The Health and Disability System Review Panel is today releasing its interim report, having delivered it to the Minister of Health last week, consistent with the timeline in its Terms of Reference (TOR).
The report reflects the submissions the Panel has received, the feedback from the many meetings attended around the country, and the analysis undertaken over the past several months. But it is still very much a work in progress.
“We have identified the likely reform themes and directions but significantly more discussion and evaluation is needed before we will be in a position to bring our thinking to recommendation stage,” says Panel Chair Heather Simpson.
Recommendations will be made in the Panel’s final report, due by 30 March 2020.
New Zealand’s health service delivery and per capita costs are in line with other OECD countries. Health systems around the world are under intense pressure and New Zealand is no different. The Panel’s TOR are wide, reflecting the scope of the challenges that we are facing now and will face in the foreseeable future.
These include rapidly increasing demand, an ageing population, the health effects of climate change, the potential created by advances in clinical practice and digital technologies, and persistent inequities of outcomes, in particular among Māori, low income and rural communities.
The Panel is taking a broad view, encompassing issues of culture and structure, governance and the Treaty of Waitangi, strategy and procurement.
Key messages from the report are that:
• a more collaborative and cooperative approach is needed, requiring changes in attitude and culture. These need to be led from the centre and applied consistently throughout the system. Mandates need to be clarified and accountabilities clearly defined
• the focus must be on the consumer, and what consumers value and need most, with more choice about how needs are met
• if future demand is to be manageable, the emphasis must be on preventing ill health and promoting wellbeing. This means more focus on population health and much faster progress on the vision set out almost 20 years ago in the Primary Health Care Strategy
• an effective Treaty/Tiriti based partnership must be developed with Māori to improve Māori health outcomes and to embrace a Māori world view
• a clearer decision-making framework is required, that allows decisions to be made in a timely manner, at the appropriate level and enforced effectively
• hospital and specialist services need to operate as a cohesive network
• funding streams, particularly within community and primary care, need to be simplified and more emphasis put on teamwork and maintaining health and wellbeing rather than on simply treating illness
• disability services planning needs to be more visible in the system with more flexibility in the way services are funded and delivered
• there needs to be a long term, nationwide health and disability service plan and more effective strategic planning throughout the system
• implementation of data standards, data stewardship, identity management and interoperability must be accelerated
• workforce strategies need to anticipate and address projected shortages, and
• the current distributed model for the design and delivery of capital projects is expensive and may not be sufficient to meet the scale of investment required.
The other Panel members are: Shelley Campbell, Professor Peter Crampton, Dr Lloyd McCann, Dr Margaret Southwick, Dr Winfield Bennett and Sir Brian Roche. The Panel is working with a Māori Expert Advisory Group to assist the review.
The interim report and an executive overview are available at: https://systemreview.health.govt.nz/interim-report