Bureaucratic centralism rules supreme in New Zealand health system restructuring

This morning Minister of Health Andrew Little announced the Labour Government’s response to the Heather Simpson review of New Zealand’s health and disability system [https://dpmc.govt.nz/sites/default/files/2021-04/heallth-reform-white-paper-summary-apr21.pdf]. I didn’t see the decision to abolish all 20 district health boards (DHBs) coming. In mitigation nor did almost everyone else. Last Sunday the Minister penned an article downplaying structuralContinue reading “Bureaucratic centralism rules supreme in New Zealand health system restructuring”

Time to end health system’s headless chook leadership

Chicken Licken (also known as Chicken Little) was a children’s story that fascinated me (briefly) as a young child. As Chicken-Licken was going to the wood one day an acorn fell from a tree on to its head leading it to conclude that the sky had fallen on him. The moral of the traditional story is to have courage, evenContinue reading “Time to end health system’s headless chook leadership”

District Health Board considers directly employing general practitioners

Like almost every economically developed country outside the ‘Disunited States’, New Zea­land has a universal health system that endeavours to be accessible for all, comprehensive, high quality and affordable. The country is well placed to achieve this because of its unitary political system and district health board structure, in which each DHB is responsible forContinue reading “District Health Board considers directly employing general practitioners”

Ministry of Health: feudal fiefdoms and a culture of obliviousness

Several Director-Generals of Health ago I recall a senior official bemoaning that the Ministry was made up of feudal fiefdoms connected only by email. The Ministry was not functioning as an integrated organisation. At the time this resonated with me. Last week I was reminded of this by the public exposure of the controversy overContinue reading “Ministry of Health: feudal fiefdoms and a culture of obliviousness”

Criticisms of Pharmac review lose sight of an opportunity

The Government’s announcement of an independent review of Pharmac, implementing an election promise, has attracted criticism from many for not including funding in the review’s terms of reference. The sentiment behind this criticism resonates with me. There is no doubt that inadequate funding has been a huge obstacle to Pharmac achieving its full effectiveness. ButContinue reading “Criticisms of Pharmac review lose sight of an opportunity”

Health Minister Little gives thoughtful keynote speech…but!

Last Thursday (25 March) I was interviewed live on Radio New Zealand’s The Panel about a keynote address the previous day by Minister of Health Andrew Little on the implementation of the review of the health and disability system led by Heather Simpson. It provided me with a good opportunity to further develop my evolving thoughtsContinue reading “Health Minister Little gives thoughtful keynote speech…but!”

If it looks like data cleansing, barks like data cleansing, smells like data cleansing then it’s data cleansing

Last week Radio New Zealand’s ‘Nine to Noon’ programme ran an excellent item based on two quality interviews highlighting the unsavoury outcomes of patient harm data cleansing for those people who require non-acute (elective) surgery but are either severely delayed or miss out. https://www.rnz.co.nz/national/programmes/ninetonoon/audio/2018788479/woman-will-spend-savings-on-hip-surgery-after-dhb-declines. Beginning with a personal story The first interview with a self-employedContinue reading “If it looks like data cleansing, barks like data cleansing, smells like data cleansing then it’s data cleansing”

Very good fluoridation political call, Dr Verrall

Infectious diseases specialist Dr Ayesha Verrall was a surprise cabinet appointment being a first-time MP. Despite the rarity she’s not mucking around. This is evidenced by her legislative proposal, as Associate Minister of Health, to shift decision-making over water fluoridation from local authorities to the Director-General of Health (in effect the Ministry of Health). TheContinue reading “Very good fluoridation political call, Dr Verrall”

Pointer to Government rethinking on district health boards?

On 4 March I blogged on Otaihanga Second Opinion about recent indications that the Government was rethinking its position on one of the two main pillars of the structural overhaul of New Zealand’s health and disability system recommended by the Heather Simpson review: https://otaihangasecondopinion.wordpress.com/2021/03/04/taking-the-threat-to-new-zealands-health-system-out-of-simpson/. Specifically the Government was likely to confirm in April that would notContinue reading “Pointer to Government rethinking on district health boards?”

Health system at risk by Government abdicating leadership of Simpson review implementation to business consultants

The Government is putting the health system at risk by abdicating the leadership duties and responsibilities of its Health Transition Unit to external business consultants. The Unit is based in the Prime Minister’s Department and is responsible for the implementation of the Heather Simpson review of the health and disability system. The leadership and shapeContinue reading “Health system at risk by Government abdicating leadership of Simpson review implementation to business consultants”