Speaker 1: You're listening to the Weekend Collective podcast from News Talks.
Speaker 2: I'd be the government is legislating health targets to lock
Speaker 2: in accountability, to use quotes around those three words. It's
Speaker 2: part of the slew of changes to the health system
Speaker 2: with the aim of refocusing on outcomes rather than bureaucracy.
Speaker 2: The Health Minister hopes it will ensure all patients have
Speaker 2: access to timely, quality healthcare. Professor Warwick bag is the
Speaker 2: dean at the University of Auckland's Faculty of Medical and
Speaker 2: Health Sciences and works with me.
Speaker 3: Now, good afternoon, Oh, good afternoon, sim How are you good?
Speaker 4: Thanks?
Speaker 2: In practical terms, I saw the headline for Simon Brown's
Speaker 2: press release talked about putting patients at the center. That
Speaker 2: sounds like sort of medicine one oh one, isn't it?
Speaker 2: Or is there more to this than a sort of slogan.
Speaker 3: It is medicine one on me. You're absolutely right, and
Speaker 3: putting patients at the center of healthcare is what every
Speaker 3: healthcare professional and person in New Zealand one right now.
Speaker 3: So I think that that is healthcare one on one,
Speaker 3: and I think what the Minister's trying to do is
Speaker 3: to ensure that there's not a whole lot of bureaucracy
Speaker 3: that's blocking that from happening. So I think that what
Speaker 3: he's trying to do is to make it more efficient
Speaker 3: to address need and those are admirable and good things
Speaker 3: to do.
Speaker 2: I guess obviously when we talk about focusing on patients,
Speaker 2: that's every medical professional. But the system, I guess he's
Speaker 2: focusing on has the system or had it? Has it
Speaker 2: lost its way?
Speaker 3: I think the first thing to say, Tim is if
Speaker 3: today you were unfortunate enough to end up with a
Speaker 3: heart attack and you present it to a hospital for
Speaker 3: the vast majority of people in New Zealand, you would
Speaker 3: get outstanding care today. Right now, if you were in
Speaker 3: a nasty car crash, for the vast majority of people
Speaker 3: in New Zealand, you'd get outstanding care today. But has
Speaker 3: the system lost its way? There are problems in the system.
Speaker 3: We could do better, and I think that that's what
Speaker 3: the minister is trying to address. So you know, for example,
Speaker 3: the targets, sorry, is.
Speaker 2: It a signal? Sorry you ker, I'm sorry you're the
Speaker 2: targets for example?
Speaker 3: Yes, So the targets, for example, I think you know
Speaker 3: that is part of the answer, But we just need
Speaker 3: to be clear that not everything that's healthcare is easy
Speaker 3: to count, and so sometimes with targets, you count lots
Speaker 3: of things that are important, but you're not counting the
Speaker 3: whole system. So that's one of the tricks in all
Speaker 3: of this is to ensure that we have a whole
Speaker 3: system approach.
Speaker 2: When you heard of the announcement, was it is it
Speaker 2: a signal of things moving in a direction that you
Speaker 2: would approve of?
Speaker 3: Well, I think we need to see the implementation. We
Speaker 3: don't have a lot of the details. But one of
Speaker 3: the things that's fantastic is around the infrastructure. You know,
Speaker 3: we have seen the challenges around infrastructure across the country,
Speaker 3: and to prioritize infrastructure is very very important. So I
Speaker 3: think that's definitely getting in the right direction. I think
Speaker 3: ensuring that the adequate frontline staff is important. That we
Speaker 3: should also remember that those front line staff needs folks
Speaker 3: behind them to ensure that the system is operating well.
Speaker 3: So it is a minister who is trying to improve
Speaker 3: a system that in many respects is already delivering very
Speaker 3: high qualities.
Speaker 2: I guess prioritizing infrastructure it sounds it's easy to say
Speaker 2: and sees to also talk about prioritizing putting patients first.
Speaker 2: But in reality, what actually needs to change. For instance,
Speaker 2: we know the delays with the need and hospital and
Speaker 2: the budget blowouts and all sorts of things. What could
Speaker 2: have been, what could have prevented something like that?
Speaker 3: Well, I think that we need to have careful governance
Speaker 3: and oversight and careful fiscal oversight over all of these aspects.
Speaker 3: And I think that's what the Minister's trying to achieve
Speaker 3: in some of what he's announcing. I think what we
Speaker 3: need to have buy hard as an agreement on these
Speaker 3: big infrastructure spends. If we don't have that by part
Speaker 3: as an agreement, then we go on this merry go
Speaker 3: round of the three year electoral cycle, and that's not
Speaker 3: helpful to getting the big projects done.
Speaker 2: Of course, it's early days. What sort of cooperation you're
Speaker 2: expecting from the opposition, I know that gets a little
Speaker 2: bit political from your point of view, But would you
Speaker 2: hope that these changes are obvious enough that they would
Speaker 2: support them?
Speaker 3: Well, I think you know some of these, Like if
Speaker 3: we're talking about infrastructure, everyone agrees that we need adequate
Speaker 3: infrastructure in both primary and secondary care, So not just
Speaker 3: in hospitals, but also in our primary care sector. And
Speaker 3: I would have thought that getting behind primary care, which
Speaker 3: the Minister is really prioritizing, would be something that the
Speaker 3: major parties could certainly both support. You know, if we
Speaker 3: have a healthy population, then we will have a prosperous nation.
Speaker 3: It's one of the core foundations to having a prosperous nation.
Speaker 3: I guess one of the other things that you mentioned
Speaker 3: earlier on is about in your comments about alcohol that
Speaker 3: you're talking about later, this is the importance of prevention.
Speaker 3: So we shouldn't only think about just at the bottom
Speaker 3: of the cliff. We should think about what we're investing
Speaker 3: to prevent many of the conditions that we're treating occurring.
Speaker 2: So what would you like to see next in terms
Speaker 2: of how the government rolls out the changes they want
Speaker 2: to implement in pursuing this refocus.
Speaker 3: Well, I think we need to have good engagement around
Speaker 3: what those targets are to ensure we don't have perverse outcomes,
Speaker 3: because one of the risks with targets is you only
Speaker 3: measure the things that are easy to count and not
Speaker 3: the much more complex aspects of healthcare delivery. So that's
Speaker 3: the key clinical engagement is really important. We need to
Speaker 3: agree what is the unmet health need, which we don't
Speaker 3: have agreement across the country on that, and that would
Speaker 3: be something that I would have thought was right for
Speaker 3: a bipartisan agreement. And I think that we need to
Speaker 3: ensure that we are focusing not only on the bottom
Speaker 3: of the cliff treatment but also on prevention, which is
Speaker 3: so very important.
Speaker 2: Looking at the just the overall the announcement, would you
Speaker 2: say that it is a sign of the government heading
Speaker 2: in the.
Speaker 4: Right direction with its approach to our health challenges.
Speaker 3: What I say the government doing is being really focused
Speaker 3: on improving our system, and I think that we have
Speaker 3: to see what the implementation will look like. That is
Speaker 3: where the challenge is. I haven't heard any Minister of
Speaker 3: Health over a long period of time who is not
Speaker 3: interested in improving the system where it comes and stuck
Speaker 3: is in the implementation. And so this is where we
Speaker 3: need to have everyone on board, working together, agreeing about
Speaker 3: what are the priorities for the system and then implementing
Speaker 3: them according to those agreements. That's what we need.
Speaker 2: To so really, I mean, it gets back to my
Speaker 2: first question. It says putting patients first, it's all great
Speaker 2: to have this talk and to talk about refocusing, but
Speaker 2: really this is really just the first step on a
Speaker 2: very long in a very long ladder, isn't it.
Speaker 3: It is the first step in a long ladder. But
Speaker 3: we are building on a system that already is a
Speaker 3: you know, it's got its problems to them, but it
Speaker 3: is a high functioning system. And as I said earlier,
Speaker 3: if you are very sick today and you need help,
Speaker 3: for the vast majority of people, that help will be provided.
Speaker 3: We just need to be really clear to him that
Speaker 3: we are not wasting money. So you know, I see
Speaker 3: the Minister's keen to train more people. We welcome that.
Speaker 3: We be open to doing that, but then we need
Speaker 3: to be thinking about where we invest in their training.
Speaker 3: So for example, let's invest in our existing institutions. Let's
Speaker 3: not waste money on new institutions. We have no track
Speaker 3: record in training.
Speaker 2: Oh so that would be is that basically, let's give
Speaker 2: more money to a Tigo in Auckland and forget about
Speaker 2: new medical schools.
Speaker 4: So I'm not sure if I'm just something there.
Speaker 3: I mean, that may be one example. Well, I mean
Speaker 3: I think you know, if we're talking about medical schools,
Speaker 3: we've said to the government as a tiger, we'll train
Speaker 3: the students you want us to train. We already have
Speaker 3: one hundred and seventy training and cut out this right now,
Speaker 3: so we don't see the sense in doing something else. Yeah,
Speaker 3: for example, but I think there's a whole range of
Speaker 3: initiatives of being efficient with our dollars, whether it's in
Speaker 3: healthcare treatment or whether it's in training. Let's make sure
Speaker 3: that we have enough momentum to do it really well
Speaker 3: and not simply try and reinvent the wheels and we
Speaker 3: don't have enough money to do then.
Speaker 4: Yeah.
Speaker 2: Actually, justin that was my last question for you. Really,
Speaker 2: how are things going at the Auckland Faculty of Medical
Speaker 2: and Health Sciences in terms of budgets and have you
Speaker 2: got what you need to be turning out the professionals
Speaker 2: that we rely on.
Speaker 3: We have what we need to. We are we have
Speaker 3: very strong growth in enrolments across all of our health professions.
Speaker 3: And what we're really focusing on is trying to make
Speaker 3: sure that we are having our health profession has operate
Speaker 3: at the top of scope. So what that means is
Speaker 3: that we're making our pharmacuts and our nurses or we're
Speaker 3: enabling them to operate at the top of their scope.
Speaker 3: You know, we saw this in the pandemic where pharmacuts
Speaker 3: were able to just spend vaccinate for the first time.
Speaker 3: That's the sort of thing that we're really focusing on,
Speaker 3: so that we're operating across the whole system, not just
Speaker 3: focusing on doctors for example.
Speaker 2: Yeah, well Warwick, I really appreciate your time this afternoon.
Speaker 2: Thanks very much.
Speaker 3: Thank you.
Speaker 4: That's Professor Rot Warwick back.
Speaker 2: He's he's a dean of the Universe of Auckland Faculty
Speaker 2: of Medical and Health Sciences.
Speaker 1: For more from the Weekend Collective, listen live to News
Speaker 1: Talk z'd be weekends from three pm, or follow the
Speaker 1: podcast on iHeartRadio.