One of the biggest challenges facing the Ardern government is in public health. New Zealand may have escaped the pressures heaped on other health systems by the Covid-19 pandemic but its health service has had its problems, not least those exposed in the first report from Heather Simpson and her team and subsequently in the Simpson-Roche report revealing deficiencies in handling aspects of the response to Covid-19
Both of those reports underlined structural weaknesses within the system, not only in the district health boards, but in the Ministry of Health. To repair them would be a singular challenge for any minister. It is notable the Prime Minister nominated Andrew Little as the one with the know-how to get to grips with those particular headaches.
But even with the skills he has, reforming district health boards will be a severe test for Little. Some of them are under enormous financial stress while others are failing to provide the full range of services in a timely manner. And let’s not forget the government has yet to make significant progress in overcoming the deficiencies it has acknowledged in the country’s mental health services.
Beyond that there are other pressing challenges in health, for example with diabetes.
Meanwhile NZ has to absorb the lessons which overseas health services have taken from the impact of the Covid-19 pandemic. The London “Observer” in an insightful article has pointed to doctors and designers – in the wake of Covid-19 – radically adapting their thinking about what healthcare can be and what it should deliver.
The pandemic has accelerated some trends, such as the one towards “hospitals without walls”—the hospital conceived as a digitally connected community rather than a circumscribed physical space. The twin pillars of digital health are electronic health records which allow patient health information to be shared across health systems, and telehealth which allows patients and physicians to communicate at distance.
While some countries in the wake of the severe acute respiratory syndrome (Sars) adapted their hospitals, equipping them and developing protocols so that they could be transformed quickly in the event of an epidemic, an alternative solution is to rapidly build a facility dedicated to the detection and treatment of epidemic patients where it is needed, as the Chinese did during Sars.
They replicated that feat several times this year, building Wuhan’s Huoshenshan hospital in 10 days, for example. Made out of prefabricated units, Huoshenshan incorporated testing and research labs and accommodation for personnel.
Other countries built fast, too, in response to Covid-19. Surge hospitals went up all over the US, while the UK constructed the Nightingale hospitals. But many of these were underused or not used at all, sometimes because they were understaffed.
One authority argued the lesson is that a systematic approach must be followed. That involves organising on-site stores of medical and protective equipment, maintaining a roster of qualified staff and setting up a command centre to oversee the execution of the disaster plan.
Whether NZ’s health system could do that is a moot point. Fortunately it has not been put to the test .
Adaptability will be the watchword in the post-Covid-19 world and Point of Order has no doubt the medical personnel in NZ’s health service have that adaptability. But what about the bureaucracy – the Ministry of Health or, for that matter, its political bosses?