer a patient from the Emergency Department to a bed in the wards has reduced by one-third. Instead of three or four staff making four or so phone calls, a bed can now generally be found in one call.

Your theatre nurses now spend half the time they used to looking for and retrieving surgical equipment, meaning faster set-up and turnaround times for operations. Translated that means more patients being seen, sooner. You’re now doing more elective surgery than at any other time in Rotorua’s history.

And on a visit to your sister hospital in Taupo some months ago, I saw how a nurse-led project had replaced a cumbersome written referral system with a visual information board. The trend line shows this innovation has reduced the average length of stay at Taupo’s inpatient unit by over a day... meaning patients are home with their families much sooner.

The average hospital nurse spends less than a third of his or her time working directly with patients. The rest is spent running up and down the corridor and massaging keyboards.

On a recent visit to Tauranga Public Hospital – I saw first hand what nurses are doing to improve patient care by improving the time they spend with patients. One ward team had increased their patient-contact time from 32% to 57%. Needless to say the nurses seemed happier and so did the patients.

New Zealand's public health system needs better productivity, an adequate and well-settled workforce and improved quality.

People who work in our public health service are in it because of their commitment to caring. Money talks, but it is not the only, or even the prime, motivator.

Greater clinical participation in the running of our public health services is fundamental to improved staff satisfaction and quality improvement.

In fact, many clinicians tell me that improving productivity is a key route to professional satisfaction.

We must make it easier for people to do the work for which they are skilled and employed.

And that is the major challenge for our public health service over the next few years.

As I travel around the country listening and talking to doctors, nurses, midwives and other health professionals I often ask: what really frustrates you about working in health care today? Is it the money? Or is it the inability to use the skills you trained for and the experience you've gained?

The answers always make me optimistic for the future of the New Zealand public health service.

Our hospitals and GP clinics are staffed with dedicated people who want to do the best for their patients and New Zealand. They want to be valued, respected and involved. They want to make a difference.

Your redevelopment here in Rotorua will be impressive. But it will be made impressive not by the entranceway, nor by the extra theatres. But by the people that will make it the hospital you deserve.

I know that your local Member of Parliament Todd McClay is working closely with many health groups in Rotorua, and will be closely watching the project over the coming years.

Thank you for what you do, and it's my privilege to begin your redevelopment project.

ENDS

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