Health academic welcomes new role

Leading part of the health sector, rather than just critiquing it, is a new-year challenge for Dunedin health academic Prof Robin Gauld.

The University of Otago health system authority is the independent chairman of a recently established body tasked with effecting what he calls the most significant policy shift in health in recent years.

The southern healthcare alliance leadership team would try to unite the Southern District Health Board and GPs.

Its work included finding ways for hospital-based doctors to help doctors and patients in rural areas, and for clinicians to contact specialists with quick questions, to reduce specialist appointments in less complex cases.

Prof Gauld, who has written extensively about the New Zealand health system, said he had ''been around for a long time'' and wanted to get involved in what he saw as good practical policy to which he could apply knowledge gained from research.

It was part of a national shift towards integrating two distinct parts of the health system.

The separation of health boards and GPs had proved ''problematic'' because it created separate streams for funding. He acknowledged there was a ''potential tension'' between his roles as academic and as health authority chairman.

''It's a tension which I think I'll have to be careful in terms of how I manage it. Because the last thing I would want is to be told off for criticising something that I'm a part of.''

The alliances were further evidence New Zealand was moving away from the competitive health model that held sway in the 1990s. While there were still elements of competition, such as health board league tables, it was now at a sensible level.

''Our dabble with the market was short and sharp. It's had profound ramifications ... it's sort of like abused children - it's taken a long time for people to recover.''

The group is developing a detailed plan to be released to the public and the health sector in due course.

He said the Canterbury District Health Board had shown how the system could be transformed in terms of integrating hospital and community care, an achievement praised in a 2013 report by the prestigious King's Fund, in Britain.

Compared with other boards, Canterbury had low rates of acute medical admissions and re-admission rates, a high-functioning emergency department and relatively short hospital stays, allowing it to do more elective surgery, the report said.

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