Two southern health oversight groups are confident they will have a role to play in the reformed health system. Health reporter Mike Houlahan reports.
Health Minister Andrew Little has been adamant the Government’s recent health reforms will strengthen the local voice in the provision of healthcare.
Southern health oversight groups are taking him at his word.
Neurologist David Gow, chairman of the Clinical Council — a group of medical professionals across a range of workplaces and disciplines — has great hopes for the reforms, and the role his organisation could play.
"I think the structures set up in the equity space will help the whole of New Zealand, but I guess what we don’t know is how Health NZ is going to figure within organisations in the governance space.
"I’m sure that there will be a central view on that and that we will hear it in due time, but for now we are committed to keeping the Clinical Council in its current form until something else comes along that we could consider to be an improvement."
Until recent years the Clinical Council was seldom seen or heard from, but after the former Southern District Health Board returned to being under the control of elected members rather than Government-appointed commissioners, Clinical Council reports became a regular feature of board meetings.
The council was set up to give clinicians a voice to executive leadership about concerns held by staff, and it has been proactive on issues such equality of access to health services and safety in hospital wards.
"As well as wanting to reduce hospital-related harms and improve patient safety, what we also want to do is improve individual practitioners’ understanding of their own care," Dr Gow said.
"If people understand their care, and if there has been an increase in, say, falls, it allows that focus to change."
Primary care is represented on the council by WellSouth medical director Carol Atmore, and rural practitioners and iwi also have a role.
"Having that broad base with that cross-system approach, you have that wide lens," Dr Gow said.
"If something is happening on, say, ward 4C, it’s really interesting to see sometimes how the angle that someone might bring from a different health sector can really inform how you may have been looking at something through quite a narrow focus, whereas if you broadened it out you might discover that the problem lies with how patients are exiting the ward rather than how they are entering it."
Measures championed by the council and then introduced by the SDHB included regular quality and safety checks to monitor efforts to prevent falls, infections and pressure injuries.
"I feel we have a structure in place now where we can identify the risks, identify the complications and then look for solutions," Dr Gow said.
"As an organisation we are committed to the Clinical Council because we have seen the benefits."
The future of community health councils, like many aspects of the reforms, was uncertain, but a hui
in Wellington a fortnight ago made
it clear to her and all other councils they had a role to play in the new system, Ms Browne said.
"It was very clear to us that the consumer voice is going to be greatly enhanced and it going to carry a great deal more strength, so I am expecting that our role will be expanded and that there will be a great deal more consumer involvement going forward.
"But, of course, we don’t know all the details just at the moment."
The Clinical Health Council (CHC) brings together ordinary citizens from across the region to offer a patient perspective on health care, and many of its members have lived experience as regular users of health services.
The CHC, like the Clinical Council, was embraced by the SDHB in recent years, and its members or associates sit on between 20 and 30 committees, including that planning for the new Dunedin Hospital.
"One of the things that we have stressed categorically is that it would be very detrimental if they [the Government] allowed all of the gains that we have made in our respective council areas to be lost," Ms Browne said.
"We have got reach into areas that the mainstream might not necessarily have, and it would take years to regain that. We have had assurance from them that that is not their intention and that they certainly do not want that to happen."
The reforms envisage that local health services and needs will be assessed through localities, and draft documents suggest that the single SDHB could be replaced by as many as a dozen localities.
Given its regional focus, the CHC was well placed to play a role in how localities would work, Ms Browne said.
"The new system envisages many small consumer groups being active in their communities, so I think there will be more consumer voices heard.
"Once people see localities being developed in their areas, I’m sure that they will get on board with that as well."
