Kevin Atkinson: Health system evolving with us

Kevin Atkinson.

Just over 15 years ago, the Napier and Hastings hospitals merged to become one regional hospital - Hawke's Bay Fallen Soldiers' Memorial Hospital.

As much as I don't want to raise the subject again because of the angst and disagreement it caused at the time, I have been reflecting on those days and the bitter battles that eschewed as communities and various stakeholders rallied to have the hospital in either Napier or Hastings.

The reason I have been reflecting is that 2015 has been the year of the health consumer. In all of the important work happening in health in Hawke's Bay, the consumer is right there at the centre. Their voice is listened to and forms part of the decision-making process. I think if we had the structure we have in place now, with both the consumer and clinical councils advising both the board and management, the merger of the hospitals would have been less fraught and the regional hospital would have had the benefit of a co-design partnership.

In 2013 we established the Hawke's Bay Health Consumer Council. The council isn't a token gesture to the community. It works hand in hand with Hawke's Bay's clinical council, which was established in 2010. The board listens to the voice of both the clinician and the consumer before it makes any final decision on whether any significant project gets the go-ahead.

Hawke's Bay has led the way in changing the way consumers and clinicians are heard. We recently hosted the chairs and chief executives from central region DHBs so they could see the councils in action. So impressed were they that a number are looking to follow us in setting up their own form of clinical and consumer councils.

We recently saw how important the voice of the consumer is with the partnership advisory group for mental health services winning the supreme award at the recent health awards.

There are undeniably huge pressures facing the health system as the population ages and we have more pressure on operating theatres, more complex patients with diabetes, obesity, more people presenting to the emergency department and a prevalence of smoking in Maori women. However, I feel more confident than I have ever felt that in Hawke's Bay we now have systems in place that will cope with the pressures we face, and consumers have been part of the design process.

We are unusual among DHBs in having generated a surplus for the past five years so that we can invest in our infrastructure. Everyone knows, no matter whether you are managing a household budget or your own business, that if you are financially sound the benefits are huge. Health is no different. This year we have seen the new mental health building completed, with patients to move in early next year. The plans for this building were put on hold time and time again as we had no money to do it. Today we have not only been able to complete the $22 million build but we have also upgraded and refurbished our facilities in Wairoa and Napier. In addition, we have built a new renal unit and are nearing completion of a low-risk maternity unit on the hospital campus.

Our next new development will be a facility that will cope with the additional demands to meet the bowel screening programme and growing patient demand for diagnostics of the digestive system.

Without being money-wise we would only be able to tamper at the edges of being able to deal with our pressures.

With a budget of about $500 million a year, the district health board is constantly looking to save to reinvest. We look for opportunities where we can do things differently and use those savings to invest in where the demand is. We also have to address health inequities and make sure everyone has the same access to healthcare as well as the means to address it. Without a very solid management structure in place this is very difficult. So I am very pleased to be able to stand up in front of the community and say it's not perfect but it's pretty good and if you live in Hawke's Bay you can be pleased you have a health system that is growing and evolving to meet the challenges as the population changes. Most importantly, the work that is being done has consumer and clinical leaders placed firmly at the centre of that decision-making process.

-Kevin Atkinson is chairman of the Hawke's Bay District Health Board.

-Business and civic leaders, organisers, experts in their field and interest groups can contribute opinions. The views expressed here are the writer's personal opinion and not the newspaper's. Email: editor@hbtoday.co.nz.