Gee, I think we’re starting to make it hard for ourselves.
I’ve spent plenty of time looking at the problems experienced by large organisations. And believe me, there are plenty.
As a result, I’ve always believed that you don’t improve performance or solve problems by making things more complicated. Of course, I’ve seen plenty of things get better because they were made more simple.
One of the areas where simplification helps is when it comes to improving outcomes for the customer. Inevitably, it seems that you can improve the lot of your customer if you enable informed decisions to be made by those who are closest to that customer. In other words, by the people at the coalface.
I’ve spent enough time poking around large organisations to know that the bigger they are, the more bureaucratic they become, and the more the people within those organisations are able to hide. Layers of underqualified people seem to make an art of avoiding the requirement to be responsive to the needs of the market. The loser is always the person those same organisations are intended to serve.
As we all know, government departments excel at this stuff. At times they seem to specialise in making it difficult to get the support that their very establishment had intended. And of course, we see plenty of hard-luck stories from people who have variously been “let down by the system” as a result.
Our health system is one where such headlines are all too common. Whether the topic is underpaid staff, irreparable buildings, long waiting lists or botched surgeries, underperformance has become all too common in an area that is vital to the quality of life we enjoy in this very special part of the world.
It doesn’t matter which political parties are in power either. The same issues occur. The same bureaucratic barriers go up. The same people, in this case the patients, are let down.
There is not much question in my mind that the old 20-strong District Health Board model was due for an overhaul. It seemed to be a one-size-fits-all approach that failed to recognise the differing needs of differing communities. The DHBs also failed to attract sufficiently experienced and talented candidates to run them. They therefore also lacked the electoral enthusiasm to motivate voters to take an interest in how these boards were led.
The end result? Some worked. Some didn’t. And thus, some of those communities have experienced better healthcare than others. The term “postcode lottery” has been used to describe the healthcare haves and have-nots.
So it was time for a change. And I have to say that I applaud Minister Andrew Little for having a go at rejuvenating the healthcare sector with the introduction of a new model.
That said, and although details are still sketchy, my immediate reaction on hearing of the proposed changes was that they have gone completely against my experience of what works best.
The health service doesn’t really get tested when people break an arm or strain a muscle, or for that matter, catch a bad dose of the flu. The reality is that the health system needs to be optimised to perform to its greatest capability, when people are very badly injured or really sick.
I guess I’ve been fortunate. I’ve seen family members and friends alike get really great healthcare under the existing model. A family member with a brain injury. A mate with a serious cancer scare. Wonderful care provided by amazing people doing everything they can despite the shortfalls of the system around them.
I suspect that experience is also a function of the fact that I live in Auckland, where many of the country’s best facilities are based.