health science
DHBs are no more with today the start of the biggest reforms the health sector has seen in 20 years. Emma Hatton speaks with the co-chair of the Māori Health Authority and member of the Health NZ board about what day someone brings.
To the untrained eye, it’s just like any other day.
“You won’t see big rah rah stuff because we need to maintain a sense of stability.”
“But…I’ll tell you something, we’re going to leave no stone unturned, that’s for sure.”
Sharon Shea (Ngāti Ranginui, Ngāti Hauā, Ngāti Hine, Ngāti Hako) is the co-chair of the Māori Health Authority and also sits on the board of Health NZ. The work has been going on for months to get the new entities up and running – fully fledged, funded and ready to reform.
The training wheels are coming off, and Shea stresses that the next two years are critical.
“I’m giving you the time frame of 24 months because that’s the length of the New Zealand Interim Health Plan and we’re all about action during that period.”
The entities are still waiting for the government’s policy statement, which is expected to land every day, which sets the high-level direction for the new system.
The Māori Health Authority and Health NZ also make up the country’s first national health plan, which Shea said was “upcoming” to be released.
“In that plan, the sector will be able to see the direction of travel and that will be more detailed than in the government’s policy statement.”
She said it would have six priorities, including climate change, support for long-term conditions, the first five years of a child’s life, and mental health and addiction.
“We are certainly ready. We have worked very hard to create the crash barriers, the handrails, clarity over the next 24 months to give people the confidence that not only will they know what is happening, but they will have a clear picture of how success will be measured .”
She says tangible results such as workforce development and clinical measures would be short-term indicators that the entities would monitor to ensure they were on the right track, indicating specific details would be revealed in the national health plan.
“You won’t see big rah rah stuff because we need to maintain a sense of stability.” – Sharon Shea, Co-Chairman Māori Health Authority
Less visible and measurable, however, would be to address long-term problems.
“You can’t turn the waka with the deepest hull… there are some things like intergenerational inequality that we can’t change the direction of in two years, but it’s our duty to be responsible for laying the tracks for that to happen.”
But what about the first day?
“Basically it all happened in 1201. All the contracts and all the staff are transferring to Health NZ and we’ve set up the financial system so that people get paid and all that sort of thing… the branding will change.”
“All the [DHB] driving from midnight no longer exist… the DHB CEOs, they are there and this is part of the stability, until at least September 30th they will definitely be part of the team.”
With meetings that are already in the agenda, it can also be started immediately.
“We have joint board meetings in the afternoon and then separate board meetings. So we have to sign some establishment cases to formalize everything… and then we’re off.
“We have a new pair of runners and we are going to sprint.”
Health Minister Andrew Little said to the naked eye that today would look the same.
“It’s about structural change. It is about the change of decision makers and how decision making comes about.
“Someone who finished his shift on Thursday and then starts [today]they won’t notice any difference. For a patient who was in hospital on Thursday and is still there [today]they won’t notice much difference.”
“My expectation is that we will see some reduction in back office staffing and equally my expectation is that whatever we free up there will be used to support primary health care.” -Andrew Little
He said patients would begin to notice changes as the new system became embedded, with greater communication between previously isolated entities and greater efficiency.
“I’m mainly thinking about recruiting to fill the nurse vacancies, with 20 different organizations all competing in the same job market or advertising and trying to get nurses to work for them…Now we have one big healthcare provider that can run a recruitment campaign that’s about the system as a whole – that’s going to make a big difference.
“And I think we’re going to see the opportunity to use resources wherever they are in the system, so if the nearest hospital can’t receive you for the procedure, but a hospital in the next town can make it much easier.” for you to get your treatment there and you will be treated much sooner.”
He said streamlining services would lead to job losses for back office staff, but the resources would be processed as the four new consolidated entities.
“My expectation is that the same number of people you have with 20 different healthcare providers, each with their own HR department, IT department, finance department, corporate services, and so on, wouldn’t necessarily be needed if you got one entity.
“So my expectation is that we will see some reduction in back office staffing and equally my expectation is that whatever we release there will be used to support primary health care.”
Little is expected to change in the early stages as the new entities are expected to go about things “pretty smart”.
“They have a few years to get things moving, getting a good rhythm going. But still in those same two years, there has to be… change that must be obvious…”
Despite the reins formally handed over to the new entities today, Little said it was by no means “hands-off” for the government.
“Certainly not. We will always make sure it works as we expect. I have already set up my first round of meetings with the chairmen and chief executives of the new entities.
“The work will change in nature … but it certainly will not diminish.”