June 14, 2025 • 9 mins
The Government is legislating health targets to 'lock in accountability'.
It's part of a slue of changes to the health system, with the aim of refocusing on outcomes rather than bureaucracy.
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Speaker 1 (00:05):
You're listening to the Weekend Collective podcast from News Talks.
Speaker 2 (00:09):
I'd be the government is legislating health targets to lock
in accountability, to use quotes around those three words. It's
part of the slew of changes to the health system
with the aim of refocusing on outcomes rather than bureaucracy.
The Health Minister hopes it will ensure all patients have
access to timely, quality healthcare. Professor Warwick bag is the
(00:30):
dean at the University of Auckland's Faculty of Medical and
Health Sciences and works with me.
Speaker 3 (00:36):
Now, good afternoon, Oh, good afternoon, sim How are you good?
Speaker 4 (00:39):
Thanks?
Speaker 2 (00:40):
In practical terms, I saw the headline for Simon Brown's
press release talked about putting patients at the center. That
sounds like sort of medicine one oh one, isn't it?
Or is there more to this than a sort of slogan.
Speaker 3 (00:56):
It is medicine one on me. You're absolutely right, and
putting patients at the center of healthcare is what every
healthcare professional and person in New Zealand one right now.
So I think that that is healthcare one on one,
and I think what the Minister's trying to do is
to ensure that there's not a whole lot of bureaucracy
that's blocking that from happening. So I think that what
(01:20):
he's trying to do is to make it more efficient
to address need and those are admirable and good things
to do.
Speaker 2 (01:28):
I guess obviously when we talk about focusing on patients,
that's every medical professional. But the system, I guess he's
focusing on has the system or had it? Has it
lost its way?
Speaker 3 (01:41):
I think the first thing to say, Tim is if
today you were unfortunate enough to end up with a
heart attack and you present it to a hospital for
the vast majority of people in New Zealand, you would
get outstanding care today. Right now, if you were in
a nasty car crash, for the vast majority of people
in New Zealand, you'd get outstanding care today. But has
(02:02):
the system lost its way? There are problems in the system.
We could do better, and I think that that's what
the minister is trying to address. So you know, for example,
the targets, sorry, is.
Speaker 2 (02:15):
It a signal? Sorry you ker, I'm sorry you're the
targets for example?
Speaker 3 (02:19):
Yes, So the targets, for example, I think you know
that is part of the answer, But we just need
to be clear that not everything that's healthcare is easy
to count, and so sometimes with targets, you count lots
of things that are important, but you're not counting the
whole system. So that's one of the tricks in all
of this is to ensure that we have a whole
(02:40):
system approach.
Speaker 2 (02:42):
When you heard of the announcement, was it is it
a signal of things moving in a direction that you
would approve of?
Speaker 3 (02:49):
Well, I think we need to see the implementation. We
don't have a lot of the details. But one of
the things that's fantastic is around the infrastructure. You know,
we have seen the challenges around infrastructure across the country,
and to prioritize infrastructure is very very important. So I
think that's definitely getting in the right direction. I think
(03:10):
ensuring that the adequate frontline staff is important. That we
should also remember that those front line staff needs folks
behind them to ensure that the system is operating well.
So it is a minister who is trying to improve
a system that in many respects is already delivering very
high qualities.
Speaker 2 (03:30):
I guess prioritizing infrastructure it sounds it's easy to say
and sees to also talk about prioritizing putting patients first.
But in reality, what actually needs to change. For instance,
we know the delays with the need and hospital and
the budget blowouts and all sorts of things. What could
have been, what could have prevented something like that?
Speaker 3 (03:49):
Well, I think that we need to have careful governance
and oversight and careful fiscal oversight over all of these aspects.
And I think that's what the Minister's trying to achieve
in some of what he's announcing. I think what we
need to have buy hard as an agreement on these
big infrastructure spends. If we don't have that by part
(04:10):
as an agreement, then we go on this merry go
round of the three year electoral cycle, and that's not
helpful to getting the big projects done.
Speaker 2 (04:17):
Of course, it's early days. What sort of cooperation you're
expecting from the opposition, I know that gets a little
bit political from your point of view, But would you
hope that these changes are obvious enough that they would
support them?
Speaker 3 (04:29):
Well, I think you know some of these, Like if
we're talking about infrastructure, everyone agrees that we need adequate
infrastructure in both primary and secondary care, So not just
in hospitals, but also in our primary care sector. And
I would have thought that getting behind primary care, which
the Minister is really prioritizing, would be something that the
major parties could certainly both support. You know, if we
(04:50):
have a healthy population, then we will have a prosperous nation.
It's one of the core foundations to having a prosperous nation.
I guess one of the other things that you mentioned
earlier on is about in your comments about alcohol that
you're talking about later, this is the importance of prevention.
(05:12):
So we shouldn't only think about just at the bottom
of the cliff. We should think about what we're investing
to prevent many of the conditions that we're treating occurring.
Speaker 2 (05:22):
So what would you like to see next in terms
of how the government rolls out the changes they want
to implement in pursuing this refocus.
Speaker 3 (05:32):
Well, I think we need to have good engagement around
what those targets are to ensure we don't have perverse outcomes,
because one of the risks with targets is you only
measure the things that are easy to count and not
the much more complex aspects of healthcare delivery. So that's
the key clinical engagement is really important. We need to
agree what is the unmet health need, which we don't
(05:55):
have agreement across the country on that, and that would
be something that I would have thought was right for
a bipartisan agreement. And I think that we need to
ensure that we are focusing not only on the bottom
of the cliff treatment but also on prevention, which is
so very important.
Speaker 2 (06:13):
Looking at the just the overall the announcement, would you
say that it is a sign of the government heading
in the.
Speaker 4 (06:19):
Right direction with its approach to our health challenges.
Speaker 3 (06:24):
What I say the government doing is being really focused
on improving our system, and I think that we have
to see what the implementation will look like. That is
where the challenge is. I haven't heard any Minister of
Health over a long period of time who is not
interested in improving the system where it comes and stuck
is in the implementation. And so this is where we
(06:45):
need to have everyone on board, working together, agreeing about
what are the priorities for the system and then implementing
them according to those agreements. That's what we need.
Speaker 2 (06:58):
To so really, I mean, it gets back to my
first question. It says putting patients first, it's all great
to have this talk and to talk about refocusing, but
really this is really just the first step on a
very long in a very long ladder, isn't it.
Speaker 3 (07:13):
It is the first step in a long ladder. But
we are building on a system that already is a
you know, it's got its problems to them, but it
is a high functioning system. And as I said earlier,
if you are very sick today and you need help,
for the vast majority of people, that help will be provided.
We just need to be really clear to him that
we are not wasting money. So you know, I see
(07:36):
the Minister's keen to train more people. We welcome that.
We be open to doing that, but then we need
to be thinking about where we invest in their training.
So for example, let's invest in our existing institutions. Let's
not waste money on new institutions. We have no track
record in training.
Speaker 2 (07:54):
Oh so that would be is that basically, let's give
more money to a Tigo in Auckland and forget about
new medical schools.
Speaker 4 (08:01):
So I'm not sure if I'm just something there.
Speaker 3 (08:03):
I mean, that may be one example. Well, I mean
I think you know, if we're talking about medical schools,
we've said to the government as a tiger, we'll train
the students you want us to train. We already have
one hundred and seventy training and cut out this right now,
so we don't see the sense in doing something else. Yeah,
(08:24):
for example, but I think there's a whole range of
initiatives of being efficient with our dollars, whether it's in
healthcare treatment or whether it's in training. Let's make sure
that we have enough momentum to do it really well
and not simply try and reinvent the wheels and we
don't have enough money to do then.
Speaker 4 (08:41):
Yeah.
Speaker 2 (08:41):
Actually, justin that was my last question for you. Really,
how are things going at the Auckland Faculty of Medical
and Health Sciences in terms of budgets and have you
got what you need to be turning out the professionals
that we rely on.
Speaker 3 (08:54):
We have what we need to. We are we have
very strong growth in enrolments across all of our health professions.
And what we're really focusing on is trying to make
sure that we are having our health profession has operate
at the top of scope. So what that means is
that we're making our pharmacuts and our nurses or we're
enabling them to operate at the top of their scope.
You know, we saw this in the pandemic where pharmacuts
(09:15):
were able to just spend vaccinate for the first time.
That's the sort of thing that we're really focusing on,
so that we're operating across the whole system, not just
focusing on doctors for example.
Speaker 2 (09:25):
Yeah, well Warwick, I really appreciate your time this afternoon.
Thanks very much.
Speaker 3 (09:29):
Thank you.
Speaker 4 (09:30):
That's Professor Rot Warwick back.
Speaker 2 (09:31):
He's he's a dean of the Universe of Auckland Faculty
of Medical and Health Sciences.
Speaker 1 (09:38):
For more from the Weekend Collective, listen live to News
Talk z'd be weekends from three pm, or follow the
podcast on iHeartRadio.
You're listening to the Weekend Collective podcast from News Talks.
Speaker 2 (00:09):
I'd be the government is legislating health targets to lock
in accountability, to use quotes around those three words. It's
part of the slew of changes to the health system
with the aim of refocusing on outcomes rather than bureaucracy.
The Health Minister hopes it will ensure all patients have
access to timely, quality healthcare. Professor Warwick bag is the
(00:30):
dean at the University of Auckland's Faculty of Medical and
Health Sciences and works with me.
Speaker 3 (00:36):
Now, good afternoon, Oh, good afternoon, sim How are you good?
Speaker 4 (00:39):
Thanks?
Speaker 2 (00:40):
In practical terms, I saw the headline for Simon Brown's
press release talked about putting patients at the center. That
sounds like sort of medicine one oh one, isn't it?
Or is there more to this than a sort of slogan.
Speaker 3 (00:56):
It is medicine one on me. You're absolutely right, and
putting patients at the center of healthcare is what every
healthcare professional and person in New Zealand one right now.
So I think that that is healthcare one on one,
and I think what the Minister's trying to do is
to ensure that there's not a whole lot of bureaucracy
that's blocking that from happening. So I think that what
(01:20):
he's trying to do is to make it more efficient
to address need and those are admirable and good things
to do.
Speaker 2 (01:28):
I guess obviously when we talk about focusing on patients,
that's every medical professional. But the system, I guess he's
focusing on has the system or had it? Has it
lost its way?
Speaker 3 (01:41):
I think the first thing to say, Tim is if
today you were unfortunate enough to end up with a
heart attack and you present it to a hospital for
the vast majority of people in New Zealand, you would
get outstanding care today. Right now, if you were in
a nasty car crash, for the vast majority of people
in New Zealand, you'd get outstanding care today. But has
(02:02):
the system lost its way? There are problems in the system.
We could do better, and I think that that's what
the minister is trying to address. So you know, for example,
the targets, sorry, is.
Speaker 2 (02:15):
It a signal? Sorry you ker, I'm sorry you're the
targets for example?
Speaker 3 (02:19):
Yes, So the targets, for example, I think you know
that is part of the answer, But we just need
to be clear that not everything that's healthcare is easy
to count, and so sometimes with targets, you count lots
of things that are important, but you're not counting the
whole system. So that's one of the tricks in all
of this is to ensure that we have a whole
(02:40):
system approach.
Speaker 2 (02:42):
When you heard of the announcement, was it is it
a signal of things moving in a direction that you
would approve of?
Speaker 3 (02:49):
Well, I think we need to see the implementation. We
don't have a lot of the details. But one of
the things that's fantastic is around the infrastructure. You know,
we have seen the challenges around infrastructure across the country,
and to prioritize infrastructure is very very important. So I
think that's definitely getting in the right direction. I think
(03:10):
ensuring that the adequate frontline staff is important. That we
should also remember that those front line staff needs folks
behind them to ensure that the system is operating well.
So it is a minister who is trying to improve
a system that in many respects is already delivering very
high qualities.
Speaker 2 (03:30):
I guess prioritizing infrastructure it sounds it's easy to say
and sees to also talk about prioritizing putting patients first.
But in reality, what actually needs to change. For instance,
we know the delays with the need and hospital and
the budget blowouts and all sorts of things. What could
have been, what could have prevented something like that?
Speaker 3 (03:49):
Well, I think that we need to have careful governance
and oversight and careful fiscal oversight over all of these aspects.
And I think that's what the Minister's trying to achieve
in some of what he's announcing. I think what we
need to have buy hard as an agreement on these
big infrastructure spends. If we don't have that by part
(04:10):
as an agreement, then we go on this merry go
round of the three year electoral cycle, and that's not
helpful to getting the big projects done.
Speaker 2 (04:17):
Of course, it's early days. What sort of cooperation you're
expecting from the opposition, I know that gets a little
bit political from your point of view, But would you
hope that these changes are obvious enough that they would
support them?
Speaker 3 (04:29):
Well, I think you know some of these, Like if
we're talking about infrastructure, everyone agrees that we need adequate
infrastructure in both primary and secondary care, So not just
in hospitals, but also in our primary care sector. And
I would have thought that getting behind primary care, which
the Minister is really prioritizing, would be something that the
major parties could certainly both support. You know, if we
(04:50):
have a healthy population, then we will have a prosperous nation.
It's one of the core foundations to having a prosperous nation.
I guess one of the other things that you mentioned
earlier on is about in your comments about alcohol that
you're talking about later, this is the importance of prevention.
(05:12):
So we shouldn't only think about just at the bottom
of the cliff. We should think about what we're investing
to prevent many of the conditions that we're treating occurring.
Speaker 2 (05:22):
So what would you like to see next in terms
of how the government rolls out the changes they want
to implement in pursuing this refocus.
Speaker 3 (05:32):
Well, I think we need to have good engagement around
what those targets are to ensure we don't have perverse outcomes,
because one of the risks with targets is you only
measure the things that are easy to count and not
the much more complex aspects of healthcare delivery. So that's
the key clinical engagement is really important. We need to
agree what is the unmet health need, which we don't
(05:55):
have agreement across the country on that, and that would
be something that I would have thought was right for
a bipartisan agreement. And I think that we need to
ensure that we are focusing not only on the bottom
of the cliff treatment but also on prevention, which is
so very important.
Speaker 2 (06:13):
Looking at the just the overall the announcement, would you
say that it is a sign of the government heading
in the.
Speaker 4 (06:19):
Right direction with its approach to our health challenges.
Speaker 3 (06:24):
What I say the government doing is being really focused
on improving our system, and I think that we have
to see what the implementation will look like. That is
where the challenge is. I haven't heard any Minister of
Health over a long period of time who is not
interested in improving the system where it comes and stuck
is in the implementation. And so this is where we
(06:45):
need to have everyone on board, working together, agreeing about
what are the priorities for the system and then implementing
them according to those agreements. That's what we need.
Speaker 2 (06:58):
To so really, I mean, it gets back to my
first question. It says putting patients first, it's all great
to have this talk and to talk about refocusing, but
really this is really just the first step on a
very long in a very long ladder, isn't it.
Speaker 3 (07:13):
It is the first step in a long ladder. But
we are building on a system that already is a
you know, it's got its problems to them, but it
is a high functioning system. And as I said earlier,
if you are very sick today and you need help,
for the vast majority of people, that help will be provided.
We just need to be really clear to him that
we are not wasting money. So you know, I see
(07:36):
the Minister's keen to train more people. We welcome that.
We be open to doing that, but then we need
to be thinking about where we invest in their training.
So for example, let's invest in our existing institutions. Let's
not waste money on new institutions. We have no track
record in training.
Speaker 2 (07:54):
Oh so that would be is that basically, let's give
more money to a Tigo in Auckland and forget about
new medical schools.
Speaker 4 (08:01):
So I'm not sure if I'm just something there.
Speaker 3 (08:03):
I mean, that may be one example. Well, I mean
I think you know, if we're talking about medical schools,
we've said to the government as a tiger, we'll train
the students you want us to train. We already have
one hundred and seventy training and cut out this right now,
so we don't see the sense in doing something else. Yeah,
(08:24):
for example, but I think there's a whole range of
initiatives of being efficient with our dollars, whether it's in
healthcare treatment or whether it's in training. Let's make sure
that we have enough momentum to do it really well
and not simply try and reinvent the wheels and we
don't have enough money to do then.
Speaker 4 (08:41):
Yeah.
Speaker 2 (08:41):
Actually, justin that was my last question for you. Really,
how are things going at the Auckland Faculty of Medical
and Health Sciences in terms of budgets and have you
got what you need to be turning out the professionals
that we rely on.
Speaker 3 (08:54):
We have what we need to. We are we have
very strong growth in enrolments across all of our health professions.
And what we're really focusing on is trying to make
sure that we are having our health profession has operate
at the top of scope. So what that means is
that we're making our pharmacuts and our nurses or we're
enabling them to operate at the top of their scope.
You know, we saw this in the pandemic where pharmacuts
(09:15):
were able to just spend vaccinate for the first time.
That's the sort of thing that we're really focusing on,
so that we're operating across the whole system, not just
focusing on doctors for example.
Speaker 2 (09:25):
Yeah, well Warwick, I really appreciate your time this afternoon.
Thanks very much.
Speaker 3 (09:29):
Thank you.
Speaker 4 (09:30):
That's Professor Rot Warwick back.
Speaker 2 (09:31):
He's he's a dean of the Universe of Auckland Faculty
of Medical and Health Sciences.
Speaker 1 (09:38):
For more from the Weekend Collective, listen live to News
Talk z'd be weekends from three pm, or follow the
podcast on iHeartRadio.
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