I normally can't work up any interest in health service restructure, I'm much more interested in models of care. Spending 25 years in and around the UK NHS taught me that all restructures do is take everyone's focus off the care to a new logo design, competing for same roles with different titles, anxiety as to where you sit (or not) in the new organisational hierarchy and take an awful lot of dosh away from patient care. An awful lot. And nothing really changes for care providers or patients. It's one of the reasons I left it.
So I now find myself in the strange position of advocating for a system restructure. This is because I believe it will be nigh on impossible to 're-orientate the system' to primary and community care rather than hospital care if we don't. If we're serious about addressing the challenges in the health system and actually delivering on national strategy rhetoric, we need to be serious about a system overhaul. One that pulls the right levers and incentives for investment, drives effective multi-agency commissioning, truly integrates health and social care... and one that enables those that directly provide and receive care to just get on and do the right thing.
Martin Hefford (CEO of Tū Ora Compass) and I wrote a personal view on how this could look and sent it to the Ministry and Minister to add to the debate that will result from the pending Health and Disability System Review recommendations. Read it here (spoiler alert: no DHBs or PHOs to be found).
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