A complete review of the health system is being welcomed by nurse leaders as “timely” and with the hope that the reviewers will be “courageous and visionary”.
Health Minister David Clark this week announced that the over-arching review of the health system – which encompasses Labour’s election promise of a review of primary health care funding – that is to look at how the country structures, resources and delivers the $18.2 billion national health system for ‘decades to come’.
Memo Musa, chief executive of the New Zealand Nurses Organisation said the review was “timely and welcome” because “clearly” health system underfunding was putting pressure on health services and failing to meet the needs of many people.
Professor Jenny Carryer, executive director of the College of Nurses was delighted by the announcement and said that the inclusion of the primary care funding review in a wider system review was “commendable and sensible”.
“I sincerely hope that appropriate people will be chosen for the review panel and that they are courageous and visionary.”
Musa said it was prudent with an increasing and aging population – and greater health inequalities – to reassess how, where and when health resources were distributed in order to understand possibilities for change to further improve access, reduce inequalities and improve outcomes.
He said the current health funding system and distribution of health resources was impeding moves to improve access to health care in some situations.
“Nurses have for many years observed that in some cases the way funding is applied, for example in primary healthcare, is a barrier to provision of nurse-led services targeted to increasing access to people with long term conditions and vulnerable populations.”
“Nursing being part of the review will be crucial as nurses bring real and powerful knowledge. With nurses involved the review will have greater potential to come up with much needed solutions to what is currently not working.” he said.
NZNO Kaiwhakahaere Kerri Nuku said she wanted a strong voice for Māori in the expert review panel.
“As social justice advocates, and as a bicultural organisation, NZNO would like to see the public health review including Māori nursing representatives,” she said.
“For the review to effectively address equitable access to health care for all New Zealanders and particularly the current, systemic and institutional barriers to health care a strong contribution from Māori is essential.
“A review outcome that delivers improved access to affordable health care services for Māori and those who are vulnerable is crucial in order for these groups to participate in work, community and family life fully,” Kerri Nuku said.
The Review terms of reference (ToR) says the increasing pressures on the health system – particularly from the ageing population and growing prevalence of chronic diseases – needed to be addressed by a “greater focus towards primary and community-based care while also maintaining our world-class tertiary care services”. As at present the country was “seeing demand, and resources directed to secondary services grow faster than primary services,” said the ToR.
During his announcement Clark said the Review had to face up to the fact that the health system did not deliver “equally well for all” – particularly Māori and Pacific peoples – and also to “get real” about the impact of the growing and ageing population and the increase in chronic diseases like diabetes.
The review is to present an interim report to Government by July 2019 and a final report by January 2020.