It's time our outdated health service was taken off life support

5 min read
Cecilia Robinson

1 May 2021

Opinion as featured in the New Zealand Herald

When Health Minister Andrew Little announced sweeping reforms to New Zealand's health sector, it was music to my ears.

For too long, our health system has been hamstrung by bureaucracy and red tape, which has created duplication and stifled the innovation that would deliver better outcomes to patients.

With 20 district health boards, we have 20 different annual plans, finance departments, IT divisions, procurement groups and HR teams - all creating their own systems and processes that do not talk to each other.

In fact, our health system has a mind-blowing 120 IT systems!

For a country of five million - the size of Sydney - this is ridiculous. We have all known this but the challenge of fixing it is so daunting, that governments of all colours have put it in the too hard basket.

So, I applaud Andrew Little for acting.

By dismantling the silos and bringing the sector together, I hope we will be finally able to coordinate efforts, shift resources and deliver consistent levels of healthcare across the country.

Some might argue that structural changes alone will not deliver improved health outcomes. They are right.

But the problem is that the current structure actually prevents change from occurring. Our health system is so complex and cumbersome, it ends up protecting the status quo rather than encouraging new thinking.

Simplifying the system, consolidating functions and creating a single leadership structure with one goal - improving the health outcomes for every New Zealander - can seed the conditions needed transformational change.

And that is what is needed. For far too long, too many New Zealanders have been left behind by our health system.

Kiwis with severe mental health issues die up to 25 years earlier than others. Māori and Pacific peoples are twice as likely to die young from conditions that could have been treated, and Māori life expectancy lags scandalously behind the life expectancy of other New Zealanders.

We need to make our healthcare system work for all New Zealanders, and this starts with making it accessible for all New Zealanders.

That is why the changes announced to our primary healthcare system are just as critical as some of the other headline grabbing changes that have been announced.

These changes will see every primary and community health service reorganised to better serve the communities that they are in.

While every locality will have a consistent range of core services, how these services are delivered will be based on the needs and priorities of the community they serve.

Why is this important? Because we know the needs of South Auckland are different to the needs of central Wellington.

While the devil will be in the detail, the reorganisation of primary health services can help deliver a primary health system that is responsive, innovative and adaptable and prevent a one-size-fits-all approach being applied across the country.

And the establishment of a Māori Health Authority will inject the voice of Māori more strongly into the health system.

But more importantly, the Māori Health Authority will have the power to commission health services.

I hope this will result in new and innovative services being developed, funded and supported that will help close the equity gap.

But we also need to embrace the power of new digital technology to help give more Kiwis access to the health services they need, when they need them, where they need them, and how they want them.

Unfortunately, our health system is built on antiquated IT systems or, worse, is still paper based. We have underinvested in technology for years and, when we have invested, we have created systems that don't talk to each other.

As a result, we are in a situation where the technology is actually holding us back rather than moving us forward. The plethora of IT systems makes it almost impossible to integrate new software or technology at a national level without huge complexity and at massive cost.

And rather than making life easier, our IT systems are forcing our frontline to waste time using a multitude of different systems for different tasks.

It doesn't have to be this way.

Technology can be the driver of real transformation. Imagine a system where primary, secondary and tertiary health services are all working from the same IT system.

There is no reason why every doctor, nurse, pharmacist and physiotherapist should not be armed with a mobile device that gives them all the data they need to do their jobs, and which allows them to input their data into that same system.

The power of information will provide the catalyst for change.

Technology will give Kiwis greater power of their own healthcare. Everyone should have the ability to make an appointment, talk to a health professional, access test results and look at all their own health information wherever they are and whenever they need to.

I fundamentally believe technology is the future of healthcare delivery in New Zealand and it will happen quicker than we expect.

Because as Kiwis, we aren't afraid of change, even if parts of our health system are.

We've seen innovation on this scale happen before. In 1997, ASB was the first bank in New Zealand to offer internet banking.

Fast forward 24 years and the thought of physically depositing cheques at a bank branch is antiquated. Personal finance has been revolutionised by technology - first by the internet, and then by smartphones.

We can do the same with healthcare. In fact, we need to if we are to drag our health system into the 21st century and make Kiwis the healthiest people in the world.

• Cecilia Robinson, Co-Founder and Co-CEO, Tend Health Limited