Dr Richard Sullivan: Health NZ chief clinical officer on the new reports revealing NZ's heart health system at risk

Health NZ has acknowledged the pile of work needed on heart health.

Research by advocacy group Kia Manawanui Trust shows half of all heart attack patients aren't seen within internationally accepted timeframes.

It also finds New Zealand has a third of the cardiologists it needs. 

Health NZ chief clinical officer, Dr Richard Sullivan, says it's much broader than cardiologists - and the whole sector needs help.

"We need more echo technicians, we 're working hard to do that. We need more cardiac physiologists, we need more nurse practitioners and advanced nurse specialists - we need the workforce."

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Episode Transcript

Speaker 1 (00:00):
Now a new report has found that our heart health
system is on the verge of collapse. According to the
Ministry of Health Data, there are fewer than one hundred
and eighty cardiologists and cardiac staff in the whole country,
and none at all in places like tied Arfitsi Lakes
or Funganui. Heart disease is responsible for twenty percent of
all deaths in this country costs US more than thirteen
billion dollars a year. Doctor Richard Sullivan is Health New

(00:22):
Zealand's chief Clinical officer and with us, Hey, Richard good Head,
do you think we have enough staff dealing with hearts
in this country.

Speaker 2 (00:31):
I'll look firstly to your point out report. I think
some great news in there that what we've seen over
the last twenty years is a significant reduction and death
from heart disease and a sidelist production in our hospitalizations.
We see a lot of work to do, particularly in
the space of our heart skins, so what we call
into cardiograms, and so that is a key challenge for us.

(00:55):
We've got some of our regions that are well staffed
and become a heart cartac space, the Northern region for instance,
Other areas as you've mentioned Tarapati, Taranaki, whereby we do
have challenges in our workforce in those places.

Speaker 1 (01:09):
Yeah. Do you think the lack of cardiac stuff in
those areas that you just named is directly responsible for
the deaths?

Speaker 2 (01:18):
Oh? Look, it's more complicated than that. When you think
about heart disease. It's really the risk factors that can I.

Speaker 1 (01:24):
Just point something out to you. The areas with the
highest heart disease death rates tier Arfity Lakes, fung Luis
and Taranaki have the fewest cardiac stuff. That seems like
that's a causation.

Speaker 2 (01:36):
Isn't it. Yeah, I'm not sure i'd quite draw that bow.
There's no doubt that. I mean, in those populations you
have just described, we see higher rates of diabetes, we
see a higher rates of other I guess those respectives
that lead to heart disease. And so yeah, super important
because it's about that primary care access first, you know,
so people can get seen, we can mitigate those risks.

(01:57):
But the problem is as once you've got heart disease,
then absolutely you know, having the right access to services
is super important to try and minimize and I'm going
harm from once you've got establish art disease. So there's
a there's are trying to reduce and prevent the risk,
and then there's Okay, I've got it and I've got
the right services to make sure that i get the
best care.

Speaker 1 (02:15):
Do we have enough full time cardiologists or any type
of cardiologists in this country?

Speaker 2 (02:21):
Look, as I mentioned, in some spaces we do, and
other me across the.

Speaker 1 (02:25):
Whole country, Richard, do we have enough in the country?
Because the answer is not made how.

Speaker 2 (02:32):
Well I'm worried about I'm not I've not been weird.
I'm not sure it is because it's not about just
about cardiologists. So we have lots of people who deliver
the heart health care. So in an area is like
one going to they don't have any cardiologists, they have position.

Speaker 1 (02:46):
Just treat people with respect, right rather than spinning us.
We have got thirty two point eight full time equivalent
cardiologists per million people, which is less than a third
of the average and European countries. That's not enough.

Speaker 2 (03:00):
I'm not I'm not suggesting that, you know, we always
need more health workforce either. I guess what I'm trying.

Speaker 1 (03:05):
To say that why don't you say no, we don't
have enough. Actually what we need is some more and
we need some more cash to be able to do that,
because that's the actual answer, isn't it.

Speaker 2 (03:14):
Just so I know, I don't agree with you. I
think the answer is far more complicated that we you know,
we need we need more eco technicians. We're working hard
to do that. We need more cutect physiologists, we need
more you know, nurse practitioners, advanced, very specialist. So so
we need the workforce to deliver heart health. But really importantly,
we also need to reduce the risk of heart health,

(03:34):
and you know that's what this report shows. It shows
we're making in roads, but we've got significant variations you
will have seen in the report, which is a real concern.
You know, we still see a Maori specific caving Twoton's
greater risk of harm from heart disease. We see these regions,
these rural spaces you've described, So it's really that focus
and you know we are you know, trying to improve

(03:57):
the opportunity here. So teleacity, as I say, is a
really good example. We've been working really closely with that
region and we're looking at joint appointments because we've really
struggled to recruit cardiologists into straarity. So we're looking at
a joint appointment between White Catto and Tiapity. Well, no,
it's not no one's to live here, it's aout. It's
about that kind of level of care because if you're
cardiologists these days, they get more specialized, so they might

(04:20):
be involved in putting stints all the neighbor doing other things.
So being able to do that as well as work
in that community because we don't put stints in that space,
you know. So it's about that kind of connection. So
you can make those roles and those jobs across regions
and that's one of the real opportunities we think we
have our we've got a national heart network but is

(04:40):
trying to address many of these challenges. So you know,
we've established national guidelines around echo. We've set up this
New Zealand training program because all our ECHO technicians used
to train the Queensland and so they wouldn't come back.
So you know, we're putting a real investment in the
spaces where we see the greatest need. A lot to
your original question, we need more people, but we need
to focus on the area.

Speaker 1 (05:01):
Yes, we do. Now very quickly, what's going on with you?
People charging this much money on parking? Are you comfortable
with that?

Speaker 2 (05:09):
So look, we're we're about the national parking policy and
I think I can say is that the issue raised
that's been paused while we just review what is the
right model coming? I can't answer that either. I'll say soon,
but I can't give you a date.

Speaker 1 (05:27):
Thanks Richard, I appreciate your time. Thanks so much for
coming on. That's Richard Sullivan, who is doctor Richard Sutherland,
Health New Zealand's Chief Clinical Officer. For more from Hither
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