If the coalition government saw Commissioner Lester Levy as the Christmas fairy, capable of sprinkling joy and new life into the health system, then the signs are not promising. Hardly a day goes by without a new negative story about the health system, and Prof Levy’s appointment in July has not stopped that.
Any small scraps of glad tidings get lost in the melee.
While there may have been a little progress towards achieving some of the government’s five health targets, many health workers are unhappy with their lot, short-staffing continues in most areas including in primary care, the future of the country’s creaking health infrastructure is still murky, and funding remains an issue.
None of these problems lend themselves to quick-fixes, but some of the decisions being made at Health New Zealand Te Whatu Ora, presumably with the blessing of Commissioner Levy, are downright baffling.
It beggars belief Health NZ appears to be charging ahead with plans to get rid of almost half its digital and data staff when around the country alarm is being raised about this.
It has been no secret our public health sector has huge information technology issues, limping along with a patchwork of about 4000 systems which are not integrated, often outmoded, and with no effective back-up.
In recent days, our reporting has drawn attention to the fragility of Dunedin Hospital’s computer set-up, with a recent outage causing confusion, delays and risking patient care.
The breakdown, which affected the emergency department and other staff’s abilities to look up medical histories, record care given and transfer notes between wards, contributed to patients having to spend more time in the emergency department. But such failures are not an uncommon occurrence at the hospital, and there are fears expected cuts to staff will make matters worse. In a sector which should value the welfare of its staff, we wonder at the logic of putting more pressure on IT staff who may remain after any cuts to staffing, particularly when existing staff are already feeling stretched. The idea that a course about managing stress levels was the solution to staff members’ stress from trying to deal with breaking systems with too few staff was a breathtaking example of how poorly the situation is being grasped by Health NZ.
Further up the island, on the West Coast, an IT worker facing redundancy has predicted slashing staff there from 13 to four will result in patient deaths. The worker drew attention to the nonsense of the government’s artificial distinction between frontline and backroom workers.
"Every nurse touches a keyboard during their day’s work. Every nurse looks at a monitor and looks at patient results. Every doctor, every GP, every surgeon ... it’s impossible to do this without IT; you can’t just do this on paper, it’s not feasible."
Her concerns were echoed in a Health NZ risk register, compiled from staff feedback about the impact of the proposed cuts, leaked to the media earlier this month. The register said doctors and nurses could be forced to leave front-line duties to plug day-to-day gaps or may struggle to master IT upgrades without enough helpdesk support.
It described rural and remote hospital services as disproportionately at greater risk of not having timely resolution to issues compared with metropolitan sites. If the cuts go ahead, there is also concern about the loss of knowledge with limited or, in some cases, no staff having the required deep understanding of systems, how they work and interact.
We hope there is still time for Health NZ to see sense on this and backtrack in the new year. If it boxes on and some of the dire predictions become reality, chief executive Margie Apa, Prof Levy and Dr Reti will need a magic wand to avoid the fallout.
