4 minute read
Tis the season
On the day I wrote this column I also took domestic leave to support my mum. She was booked for day surgery for an eye problem. It was going so well - even down to finding a park - and she’d been handed her hospital bracelet, when…
Sarah Dalton | Executive Director
Most of you can guess what happened. Her operation was cancelled to allow for an acute case.
It was fine – mum was even a bit relieved – and the booking clerk whose job it was to share the news was grateful we took it all in our stride.
But it also speaks to two key challenges within our health system - both of which featured heavily at this year’s Annual Conference.
The first is workforce. We don’t have enough clinicians out there – doctors, nurses, allied health staff. Or even support staff or IT liaison, let alone community-based aged residential care , GPs, dentists, midwives, or mental health workers.
It is a problem caused by active disinvestment in our health workforce. Inadequate funding over many years has been made worse by penny-pinching cultures, where balancing the books has trumped care for people (both staff and patients).
Te Whatu Ora’s arrival has now made it politically acceptable to admit to staffing shortages. Te Whatu Ora board members and senior staff all concede there are troubling gaps in our workforce. The Ministry of Health appears to agree. Perhaps this offers a tiny spark of hope.
But troubling echoes of the old DHB cultures remain. Members still struggle to get basic entitlements and our industrial staff are busy supporting many services who continue to battle the ongoing culture of “no”.
I have met with district directors in various parts of the country, and I’ve been heartened they broadly agree we need a shift in attitude: to acknowledge people’s contribution, to listen first, to choose de-escalation over aggressive HR-process-driven approaches. But there is much to do — and not enough resource to make rapid improvements.
There’s also a troubling tendency to fixate on overseas-trained clinicians as the answer, while immigration processes remain swamped, unsympathetic and clunky; and everyone is aware Australia pays health workers a hell of a lot more than it appears NZ ever will.
I was talking to a group of psychiatry trainees earlier this week. Their diversity, passion and intelligence filled me with optimism. But they asked, quite reasonably, how can we continue to earn so much less than Australians, when both our Government and our employer know how stretched the international medical market is, and how hard it is to recruit?
The second key challenge is the larger question of what kind of health system we are prepared to fund? We commissioned Max Rashbrooke to write a discussion paper (available on our website) that tries to shape this critical question. Is it ok that we contribute so much less (as a proportion of GDP) than many other OECD countries? Can we keep pretending the current funding arrangements offer equitable access to care? Is designing a whole new health system without including how we fund it a tiny bit naïve?
While the coming year promises to be full of challenge, I hope that many of you will soon have a rest and some time to relax (and play) with whānau and friends. I am so grateful for your hard work and service to our communities over the last, very difficult, 12 months.
I would also like to thank the ASMS staff for their unstinting efforts on your behalves. They are a great crew and we are very lucky to have them. In particular, senior industrial officer, Lloyd Woods, begins his well-earned retirement in January. I know you have heaps of plans, Lloyd, and that you will have many projects on the go. Thank you, too, for all your years of hard work and service to Toi Mata Hauora, and to the union movement.
