Dr David Gow is, arguably, the best prepared new chief medical officer (CMO) that the southern health system has ever had.
He was, until recently, the chairman of the clinical council, the committee which represents the concerns of doctors, nurses and other health professionals to management.
A driven and articulate advocate for improvements in both patient and staff safety, he now gets to walk the talk as the executive in charge of implementing the types of reforms he has advocated for.
"I will still sit on the council but it’s not the same as having that ability to step to one side of a process, because you are totally involved in it."
Under Dr Gow’s leadership the council has advocated for a range of patient safety initiatives, many of which have now become part of clinician’s daily routines.
From being a seldom seen organisation five years ago, the council became a body that the Southern District Health Board (Southern DHB) regularly consulted, and which gave regular updates from the "shop floor".
"I do have a passion for improving patient safety, equity and staff wellbeing, and I am happy to be judged in that space."
English-born Dr Gow does not intend to give up his day job, despite his new responsibilities as CMO.
His contract has 80% of his hours dedicated to CMO duties, and for 20% of his time he will revert to being Dr Gow.
"I will continue to do a neurology clinic once a week, and will continue to support the service by doing some day time on call and weekend on call," Dr Gow said.
"I’ve not had a long aspiration for medical leadership. It’s grown out of my clinical footprint and then through the clinical council, but by practising you remain in touch with your patients, which is super important for me as an individual.
"But you are also using all the systems that other people are using wherever they are in the health system, so you have an understanding of how well they are working and what issues there might be."
It has been eight months since the departure of the previous CMO, Nigel Millar, and a lot has happened.
Both men’s former employer, the Southern DHB, is no more, having been replaced by Te Whatu Ora Health New Zealand Southern (HNZS) as part of the Government’s sweeping reforms in the sector.
That revamping of the way health is administered and funded means some uncertainty clouds Dr Gow’s new position which, as it stands, includes oversight of clinicians throughout Otago and Southland.
However, that may change once the new health localities, which the government intends to provide local input on regional and provincial healthcare provision, are finally established.
Despite not knowing who he might report to in future and how that may, or may not, affect the scope of his duties, Dr Gow was enthusiastic about the possibilities that being CMO could offer.
"That need for collaboration has always been there in terms of good practice, but I think that now there is a necessity for us to make the best of being under the auspices of Te Whatu Ora rather than the Southern DHB structure.
"It is really exciting to consider where we might be in five years time, with better developed clinical networks across the South Island, better developed inter-regional flow, better developed locality networks and a focus on wellbeing and equity."
One intention of the health reforms, that of primary, secondary and tertiary health care working more closely together, is a change that Dr Gow needs no convincing of, describing it as incredibly important.
As head of the clinical council, he asked his WellSouth counterpart, Carol Atmore, to join.
As CMO, he is now a member of the primary health organisation’s clinical governance group.
"The key is to try to focus on the long-term goal of improving outcomes for our patients and their whanau, and particularly improving patient safety," Dr Gow said.
"Looking through that quality improvement lens to give you that view of where you want to be going forward as an organisation, you can make sure that those structures are in place, together with good relationships, so that when events do happen you can respond to them in a team manner and not lose that course that you have set."
While the CMO position is an internal management role, Dr Gow will also become one of the most visible executives at HNZS.
The CMO is the manager who often has to front when things go wrong, such as when a patient suffers harm or the wards become so blocked that people are waiting for hours for a hospital bed.
"It is absolutely right to be open and transparent and apologise and stand behind what has happened," Dr Gow said.
"Equally, it is also important that we work collaboratively to improve and to learn the lessons so that those things don’t happen repeatedly.
"As a system, we have been facing some issues that no health system in the world was designed to cope with, but openness and empathy are the keys."
