The King’s Fund is an independent thinktank focussing on the health system in the United Kingdom. Founded in 1897 it is a non-government organisation and charity that actively publishes research and analyses as well as organising conferences and other events. It has a strong focus on the benefits of integrated care – between community (includingContinue reading “Canterbury and Cardiff & Vale: what some don’t what to know about”
The Labour government’s ‘strategy’ for collective bargaining between district health boards (DHBs) and the various health unions can best be described as a slogan. The problem is that while slogans can make effective sound-bytes, a strategy they certainly are not. As result of this mistaken approach the Government has created a situation that undermines itsContinue reading “Slogans and sound-bytes don’t make a collective bargaining strategy; ask New Zealand’s nurses”
Health systems are delivered by highly committed and skilled health professionals overwhelmingly driven by compassion. Unfortunately many have to work in environments where leadership cultures are antithetical to that compassion. Broadly speaking the prevailing leadership culture in New Zealand’s health system is managerialism which involves decision-making through a very narrow lens that is management ratherContinue reading “Dirty politics in action: smear campaign in New Zealand’s health system”
In the 1991 Budget, the National government of Prime Minister Jim Bolger confirmed its intention to restructure New Zealand’s public health system by basing it on competitive market principles. Formally commencing on 1 July 1993, this restructuring was designed by then Minister of Health Simon Upton aided and abetted by external business consultants. When addressingContinue reading “Gaius Petronius Arbiter on abolition of New Zealand’s district health boards”
When the coronavirus pandemic hit Planet Earth in early 2020 it was confronted with two main opposing strategic responses to community transmission. One was elimination which was followed by parts of Asia including China, Vietnam, Thailand, Singapore and Taiwan while the second was mitigation (suppression was a stronger version) which was much of the restContinue reading “Taiwan a Covid-19 wake-up call for New Zealand”
Last week I published in the Victorian University hosted Democracy Project the second part of a two-article series of the escalating clash between the Ministry of Health (MOH) and Canterbury District Health Board (CDHB) in the context of the recovery response to the earthquake devastation of 2010-11 https://democracyproject.nz/2021/05/19/ian-powell-a-very-bureaucratic-coup-part-two/. This was largely a leadership culture clashContinue reading “A fleeting health system consensus”
Last year I read a fascinating article published by the monthly Le Monde Diplomatique on early health system initiatives in the United States’ Elk City and Canada’s Saskatchewan province https://mondediplo.com/2020/08/02populism-expertise. This got me to thinking about the small rural town of Kurow and its role in the establishment of New Zealand’s universal public health systemContinue reading “Early health system initiatives: Elk City, Saskatchewan and Kurow”
Minister of Health Andrew Little claimed that his recently announced health restructuring was bold. But it was only bold in the sense that whiteboard warriors are bold. Sitting behind this embellished claim is the unacknowledged view that structural change drives health system improvement. This conflicts with long experience that first, it doesn’t and second, sustainedContinue reading “Improving income support critical for improving health system”
General practice ownership in New Zealand has been incrementally challenged for some years. It is a challenge can’t be ignored and won’t go away. General practice is central to the delivery of primary care as a vital part of a wider, universal public health system that seeks to ensure access for all New Zealanders toContinue reading “New branch of specialist medicine poses challenge and opportunity for New Zealand’s health system”
What has a pay freeze got to do with a universal public health system? Actually quite a lot. Health systems, especially public hospitals which handle the more complex and urgent cases that the rest of the system can’t fix, are by their very nature labour intensive. Overwhelmingly delayed or denied access to public hospitals areContinue reading “Pay freezes, health systems and medical specialists”
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