I love it when the planets line up on things. Over the past few months we’ve all been getting more excited about, and busy with, the government’s Ultra Fast Broadband (UFB) initiative. And whilst the MED has made explicit reference to “health services” (along with schools and businesses) as priority broadband users, there has been little talk in telecommunications industry circles about a watershed report released in August last year.
‘Meeting the Challenge’, as the report was aptly titled, was commissioned by Health Minister Tony Ryall only three months after the Nats swept to power. The Ministerial Review Group, formed under the chairmanship of Treasury pragmatist Murray Horn, was to take a critical look at opportunities to more sustainably deliver better health outcomes to New Zealanders. It made some 170 recommendations on how to reduce bureaucracy, improve front-line health services, and improve value in the public health and disability sector.
I’ve written and spoken publicly before about the need to be smart about how we do things in this country, and on the public management system – essentially the framework within which our public sector is organised and managed – and its tendency to encourage inefficient silo’d behaviour. The Health sector has been a classic case in point: twenty-two DHBs with separate reporting lines to the Minister and a policy engine (MoH) seemingly with little real ability to influence the behaviour of the sector at large.
One of the headline structural recommendations of the report was “Creating a new Crown Entity to provide shared services to DHBs and reduce the cost of common ‘back office’ functions so that more resources can be shifted to the front-line.”
One of the “shared services” that international precedent would indicate should be high on the pick-list would be telecommunications. Indeed, as a sector the opportunities inherent in a ubiquitous connectedness fabric are enormous – and I’m not talking about the nickel-and-dime, procurement-related savings that would inevitably be a happy by-product of shared networks.
Many TR readers would be familiar with the ‘Connected Health’ programme that has been underway for some time now within the Ministry. A key focus of that programme is its “focus on enabling connectivity to New Zealand’s 12,500 health service providers and empowering the thousands of health workers employed in the Sector by improving the capability to collaborate and share information”.
Hard outcomes of that programme have been difficult to discern as yet and whilst I’m sure I’ll cop some flak from the current stable of providers of networking services to health sector organisations, my sense is that the fragmentation of that supply market is one of the key factors that has thus far stymied attempts to really get to grips with a ‘connected health sector’. That and, of course, the simple fact of the inadequate infrastructure.
With the UFB initiative set to change the face of telecommunications network provision, and the quality and reach of infrastructure in this country, the opportunity exists to start deliberately focusing with confidence on the significant preparatory work that will need to be done to ready the sector, not just the big hospitals, to begin to use the new connectivity capability and speeds as it comes on-stream. And investors in the new infrastructure should take heart and get on the front foot working with sector agencies.
Also, the formation of the National Health Board (NHB) to deliver ‘national’ services (removing them from the silo’d world of MoH and the DHBs) means one of the other major inhibitors to progress towards a more efficient system delivering better patient outcomes looks set to be addressed. Sensibly the MRG’s report also recommends that a common, safe, transferable patient record be implemented within a reasonable time period.
So we have a nice set of planets aligning. It behoves us to take full advantage of the opportunity to make a substantive change that will positively impact on all New Zealanders.