Hamish Rutherford from NZME talks to Ian Powell, Executive Director of the Association of Salaried Medical Specialists, one of the panellists taking part in HealthCentral ChalkTalks’ panel discussion on the “Future of New Zealand’s Healthcare – how do we achieve a more productive, sustainable and equitable health system.”

Hamish: You said to me [earlier] that what makes good clinical sense makes good financial sense and we need to get specialists in the engine room of decision making. What did you mean by that?

Ian Powell: Specialists have an extraordinary amount of knowledge and expertise in complexity. One thing that characterises our public hospitals is that they are highly complex, they’re 24/7, and they’re driven by acute demand. Inevitably you’ll get duplication and fragmentation in our environment like that. They can make our systems more efficient, more effective, because they know how they it works because they’re natural problem solvers but we do not have the workforce capacity to give them the free time or the time available to be involved in that positive work.

Hamish: One of the themes we have here is getting better productivity. How do we do that in a system that’s already under strain?

Ian Powell: Well productivity’s the wrong word to begin with the real focus is on better outcomes – quality, financial. And to do that you actually need to build your workforce capacity and while I can speak for specialists I think similar points can be made for nurses and other health professionals as well. But if you have enough of them to ensure that first of all they’re not paying for the health system with their own personal health by being overworked and secondly that they can be involved in system’s improvement, they can make the system a lot more sustainable than it is now.

Hamish: Is our workforce ready for the strains of an older and as you say more frail population?

Ian Powell: It’s struggling with that because the workforce itself is, like the rest of the population, is getting older. Increasingly we will be losing people through just natural attrition, through retirement and the rest, at a greater rate than we might be recruiting. So that’s a real problem you get the demand on the system increase. We are getting to the stage that an aging population is not simpler living longer but living longer while frail so our hospitals could end up being saturated by babies and frail old people.

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