Future Shake Up of our Health Services – David’s Views

There is no doubt that a major shake up is coming – and the CCDHB will need to be ready for this. There will be major governance changes, to which I believe I could contribute.

Every day the media presents stories of the way in which the health service is failing. Maori and Pasifika and low income households are particularly disadvantaged.

Recent Review of Health Services

A just completed review of our health services diagnoses many problems, all of them well known and previously documented – although at this stage without recommendations, which will be put forward next March. In its view there is fragmentation and duplication between DHBs, primary health organisations (PHOs). non-governmental providers and other services. (The performance of Ministry of Health is also a key issue to me.) It concludes that the system does not serve consumers’ values and needs, does not have enough focus on prevention and wellness and results in a “post code” lottery of healthcare. The latter point is illustrated by the fact our 20 DHBs largely “do their own thing” in how they deliver their health care services. DHB contracts with service providers differ across the country – for no apparent reason. A good example is the delivery of crucial home care services which keep people in their homes and out of hospital. As such we have nothing like a national health service. We have 20 different health services, thanks to the DHB model, which will need to change.

Addressing Short Falls

The Government’s new national strategies and funding for mental health and cancer diagnosis and treatment are welcome. But implementation will fall short unless we have the required numbers of psychiatrists, psychologists and oncologists – not to mention addressing shortages of nurses and midwives for other areas of healthcare.

How on earth did we get into this sitation? The National Government’s cuts to health funding have not helped, but I suggest it is the governance structure which has been the key failure. DHBs need board members with an understanding of governance, able to understand financial statements, able to understand what the dozens and dozens of health performance indicators mean and don’t mean, understanding the need for sound asset management and willing to pursue issues without being fobbed off by management.

I hope I am not being immodest in claiming that I would bring this knowledge and experience to the CCDHB board.