Major review of health system

This one is called a Review but it seems to be similar to the scores of working groups and committees and inquiries set up by the Government.

A major health Review, to be chaired by Heather Simpson, senior staffer for Helen Clark when she was Prime minister and also in when working for the UN, and I think also assisting the current prime Minister’s office, will report back by January 2020.

That is unlikely to leave enough time to make any major changes prior to the election, but will likely provide for a  basis for Labour-Green campaign policy.


Major review of health system launched

Health Minister Dr David Clark has announced a wide-ranging review designed to future-proof our health and disability services.

“New Zealanders are generally well served by our health services, particularly when they are seriously unwell or injured. Overall we are living longer and healthier lives – but we also face major challenges,” says David Clark.

“The Review of the New Zealand Health and Disability Sector will be wide-ranging and firmly focused on a fairer future. It will look at the way we structure, resource and deliver health services – not just for the next few years but for decades to come.

“We need to face up to the fact that our health system does not deliver equally well for all. We know our Māori and Pacific peoples have worse health outcomes and shorter lives. That is something we simply cannot accept.

“We also need to get real about the impact of a growing and aging population, and the increase in chronic diseases like cancer and diabetes. Those issues in turn create pressure on services and the health workforce that need to be addressed for the long term sustainability of our public health service.

“The Review will include a strong focus on primary and community based care. We want to make sure people get the health care they need to stay well. Early intervention and prevention work can also help take pressure off our hospitals and specialist services.

“People rightly have high expectations of our public health service. As Health Minister I want to ensure we can meet those expectations now and into the future,” says David Clark.

The Review will be chaired by Heather Simpson, who is perhaps best known as Chief of Staff to Helen Clark from 1999-2008 but also has a background in health economics. The Review will provide an interim report by the end of July 2019 and a final report by 31 January 2020.

 

The review would culminate in a report to Government, including recommendations, on:

  • How the health system can improve accessibility and outcomes for all populations
  • Whether the health system promotes the right balance between availability of services,
    (particularly tertiary services) population density and proximity
  • Whether the current system is well-placed to deal with environmental challenges such as climate
    change, antibiotic resistance and technological advances
  • Whether there are changes that can be made to the health system that would make it fairer,
    more equitable and effective
  • How the technological and global healthcare context is evolving, what opportunities and risks
    this rapidly-evolving context presents, and whether there are changes that would support the
    health system to adapt effectively given the rapid changes underway.

In examining the points above, the review would consider the following:

  • Demographic impacts – what the predicted population changes are, their potential impacts
    upon service demand, workforce availability and risks that may need to be managed
  • The international landscape – what New Zealand might learn from examining where health
    systems are heading internationally and what the impacts are, including input from relevant
    international organisations such as the OECD, World Health Organisation and the
    Commonwealth Fund
  • Decisions around distribution of healthcare resources, capacity of the health system to deliver
    care and clinical effectiveness (quality and safety) – e.g. how does the current geographic
    distribution of services help or hinder the system as a whole
  • Funding – how financial resources applied to health funding could be altered to provide
    greater flexibility in allocation, better transparency of return on investment, better support
    innovation in service mix/design and investment in key enablers, and reduce inequities
    through targeting those in need
  • Investment practices – providing a nation-wide view of how much infrastructure will be
    needed, over what timeframe and the balance to be struck across service provision and
    delivery
  • Ways to support the increasing priority of the role primary care and prevention has within the
    wider heath service
  • Potential opportunities and risks associated with rapidly emerging technological advances and
    the implications for, including but not limited to, clinical tools and settings, communication and
    transport
  • Institutional arrangements – roles and responsibilities, funding, accountability and delivery
    arrangements.

[DRAFT] Health and Disability Review Terms of Reference.pdf

Leave a comment

25 Comments

  1. Kitty Catkin

     /  May 29, 2018

    Well, they have to be seen to be doing something.

    Reply
    • duperez

       /  May 29, 2018

      Over the months the Government’s said that by way of working groups and committees, inquiries or reviews, they’re going to look at aspects of the way things are done.

      We could have a survey:

      1 They’re wasting their time because everything is perfect. Our systems in a wide range of fields are effective and efficient and the best value is being gained by the spend.

      2 They don’t want to do anything so the strategy is a way of pretending they are.

      3 Well, they have to be seen to be doing something.

      4 They’re looking at the way things are done to see if systems are fit for purpose and cost effective. (Bastards, anyone would think they’re in there to govern.)

      Reply
    • NOEL

       /  May 30, 2018

      I wonder if kicking the patient out of Emergency at 2am during a storm when there are only four beds occupied but the patient has reached the magical 6 hours,is included?

      Reply
      • Kitty Catkin

         /  May 30, 2018

        Was that the one in the US ?

        Reply
      • Kitty Catkin

         /  May 30, 2018

        The chances of there only being four beds occupied are slight. There would be no reason why the person couldn’t stay if there was an empty bed; I did once, but had to go to the waiting room when it was needed. Fair enough.

        What if there’s a real emergency that has a lot of people in A & E and someone can’t be seen before the 6 hour limit is reached ?

        I think that you are thinking of the US case where a mentally ill woman was put out on a freezing (literally) night in a hospital nighty and possibly a dressing gown which looked as if it was thin cotton.

        Reply
  2. David

     /  May 29, 2018

    This government is an utter disgrace, it is literally turned into a retirement scheme for various useless fools from the Clark era who are being given a chance to implement policy that was rejected a decade ago.

    Reply
    • duperez

       /  May 29, 2018

      Apologies for missing 5 “This government is an utter disgrace” from my suggested survey. 🙃

      Reply
      • PDB

         /  May 29, 2018

        You missed number 6) Nine long years in opposition where they could have had numerous working groups, committees, inquiries & reviews and actually hit the ground running with ready-made policies rather than wait until being in govt and having absolutely no idea how to govern.

        Reply
        • Gezza

           /  May 29, 2018

          No they couldn’t. They wouldn’t have had as easy access to the funding and the availability of information that they can now have, and grant, as the Government.
          Not saying I disagree that this review looks like it could waste a lot of time & money, but there are certainly limits to how much they could find out and do until they got their hands on the organs of government,

          Reply
          • Gezza

             /  May 29, 2018

            Um … I’ve only just realised how I put that last bit. Could’ve put that a bit better perhaps.

            Reply
          • PDB

             /  May 29, 2018

            In some instances that would be true – but most of these committees etc are talking in very generic terms that could have been done in the past 9 years.

            The fact is most of these working groups are basically being set up/stacked with like-minded people to produce a pre-determined result under the guise of being decided upon by an independent panel.

            Reply
            • Blazer

               /  May 29, 2018

              National instigated a very similar number of…working groups/committees,same ,same.

  3. David

     /  May 29, 2018

    Ever wonder if Ardern can govern and be pregnant at the same time well you have your answer.

    Reply
  4. Alan Wilkinson

     /  May 29, 2018

    Just rereading those terms of reference makes clear how over-bureaucratic our health system is. Once the Government takes your money and says it will look after your health it makes all the decisions for you and preempts the market responding to customer needs. The balance is far too far distorted that way in this country.

    Reply
    • Gezza

       /  May 29, 2018

      The market here tends to leave the serious stuff like cancer treatment and emergencies following private sector botch ups or lack of proper after care to the public hospitals – even though it might be the same surgeon who patches you up in the public hospital.

      What areas were you thinking of where the market would do a better job?

      Reply
      • Alan Wilkinson

         /  May 29, 2018

        If you want timely cancer diagnosis and treatment you go private, Sir Gerald. Likewise if you need a hip or knee replacement. If you want botch-ups you will find far more in the public system with some DHBs being particularly profligate.

        Reply
        • Gezza

           /  May 29, 2018

          Underfunding for bulk services is why you find stuff ups in the public system, Sir Alan. The hoi polloi cannot afford the services of the consultants in the private hospitals who cream it from both ends of the market, and wash their hand of their emergencies at the private hospitals because they aren’t covered by enough staff, and certainly not them, at night. Oh no – straight into the public emergency system, where there are staff.

          Reply
          • Alan Wilkinson

             /  May 29, 2018

            The worst stuff ups are caused by atrocious recruitment rather than overload. Waikato DHB has set the bar right at the top but others have bad records too.

            Reply
            • Gezza

               /  May 29, 2018

              Well if all the top quality consultants have to take big chunks of time off from the dhbs to cream it off the health insurance companies someone’s got to be recruited to stand in for them – ordinary & poor folk need treatment too.

            • Gezza

               /  May 29, 2018

              Are there any private health care providers providing ongoing dialysis treatment, Al? Do you know?

            • Gezza

               /  May 29, 2018

              No. Exactly Al. I can’t find any either. The Private Sector health industry in NZ just cherry picks the money spinning stuff, eh?

            • Alan Wilkinson

               /  May 30, 2018

              How hard did you look? This took me at least 2 secs:
              http://www.kidney.net.nz/dialysis.html

              In any case, you are just trying to support my point – that NZ health services are excessively dominated by govt institutions.

            • Gezza

               /  May 30, 2018

              Dialysis services in New Zealand are Government funded for New Zealand residents only.

              Fee-paying, private dialysis services are available in New Zealand, for non-NZ residents, visitors to New Zealand and New Zealand residents preferring individual care of the highest standard. At present I provide these in Auckland; but we can assist you in finding dialysis services elsewhere in NZ during your stay.

              Treatment costs vary according to the type of dialysis (peritoneal or haemodialysis); duration of treatment; and locality of service provided. Please contact Chris Davies (dialysis unit coordinator) for more detail on haemodialysis.
              . . . . . . . . . . . .

              You found ONE private provider in Auckland.

              So now go and find out how many New Zealand residents eligible for NZ Government-funded dialysis treatment are actually paying for it themselves at his service, Al.

              And how many are non-residents & visitors to NZ.

              And how much it costs.

            • Alan Wilkinson

               /  May 30, 2018

              Why? What’s your point?

            • Gezza

               /  May 30, 2018

              Once the Government takes your money and says it will look after your health it makes all the decisions for you and preempts the market responding to customer needs. The balance is far too far distorted that way in this country.

              The market won’t supply anything it can’t make a profit from – we are far better off having an efficient public health system that delivers decent health care to the public than leaving it to the market to provide specalised services to the wealthy on the whole. The scope for the market here is tiny and long may it stay that way.

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