Leading part of the health sector, rather than just
critiquing it, is a new-year challenge for Dunedin health
academic Prof Robin Gauld.
The University of Otago health system authority is the
independent chairman of a recently established body tasked
with effecting what he calls the most significant policy
shift in health in recent years.
The southern healthcare alliance leadership team would try to
unite the Southern District Health Board and GPs.
Its work included finding ways for hospital-based doctors to
help doctors and patients in rural areas, and for clinicians
to contact specialists with quick questions, to reduce
specialist appointments in less complex cases.
Prof Gauld, who has written extensively about the New Zealand
health system, said he had ”been around for a long time”
and wanted to get involved in what he saw as good practical
policy to which he could apply knowledge gained from
It was part of a national shift towards integrating two
distinct parts of the health system.
The separation of health boards and GPs had proved
”problematic” because it created separate streams for
funding. He acknowledged there was a ”potential tension”
between his roles as academic and as health authority
”It’s a tension which I think I’ll have to be careful in
terms of how I manage it. Because the last thing I would want
is to be told off for criticising something that I’m a part
The alliances were further evidence New Zealand was moving
away from the competitive health model that held sway in the
1990s. While there were still elements of competition, such
as health board league tables, it was now at a sensible
”Our dabble with the market was short and sharp. It’s had
profound ramifications … it’s sort of like abused children
– it’s taken a long time for people to recover.”
The group is developing a detailed plan to be released to the
public and the health sector in due course.
He said the Canterbury District Health Board had shown how
the system could be transformed in terms of integrating
hospital and community care, an achievement praised in a 2013
report by the prestigious King’s Fund, in Britain.
Compared with other boards, Canterbury had low rates of acute
medical admissions and re-admission rates, a high-functioning
emergency department and relatively short hospital stays,
allowing it to do more elective surgery, the report said.