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I'd be the government is legislating health targets to lock in accountability, to use quotes around those three words. It's part of the slew of changes to the health system with the aim of refocusing on outcomes rather than bureaucracy. The Health Minister hopes it will ensure all patients have access to timely, quality healthcare. Professor Warwick bag is the dean at the University of Auckland's Faculty of Medical and Health Sciences and works with me.
Now, good afternoon, Oh, good afternoon, sim How are you good?
Thanks?
In practical terms, I saw the headline for Simon Brown's press release talked about putting patients at the center. That sounds like sort of medicine one oh one, isn't it? Or is there more to this than a sort of slogan.
It is medicine one on me. You're absolutely right, and putting patients at the center of healthcare is what every healthcare professional and person in New Zealand one right now. So I think that that is healthcare one on one, and I think what the Minister's trying to do is to ensure that there's not a whole lot of bureaucracy that's blocking that from happening. So I think that what he's trying to do is to make it more efficient to address need and those are admirable and good things to do.
I guess obviously when we talk about focusing on patients, that's every medical professional. But the system, I guess he's focusing on has the system or had it? Has it lost its way?
I think the first thing to say, Tim is if today you were unfortunate enough to end up with a heart attack and you present it to a hospital for the vast majority of people in New Zealand, you would get outstanding care today. Right now, if you were in a nasty car crash, for the vast majority of people in New Zealand, you'd get outstanding care today. But has the system lost its way? There are problems in the system. We could do better, and I think that that's what
the minister is trying to address. So you know, for example, the targets, sorry, is.
It a signal? Sorry you ker, I'm sorry you're the targets for example?
Yes, So the targets, for example, I think you know that is part of the answer, But we just need to be clear that not everything that's healthcare is easy to count, and so sometimes with targets, you count lots of things that are important, but you're not counting the whole system. So that's one of the tricks in all of this is to ensure that we have a whole system approach.
When you heard of the announcement, was it is it a signal of things moving in a direction that you would approve of?
Well, I think we need to see the implementation. We don't have a lot of the details. But one of the things that's fantastic is around the infrastructure. You know, we have seen the challenges around infrastructure across the country, and to prioritize infrastructure is very very important. So I think that's definitely getting in the right direction. I think
ensuring that the adequate frontline staff is important. That we should also remember that those front line staff needs folks behind them to ensure that the system is operating well. So it is a minister who is trying to improve a system that in many respects is already delivering very high qualities.
I guess prioritizing infrastructure it sounds it's easy to say and sees to also talk about prioritizing putting patients first. But in reality, what actually needs to change. For instance, we know the delays with the need and hospital and the budget blowouts and all sorts of things. What could have been, what could have prevented something like that?
Well, I think that we need to have careful governance and oversight and careful fiscal oversight over all of these aspects. And I think that's what the Minister's trying to achieve in some of what he's announcing. I think what we need to have buy hard as an agreement on these big infrastructure spends. If we don't have that by part as an agreement, then we go on this merry go round of the three year electoral cycle, and that's not helpful to getting the big projects done.
Of course, it's early days. What sort of cooperation you're expecting from the opposition, I know that gets a little bit political from your point of view, But would you hope that these changes are obvious enough that they would support them?
Well, I think you know some of these, Like if we're talking about infrastructure, everyone agrees that we need adequate infrastructure in both primary and secondary care, So not just in hospitals, but also in our primary care sector. And I would have thought that getting behind primary care, which the Minister is really prioritizing, would be something that the major parties could certainly both support. You know, if we have a healthy population, then we will have a prosperous nation.
It's one of the core foundations to having a prosperous nation. I guess one of the other things that you mentioned earlier on is about in your comments about alcohol that you're talking about later, this is the importance of prevention. So we shouldn't only think about just at the bottom of the cliff. We should think about what we're investing to prevent many of the conditions that we're treating occurring.
So what would you like to see next in terms of how the government rolls out the changes they want to implement in pursuing this refocus.
Well, I think we need to have good engagement around what those targets are to ensure we don't have perverse outcomes, because one of the risks with targets is you only measure the things that are easy to count and not the much more complex aspects of healthcare delivery. So that's
the key clinical engagement is really important. We need to agree what is the unmet health need, which we don't have agreement across the country on that, and that would be something that I would have thought was right for a bipartisan agreement. And I think that we need to ensure that we are focusing not only on the bottom of the cliff treatment but also on prevention, which is so very important.
Looking at the just the overall the announcement, would you say that it is a sign of the government heading in the.
Right direction with its approach to our health challenges.
What I say the government doing is being really focused on improving our system, and I think that we have to see what the implementation will look like. That is where the challenge is. I haven't heard any Minister of Health over a long period of time who is not interested in improving the system where it comes and stuck is in the implementation. And so this is where we need to have everyone on board, working together, agreeing about what are the priorities for the system and then implementing
them according to those agreements. That's what we need.
To so really, I mean, it gets back to my first question. It says putting patients first, it's all great to have this talk and to talk about refocusing, but really this is really just the first step on a very long in a very long ladder, isn't it.
It is the first step in a long ladder. But we are building on a system that already is a you know, it's got its problems to them, but it is a high functioning system. And as I said earlier, if you are very sick today and you need help, for the vast majority of people, that help will be provided. We just need to be really clear to him that we are not wasting money. So you know, I see the Minister's keen to train more people. We welcome that.
We be open to doing that, but then we need to be thinking about where we invest in their training. So for example, let's invest in our existing institutions. Let's not waste money on new institutions. We have no track record in training.
Oh so that would be is that basically, let's give more money to a Tigo in Auckland and forget about new medical schools.
So I'm not sure if I'm just something there.
I mean, that may be one example. Well, I mean I think you know, if we're talking about medical schools, we've said to the government as a tiger, we'll train the students you want us to train. We already have one hundred and seventy training and cut out this right now, so we don't see the sense in doing something else. Yeah, for example, but I think there's a whole range of initiatives of being efficient with our dollars, whether it's in
healthcare treatment or whether it's in training. Let's make sure that we have enough momentum to do it really well and not simply try and reinvent the wheels and we don't have enough money to do then.
Yeah.
Actually, justin that was my last question for you. Really, how are things going at the Auckland Faculty of Medical and Health Sciences in terms of budgets and have you got what you need to be turning out the professionals that we rely on.
We have what we need to. We are we have very strong growth in enrolments across all of our health professions. And what we're really focusing on is trying to make sure that we are having our health profession has operate at the top of scope. So what that means is that we're making our pharmacuts and our nurses or we're enabling them to operate at the top of their scope. You know, we saw this in the pandemic where pharmacuts were able to just spend vaccinate for the first time.
That's the sort of thing that we're really focusing on, so that we're operating across the whole system, not just focusing on doctors for example.
Yeah, well Warwick, I really appreciate your time this afternoon. Thanks very much.
Thank you.
That's Professor Rot Warwick back.
He's he's a dean of the Universe of Auckland Faculty of Medical and Health Sciences.
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