We know that the clinical staffing ratios per bed are significantly higher in Aotearoa New Zealand hospitals than OECD averages8 and that out of our total DHB workforce of 76,230, roughly 17% are in management and administrative positions. This ratio rose further from the additional 2,768 workers required to support the COVID-19 response with 35% in administrative or management positions9.
Our border and immigration policy makes it hard to attract healthcare professionals (despite medical professionals being on the new immigration Green List) and our salaries and working conditions make it even harder to retain them. Critical workforce issues are rife across many professional groups and we are facing significant industrial actions by health workers.
Aotearoa New Zealand’s ability to deliver a viable – and sustainable – health system lives and dies by the availability and productivity of our health workforce. Therefore, investments which foster productivity, changes in service model and allow people to work at the peak of their professional capacity are vital. Unless we ‘bend the cost curve’ we cannot turn around the system’s performance.
The other side of the equation is bending our demand curve. For New Zealand children, avoidable hospital admissions account for approximately 30% of all paediatric admissions nationally, and for 20-25% of admissions for adults 65 and older10. Clearly improving access to simple, lower cost and early interventions trumps the use of reactive and more expensive hospital care.
Here’s what we know about these investments from the Budget announcements:
- $76 million over four years to develop the health workforce, including $37 million to cover 1,500 more training places for primary care workers.
- $39 million invested over four years to provide the Māori workforce with additional access to training and development. Both of these workforce investments will help in an environment where it is difficult to import additional health workers.
- Pharmac gets its biggest ever increase to baselines, investing an extra $191 million over the next two years. This will hopefully help with access to new medicines.
- Joined up information technology (IT) systems will be part of the digitally enabled health system. This investment will allow access to specialist care regardless of where an individual lives. Health New Zealand is expected to develop centres of excellence for specialist care.
- Perhaps most significantly, $580 million in funding over four years to support hauora Māori health services, and support for Whānau Ora Commissioning Agencies.
For these investments, clarity of thought and purpose will be paramount to ensure that money does actually shift the needle and deliver a successful outcome and lasting change.