Andrew Dickens: The health report is a lot better than you think

Andrew Dickens,
Publish Date
Thursday, 5 September 2019, 4:44PM
I was guilty of being ignorant about the report. (Photo / Supplied)

Something weird happened to me this morning. I was reading an article when I heard Mike Hosking reading it out on air. It's because it was so good.  

The Herald’s Pattrick Smellie wrote this: "Some days, it's hard to decide whether the government is committed to action or simply to talking about action.

“Examples from the last week: a massive public health system report that includes no recommendations; a draft food safety strategy so bland that it's unclear what the proposals are; a timid draft minerals strategy that confuses consultation with platitudes."

Which is bang on - almost.  

Because I've been reading Heather Simpson's interim report and it really is very good. Yes, there are no recommendations but there never was going to be. The recommendations come in march and we knew that right from the start of project 18 months ago. So to complain there is no recommendations is actually a really ignorant thing to do.  And I was guilty of that two days ago.

So reading it I've realised this report is the best snapshot of the health system I've ever seen, documenting both the good and the bad.  No wonder it took 18 months.  It is a comprehensive look at a massive beast. It show how on the whole the system provides good outcomes but when it's bad it's very bad and very public.

We all think we know the problems and so we all think we know the answers but the reality is far more complicated. One of the reasons  the system isn't purring along is because too many amateur politicians have put their oar in over the years

For instance we all think there are too many DHBs, with too much duplication and too much wastage. So instead of 20 then why don't we just cut them down to six.  

But the truth is some of the smaller DHBs are the best performing and some of the biggest DHBs are the worst performing and so bigger is not better. The report points out some of the smaller DHBs could do with a helping hand from the big brothers and that could make a huge difference. It says the problem is not necessarily too many DHBs but the leadership of them and the communication between them.

It also addresses what we now call the postcode lottery of healthcare.  You know that's the reason we have so many DHBs in the first place. Would Southland health really be run better out of Christchurch?  Fewer DHBs could mean more Blair Vinings and not fewer.

So here's the thing. This health system is the sum of many governments.  the report says on the whole it works. All parties no matter their politics need to read it.  and need to think about how to fix the problems and come up with a system based on best practice not politics.

I'm actually looking forward to the recommendations in March.

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