Hamish Rutherford from NZME talks to Dr Janice Wilson, Chief Executive of the Health Quality & Safety Commission – 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 healthcare system.”

Hamish: How variable are the outcomes for people with health challenges in New Zealand?

Well the first thing to say is that the vast majority of people really get good health outcomes for their health challenges or their illnesses. But we do see that there are geographic variants. We do a thing called an ‘atlas of healthcare variation’ and we see that sometimes there’s geographic variation. There’s often variation around ethnicity, so there’s particular poorer outcomes for Maori and often for lower socio economic people – and people talk about a kind of post code lottery so sometimes it does depend on where you live as to how easy the access is to healthcare services as you can imagine in some rural areas it’s harder to access. But also we find that people’s journey through the system there’s sometimes is variation in how they’re treated, depending on where they live, or often their ethnicity or sometimes their age or gender and therefore you get a variation in outcome. And the most striking thing that we find is that Maori in particular have much, much poorer health outcomes than the rest of us.

Hamish: What can we do to improve that?

Well there’re probably a number of things that we can do. First, is letting people know that so that our practitioners and health boards can start to look at their population. Young people quite often don’t go to primary care because they can’t afford it – so there needs to be some thinking, nationally about how to address that financial barrier. But there are issues too about biases that practitioners have, that are implicit and perhaps not recognised and people tend to be treated differently. We know that Maori and some other groups perhaps get less medication than if you are non-Maori, and maybe don’t get seen quite so soon or quite so smoothly through the system so that there is that implicit bias or institutional racism I think what people are talking about now that needs to be addressed. The medical council are putting out some new guidelines soon to help medical practitioners help think about their impact and their culture and how to address those kinds of issues.

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