The boxer Mike Tyson once said “everyone has a plan until they are punched in the face”. Well, says new Health NZ chair Rob Campbell, our health system is wearing those punches now.
Speaking at the Health Tech Conference in Auckland, Campbell is this morning declaring war – he uses that term – on those he says are exploiting the health system for their own gain.
The brutal warning comes from a man who has worked as both a unionist and as a director of big listed companies like SkyCity Entertainment Group. Now he is stepping into perhaps the biggest challenge in the public sector – and he says that since he’s got involved, he’s been seeing far too many reports and grand schemes; far too few simple improvement actions.
“While staff on the front line are under real pressure coping with current realities, the corridors of management are cluttered with consultants, contractors and vendors hawking their wares to solve problems which they promote to meet whatever they have for sale.”
Health NZ and the Māori Health Authority are to be established on Friday, progressively taking over from the 20 DHBs that presently run the country’s hospitals and fund its primary health organisations and hauora.
Campbell has sent a signal to about 80,000 staff who will be soon joining Health NZ, and more than 200,000 staff in funded agencies, that the Pae Ora Act creates a structure to drive through change.
Too much of what they have been doing deals with ill-health actual or potential, rather than what most would regard as health; there is the danger that hospitals become like prisons, dealing with the problems left over when the system fails, he says.
“There is far too much money being spent on ‘holy grail’ solutions being developed and scoped, far too divorced from the services clinical and care delivery and whānau need now … It is all long overdue for a clean-up.”
– Rob Campbell, Health NZ
And he has sent an even more uncompromising warning to health technology providers and other suppliers – “money changers in the temple” who he says are exploiting New Zealand’s hospitals and health system for their own gain.
“There are far too many service and hardware salespeople roaming around selling to far too many points of potential use. It is like a massive noisy bazaar in the dark with the throngs simply getting in each other’s way.
“There is far too much money being spent on ‘holy grail’ solutions being developed and scoped, far too divorced from the services clinical and care delivery and whānau need now … It is all long overdue for a clean-up.”
He says “sophisticated technologies serving the interests of the elite” do not help whānau with immediate needs for basic support and treatment. “The war we need to be fighting is the war against ill health in those communities.”
Acting Prime Minister Grant Robertson told Newsroom he didn’t anticipate any cleaning out of consultants in the data or digital sector.
“I don’t think he’d be suggesting that we wouldn’t have contractors to deal with the data and digital issues we’ve got, that is the nature of that industry. I think what he’s pointing to is that if your driving force and driving goal is access to healthcare services, then I think it’s really important that the chair of the board focuses on that,” he said.
The 20 district health boards Health NZ is replacing have had “more people in middle management consultancy-type roles than we would need for a nationwide health service”, he said.
“Rob’s a pretty frank character, he’s always someone prepared to speak his mind. One of the reasons we put him in this role is because we know we need to change and we’re changing a big system.”
Health NZ will reassess its suppliers and contractors, without regard to historical practice, commercial relationships, regional or district rivalries, or narrow political interests, Campbell says.
“It does not need more noise from vested interests.”
Health tech is just one, good example of suppliers capturing the public health system, pushing the products they want to sell rather than those the New Zealand public needs to improve their wellbeing.
“We have to be resolute in stripping out unnecessary levels of governance, advice and management not so much because of the direct costs involved but because they obscure and slow and deflect effective decisions.
“We have to greatly simplify and clarify the vast number of contracts and arrangements which clutter the system.”
Campbell says the health system doesn’t need a nudge, it needs a good hard shove. That will be characterised by enabling and where necessary force-feeding equity; eliminating duplication, waste, and bureaucracy; and encouraging ideas and new practices that emerge.
“Some of this approach will be a shock internally and externally…. We intend to review pretty much everything under the new lens, and do so with rigour.”
