There has been a great deal of media coverage recently about the Canterbury health system and the constraints it faces. Amid the confusion, it is timely to recognise what the total health system (led by the Canterbury DHB) has actually achieved.
Despite the challenging circumstances post the 2010/2011 earthquakes, our health system has continued to deliver the very best care to our community. There will always be people whose needs haven’t been met, but our health system has always been there for the people of Canterbury. The leadership of our health system has made a personal commitment to ensuring that, whatever happened after the earthquakes, the community could rely on its health system.
Keeping the Canterbury health system on track has necessitated creative solutions to problems never faced by any organisation before. The system needed to keep services running safely from damaged buildings, including delivering surgery during thousands of aftershocks and it needed to find innovative ways to change services in response to the changed needs of broken and fragmented communities. This included a dramatic increase in mental health demand. It also needed to have an eye to the future and planning future services and facilities.
The enormity of these challenges cannot be underestimated. The 18,000 people that work in community and primary care, hospital, mental health and public health services took this opportunity to make the Canterbury health system even better. And they have. In every respect it rates highly amongst its peers as an efficient, effective health system. It is internationally recognised and praised as one of the top five integrated health systems in the world.
Solutions developed in Canterbury are now being adopted around the world. In the UK another journey is starting, to implement the Canterbury way of working. This follows in the footsteps of most of Australia. The NHS England transformation strategy “Five Years Forward” was informed by what they learned from Canterbury. Canterbury clinicians and leaders are sought-after speakers in international forums. Locally, the Canterbury approach has been used as a case study by the Productivity Commission, the States Services Commission and ACC. Internationally, the list is longer and includes the World Bank, the Kings Fund and the World Health Organisation. And last year the Canterbury Clinical Network won the IPANZ Supreme Award for public sector value.
These are high accolades indeed!
But all of this is at risk as yet another challenge is thrown at a system which is already so stretched. The replacement acute hospital is still two years away and our population is increasing rapidly. However, and inexplicably, Canterbury’s share of national funding is declining which is placing extreme financial pressure on the DHB.
With everything Canterbury has had to deal with, and in unique circumstances, I would have thought that the Ministry of Health might have considered the impact of continuing to apply the standard funding formula. They might have questioned a formula that reduces Canterbury’s share of national funding, despite an increasing population. Other experts have noted that post earthquakes, population changes and changes in health need, make the use of a population based funding formula inappropriate. Canterbury is leading the world in understanding the impacts of a major natural disaster, on a first world country and the possibilities of an integrated system. The rest of the world is watching Canterbury!