Rob Campbell
Rob Campbell is chairman of SkyCity, Tourism Holdings, WEL Networks and Summerset. He trained as an economist and originally worked as a trade unionist before eventually becoming a professional director.
health science
Two weeks into hew health order, new chairman Rob Campbell reveals how Health NZ is concerned and working to tackle the shortage of doctors and nurses
Remark: When the first Fortnite online game came out, things went pretty well. But save the world was nothing compared to his successor, battle royalewhich became ballistic.
The first two weeks of the Pae Ora world we wanted to save the health system, but we soon realized that we were also in a battle royale with snipers, bombers and booby traps galore.
It’s all over.
Let’s take a step back and see where Pae Ora places Te Whatu Ora (Health NZ). How the ‘game’ works. I do this for understanding and not for excuse or avoidance.
The structure of the new health system is laid down in the Pae Ora (Healthy Futures) Act and in a series of cabinet decisions on how that structure should work, including its priorities. These are described in more detail in a government policy statement to which we (and the Māori Health Authority Te Aka Whai Ora and the Ministry of Health) commit ourselves.
That, in turn, will produce an interim health plan to be issued by the minister shortly, outlining a lot of details about what we need to do and how we’ll be monitored.
We try to emulate our colleagues in an emergency department. The demands are incessant, usually competitive and sometimes overwhelming. The resources are short. It can even look like chaos. The only way to deal with it is to keep the peace in the center.
It’s not exactly a free-for-all, and any relationship to the free-for-all of a real Fortnite game will be gone by the time you’ve read all that.
I’ve read it all, so have my board and (I hope) executive colleagues, and we’re under no illusions.
Discretionary spending is limited
It gets harder than that. Some large numbers are spent in the health system. But our “discretionary” spending is quite limited.
The vast majority is committed to personnel, buildings, supplies and already contracted services for the coming years. That’s the way it should be: the elected government sets the rules and dictates where the money goes.
But anyone who thinks Te Whatu Ora has the freedom to quickly revolutionize the health system as they see fit is misguided.
We are not misled.
As an emergency department
The expectations are high. It seems that every part of the system has goals, claims and struggles to satisfy. Many politicians and media commentators see an opportunity or responsibility to have a vision every step of the way.
The noise is intense and we can be so easily distracted or retreat to the defense. We choose not to do either.
We try to emulate our colleagues in an emergency department. The demands are incessant, usually competitive and sometimes overwhelming. The resources are short. It can even look like chaos.
The other immediate priority is not to get in the way of the people doing essential work. (We don’t.)
The only way to deal with it is to stay calm in the center, make rational trade-offs and allocate time and other resources, take each priority as it comes and work your way through it.
For Te Whatu Ora, we focused first on making sure that the immediate transition didn’t cause any system failures (it didn’t). Along with that is setting up board and senior executive teams, procedures and decision systems that can handle the immediate flow of decisions that are needed (which we have).
Some of our systems are a bit improvised – we’re operating from temporary premises – but we’re going.
The other immediate priority is not to get in the way of the people doing vital work (we didn’t).
These may seem quite limited objectives, but we are realistic. Not exciting but essential.
Personnel action, no headlines
This work alone yields some small efficiency gains. Also, being free from the various structures of district government, some action teams have been released to make some changes that can be done in weeks and are underway.
Neither is worth a cup by itself and we won’t aim for that, but each makes a difference.
We’ll have to hit some band-aids in the short term to cope.
There is, of course, a lot of concern about clinical staffing. Of course we share that concern. Teams are actively working on recruitment, training, planned care and other aspects of these shortages. No reports, actions.
We do need to make some short-term arrangements to deal with band-aids – all of them were necessary, regardless of the reforms. All problems were years in the making and will be years in solution. There is no magic pill. We need to rise above the past practice of short-term patches. That’s why we’re here.