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Invercargill residents voiced their opinions this week on the Government's planned "shake-up" for NZ's Health and Disability system.
Industry professionals met with concerned residents at the Southland Hospital Education Centre on Monday evening.
The discussion was part of the University of Otago's annual Winter Symposium Series.
New Zealand Doctor editor Barbara Fountain was MC for the event. Panel guests were Prof Peter Crampton, a Government-appointed expert for the review panel, head of the pathology department Prof Sarah Young, and Associate Prof Konrad Richter, a colorectal surgeon and surgical oncologist based at Southland Hospital and associate dean Southland at the Dunedin School of Medicine.
Prof Richter acknowledged a need for "compassion to have a voice" in medical practice.
"The incentive here in New Zealand is difficult. I feel like the incentive is actually saving money at all costs.
The country had an "excellent" health system but access was getting more and more difficult for everyone.
Some of the issues included the lack of access to private health care, delayed diagnoses, wait times for specialist referrals and for surgery, he said.
"We need to have a more robust, honest debate about what we can offer from our health system."
Invercargill resident Tracy Peters, who felt let down by the system with her own treatment, had attended Prof Richter's four previous public discussions.
"There's a real need for those seminars. Both parties get to express themselves and talk about their experiences," she said.
Mrs Peters, who is paraplegic, said she wanted "the facts" from the system.
"It would have always been heartbreaking to hear I can't use my legs any more," she said, but at least she knew how to deal with it.
People needed more advice on how to manage their own care when living with an illness or disability that could have been prevented, she said.
Prof Richter said an absence of engagement between managers and clinicians played a part in inefficient treatment of patients.
"It only works if there's clinical input into counting numbers ... If you look only at key performance indicators you may create diverse incentives."
He said managers needed to divert their resources from meeting targets and work with front-line clinicians who dealt with patients to "get their priorities right".
Prof Richter said the discussion between the panel and the public had been "top-notch" and "rare" in New Zealand.