The announcement to dismantle the DHB system by Minister of Health Andrew Little yesterday promises to completely change the sector as we know it. But has the Government just handed the country a celebratory earth-day gift without even realising it?
Little's sweeping changes are intended to fix the well-publicised issues which have dogged the sector for decades. Things like our shocking record around Māori and Pasifika health, and the regional budget deficits stretching into unfathomably large numbers.
Not mentioned once, was the sector's immense environmental impact.
The average New Zealander won't have seen much healthcare waste before, it's the kind of problem that lurks inside bright yellow bags and behind closed doors outside of the public eye. But most days, without including clinical waste, we can expect a hospital with 100 beds to put out at least three to four entire skips worth of single-use rubbish.
Compound this incredible amount of waste with the fact that our public healthcare sector makes up 8 per cent of the country's emissions profile and you're starting to get the picture of an industry in dire need of a shake-up.
So what's all of this got to do with the Government's announcement to abolish the DHBs?
We work with the private and public hospitals across the country to remanufacture Single-use Medical Devices for safe clinical reuse. Essentially, we're taking the used devices previously considered to be landfill padding, and giving them new life.
We are among a number of other initiatives also trying to bring about sustainable impact to hospitals, none of which could claim that their programmes are being consistently implemented in every DHB in the country.
Despite our successes with some hospitals of all sizes, the differing approaches taken by each of the 20 DHBs means that rollout has been inconsistent between regions.
Because every DHB has the autonomy to make its own decisions based on its own set of standards, we're seeing some regions getting all of the benefits of sensible sustainability-led programmes, and others with none at all.
I won't argue that there haven't been some great instances of collaboration between DHBs, but the unfortunate truth is that under the existing system, organisations have been forced to see each other as competitors, fighting tooth and nail for the same pool of funding.
By establishing a central authority to govern and set a cohesive strategy across the country, we can let pragmatism take centre stage with a new era of information sharing.
We should no longer see 20 different regions battling to achieve the same goal in 20 different ways, rather working together toward the collective health, wealth, and sustainability of greater New Zealand.
A hospital in Christchurch that manages to drastically cut down its waste should no longer let that success live in a vacuum. A hospital as far north as Kaitaia or as far south as Invercargill should be able to more easily learn from this, understand what it did, and figure out how they can do it too.
We should not have instances where fulltime clinicians need to moonlight as their hospital's sustainability officers, battling with bureaucracy to introduce climate-friendly initiatives. Instead, we need to see a single chief sustainability officer in the central agency, helping to lead a cohesive effort across the country, and supporting sustainability managers and advocates at all levels of each hospital.
Better collaboration across the entire country, from procurement, to nursing to facilities management, and every department in between, gives us the opportunity to deliver a better healthcare system for patients, for the environment, and for the thousands of people working to keep New Zealand healthy.
At the moment, no healthcare system in the world is excelling from a sustainability standpoint, but that doesn't mean New Zealand can't be the first to. By showing central leadership through the new structure, the reformed system has the chance to show the world that our physical health doesn't need to come at the expense of our earth's health.
- Oliver Hunt is the chief executive of Medsalv, formed in 2017 to combat the high level of waste produced in New Zealand's healthcare system.