Debt-plagued DHB's advice to UK 'ironic'

12:34 pm on 3 October 2017

Analysis - News about Canterbury's health system has been dominated recently by its $52 million deficit, and government pressure to cut it by $17m.

Christchurch hospital

Christchurch Hospital. Canterbury DHB has worked hard to keep its damaged hospitals from being overwhelmed in the aftermath of the 2010 and 2011 earthquakes. Photo: RNZ / Karen Brown

That's led the DHB, which has a difficult relationship with the Health Ministry, to complain it would mean cuts of unprecedented scale.

But, in a development with fewer headlines, since the quakes of 2010 and 2011, Canterbury District Health Board has also transformed health services in Canterbury, increasing the focus on primary care to both provide faster care closer to people's homes and help protect damaged hospitals from being overwhelmed.

That's also a pressing issue for the UK's National Health Service, or NHS, with rising deficits and other headaches. It led the new inspector of English hospitals, Ted Baker, to remark this week that half of beds are being taken up by people who don't need to be there.

He added the NHS is stuck in the past and missed a chance to modernise and invest in community services under the last Labour government.

Canterbury's efforts have caught the attention of the King's Fund, an independent charity working to improve health and care in England.

So today, leaders of the debt-plagued Canterbury healthcare system are in London, flown there by the King's Fund, to tell British health experts how to improve stretched services.

Canterbury District Health Board CEO David Meates

Canterbury District Health Board CEO David Meates Photo: Supplied

In a report in August, the King's Fund said one of the biggest challenges for the NHS is "how to slow increasing demand for acute hospital care".

New Zealand had done it gradually, with changes that began before the quakes, it said.

"As a result of the transformations, the health system is supporting more people in their homes and communities and has moderated demand for hospital care, particularly among older people.

"Compared with the rest of New Zealand, Canterbury has lower acute medical admission rates; lower acute readmission rates; shorter average length of stay, lower emergency department attendance; higher spending on community-based services; and lower spending on emergency hospital care."

Canterbury DHB chief executive David Meates told RNZ his region had been striving to achieve "one health system and one budget" for a decade.

"The Canterbury health system, if it had not been on the journey towards integration before the earthquakes of 2010 and 2011, the health system here would have imploded and ground to a standstill."

Stardom abroad versus scrutiny at home wasn't lost on him.

Vince Barry

Vince Barry Photo: Supplied

"It is somewhat ironic that health systems both in the UK, Australia and other areas are continuing to look at ... the Canterbury health system."

But the population-based funding formula used by the government remained a concern, he said.

"It is a good allocative model where you have populations that are slowly increasing or slowly declining over periods of time ... What it was never designed to do was actually to deal with the post-major disaster environment."

The Health Ministry agreed, saying that was why the DHB received $106m in extra funding, including $20m for mental health, and was allowed to spend $38.5m more than it received last year.

The chief executive of community service Pegasus Health, Vince Barry, said the NHS "has become unaffordable in its present structure and system, so they're looking for what ways are there that they can gain efficiencies and make the care to people more affordable".

Canterbury had shown how to "de-silo things, remove organisational structures from impeding discussions and [re-design] the system", he said.

He added that the King's Fund had visited Canterbury in 2013, and recently completed its second report.

"That's why they now appear to be more impressed, because they've come back four years later, they've had information four years later to show that things are sustainable."

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