The health future of the region

Health is the lifeblood of Otago and Southland in many ways. First, residents rely on the ability to access the best healthcare they can in a timely manner, when they need it the most.

However, the ongoing success of the Otago Medical School provides other opportunities for the region because it continues to attract the best and brightest of New Zealand and overseas students to its teaching.

Those students come in contact with some of the most able medical specialists New Zealand can offer.

Both main political parties have pledged to build a new hospital. National and Labour are proposing different methods of funding but a new $1.4billion hospital on a suitable site seems assured.

Southern District Health Board chief executive Chris Fleming last week revealed a new exciting model of healthcare which may be introduced in the region.

The changes will not be a tweak at the margins. They will require bold decisions about reallocating funding within health services.

Debate over a new hospital and the future of the medical school will hopefully spark more of a debate about how health services can be delivered throughout the region, rather than a focus just on the growing deficit recorded by the board.

Health is expensive and there seems no easy answers to the way the sector is funded. Population-based funding does not seem to be working. Waiting lists abound in all parts of the country and there are plenty of reports about how people are struggling and suffering while they wait to be seen by a specialist.

Earlier this year, University of Otago pro vice-chancellor and business school dean Prof Robin Gauld took a no-nonsense approach to the provision of healthcare in Auckland.

Speaking at the university's winter symposium series, Prof Gould said doctors are most needed in South Auckland but the area is the least well served by GPs while the best served area is the central city.

He advocated Auckland doctors learning from those in places like Ranfurly, Wanaka and Te Anau, where their ``big brains'' ensured they can treat patients with complaints usually treated in an Auckland hospital.

The most important part of the South Island health system is collaboration, something not happening in the north, Prof Gould says.

Mr Fleming says the southern board cannot afford to keep doing what it has been doing and the shift in funding and thinking is vital.

The rebuild of the hospital is a perfect time to change the overall delivery of southern healthcare and set up a new model.

The new approach deserves to be welcomed by the region, a region which is calling loudly for a better delivery of health services.

Hospitals are holding on to patients for too long and the capability and performance of the primary and community sector needs to be strengthened.

When health services were moved to a more centralised system in the 1990s, Otago and Southland lost their advantage of having extra money made available because of the distance from base hospitals. The logic given at the time was desperately sick or injured patients were only a helicopter journey away from specialised care. The approach has not been successful.

The new system will be a far less ``siloed`` approach, something which must be welcomed by the region.

The southern board has set itself a tight timetable. It plans to develop an action plan by the end of November and do more consultation in December. The 2018-19 year will be the first year of the plan.

New Zealand is almost sure to have a new health minister by the end of November. He or she must support the board's ambitions for change, rather than attempt to slash or restrict services. The health of the region is at stake.

 

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