New Zealand’s health system reform: will it work?

A single truly national public health service

– Hon Andrew Little, Minister of Health

Hon Andrew Little has announced the widest sweeping changes I’ve ever seen proposed in our health system. This is a bold move with the intention of streamlining the national health service to provide better care for New Zealanders.

In theory, a centralised organisation, Health New Zealand, to run hospitals and primary/community care is a good idea. It seems logical that everyone can benefit from the best ideas and superior buying power.

In addition, changing the way we prioritise Māori health and workforce wellbeing are also incredibly worthwhile ideals.

However, the goal of having this live by July 2022 might be too ambitious. A change of this magnitude would be hard in any organisation, and the national health service isn’t just any organisation.

The public service moves slowly. Systemic change in the medical industry moves slowly. This is as slow as it gets.

75% of change initiatives fail due to a failure to engage the front line staff. In my 18 years in the health industry I have never seen a large change initiative where the front-line was adequately engaged; hence most fail to live up to their goals. If we want this to be a success then this is where we must start.

Personally, I don’t believe enough time has been allowed to do this engagement effectively. This goal of this change is worthy of giving this the time it needs. It feels like it’s being rushed through, perhaps as a governmental show of strength that ‘we can do this.’

I’d like to see this change work. However, my experience with large-scale industry change is that most fails. Failure is a terrible option because it is the people of New Zealand, and the medical staff, who will pay the price.

I think it’s time to pump the brakes and engage the stakeholders.