Evolution

The recent announcement by Andrew Little, the Minister of Health, of a restructure of the healthcare system including establishing a new Māori Health Authority, paused the current email series on team effectiveness model. Reminding us all that change itself is one of the few permanent things in the world we live and work in. [Subscribe here if you aren’t already getting the weekly emails - the team series continues for the next few weeks].

The announcement was expected following a review undertaken and led by Heather Simpson. This review and the subsequent transition is held by  The Department of the Prime Minister and Cabinet and is a significant shift for all New Zealanders. 

Aotearoa’s healthcare system needs to change for a number of reasons. The reform is acknowledging the stress that the system is under, with a postcode lottery of care, significant inequities for Māori and duplication of process and systems with the 20 District Health Boards and the central nature that they take in the breadth of healthcare that is required. 

Having worked in the NHS in the UK and being part of the work to address the postcode lottery of health care that existed - it was hard work, it was energising work and it brought about change. It created the space for people, specialists and patients to come together and move in the right direction. 

This announcement and structure change is about that. I believe and hear everyday about the strain the system is under. I hear from staff and patients. I see the impact and I believe very much that change is needed. 

Reducing the competition and fear that seems to exist between the DHBs is key. I don’t believe patients see or understand (nor should they need to) the complexities of our system as they travel regionally or nationally for what they need. Coming from the UK to New Zealand it took a while to recognise the impact that had on how we deliver care and the duplication and confusion that can occur. I’m not saying the NHS was or is perfect, I’m saying that the sense of being part of something big gave everyone a sense of ‘in it together’. More of that, more collaboration and an infinite game mindset will mean better outcomes for staff and patients. 

I'm the partner of someone on the receiving end of care and how the system works is the least of your worries. You want good efficient safe care. You want to be treated with compassion and be seen as a whole person. You want to be heard. You don’t want to have the difficulties of communication and different systems presented to you. I believe this is what the structure change is trying to achieve. 

The health inequities that Māori face has to be addressed. I am no expert, nor qualified in how that should be done. I do believe that this must sit with Māori leaders to create, and has to be funded to recognise the effort and change that will be required. Inequities in health care exist everywhere. COVID-19 has seen these further exploited. As leaders you need to find the courage to listen, hear and talk about what needs to change. I step up knowing I will get things wrong and I also know that good leaders are not silent about the hard things. 


For more information and details of the NZ Health Reform: 

The White Paper explaining the reform and the structure is a readable 12 page document 
The Ministry of Health has a summary page with links to the information you need 
From Stuff this is a great explanation of the changes 
What the experts are saying from RNZ

Being part of delivering a publicly funded healthcare system is huge privilege, opportunity and challenge. The lessons of COVID-19 has taught the world how much the complex system that healthcare has become requires attention. That is going to take leaders who know themselves and what it takes for them to be at their best and keep learning. Leaders who can then create teams who feel physiologically  safe, trusted, who know what they need to do and have the resources to do it. Leaders who get out of the way to let staff do their work. 

It’s going to take you.