Crucial that ‘Māori are central‘ to health review

Health workers want a review into the state of the health sector to be quick and inclusive to curb the suffering of vulnerable communities.

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Health Minister David Clark into health care yesterday saying complexities in the current system were getting in the way of people accessing the care they need.

The review aims to identify who is missing out in the health system and how it can be fixed.

“We need to face up to the fact that our health system does not deliver equally well for all,” Mr Clark said.

“We know our Māori and Pacific peoples have worse health outcomes and shorter lives. That is something we simply cannot accept.”

He wanted to see more service sharing and less bureaucracy in the sector.

Part of the of the review will examine the mix of governance, business, ownership and accountability models within the health system and whether this warrants a shake-up.

That could mean fewer DHBs.

Minister of Health David Clark told Morning Report it was a once-in-a-generation opportunity to take a hard look at the health system, with discussions with experts and clinicians.

Auckland councillor for Manukau Efeso Collins said the outcome of the review, due back in a year‘s time, could be too late for some.

The troubled is already at capacity and turning people away, he said.

Women about to give birth, people with kidney issue or cancer were not getting the care they needed, Mr Collins said.

“That‘s not going to give anybody any confidence whatsoever.”

Mr Collins said the structure and governance of DHBs must be reviewed.

“I cannot believe that in 2018 we have a hospital in South Auckland that is rotting,” he said.

“This is unacceptable for today‘s age, so we‘ve got to make sure that we‘re acting decisively for the community.”

The minister, the Ministry of Health and DHBs needed to talk to each another and take urgent action to remedy some of the major problems at hospitals like Middlemore, Mr Collins said.

Salaried Medical Specialists executive director Ian Powell mostly supports the current DHB system and said reviewers should avoid getting too fixated on DHB structures.

“Focusing on the number of DHBs is a dead end,” he said.

“You only have to look at the fiasco that‘s happened with the merger of the Otago and the Southern DHB to know that restructuring is counter-productive,” he said.

Sharing services was the best way to take pressure off providers and ensure people could access services, Mr Powell said.

“It can be, in some cases, sharing the after-hours rosters with other DHBs that are close enough to enable that; it can be having a service that covers more than one DHB so it can be shared around so people can maintain their skills,” he said.

A senior lecturer in Māori Health at the University of Auckland, Rhys Jones, said Māori voices must be included to address inequities in health services.

“It‘s really important that Māori are central within those conversations,” he said.

“Māori communities actually have the solutions to a lot of our problems that they can provide meaningful input,” Dr Jones said.

Dr Jones said healthcare providers, including DHBs, must be held accountable if they fail to deliver good healthcare to Māori.

The review is being chaired by Heather Simpson, who served as the former Prime Minister Helen Clark‘s chief of staff for nine years, but other members have yet to be appointed.

An interim report will be completed by next July with the final version due in January 2020.