NZ launches new health system. A bowel cancer patient, a GP and an anaesthetist respond

Today New Zealand launches a new health system replacing 20 district health boards with a national body - Health NZ - in a bid to end postcode lottery. Health reporter Emma Russell talks to a bowel cancer patient, a hospital anaesthetist and a GP about the changes.

In launching the new health system, Health Minister Andrew Little said today marked the first day in improving outcomes for everyone across New Zealand, and "a beacon towards equity".

He said while it had been clear our health system had to change, the Covid-19 pandemic forced the issue when it came to decision making, leadership and delivery.

"I think the future is exciting, but even on the first day of this new system it is an opportunity to be seized," he said.

The challenge was now laid down for those in leadership to make the system work, he said.

Little described Health NZ and the Māori Health Authority as "a step or two closer" to tino rangatiratanga when it came to health.

He said while we would always need hospitals there was more that could be done to keep people healthy - and this was an important objective of the reforms.

Director-general of health Dr Ashley Bloomfield attends the launch of the two new health entities. Photo / Jed Bradley

Little also paid tribute to outgoing director-general of health Dr Ashley Bloomfield who he said would go down as one of the greatest public health leaders in New Zealand's history.

Bloomfield described it as a special day and a significant opportunity to strengthen and improve the health system.

He said despite previous challenges, our health system protected our people and delivered a world-leading response to Covid-19.

He said the new health system would see a new model of leadership that focused on an invitation to collective action. He said he had faith that high-quality health care would be delivered to all under the new system.

Trusting the system

Roz Tuitama's bowel cancer should've been picked up at least two years earlier.

Our country's health system let her down.

From today the country's 20 district health boards cease to exist, replaced by Health NZ in charge of the health system both clinically and financially.

The Māori Health Authority, run by a board of up to eight, will jointly develop and implement a New Zealand Health Plan with Health NZ.

Within those new structures will be about 80 locality networks, and iwi-partnership boards to guide decision-making.

In 2015, Tuitama was rushed to Auckland City Hospital's ED with severe bleeding.

Doctors said it was a digestive problem and sent her home, said Tuitama, 57, a Māngere primary school assistant principal.

"You don't question the system ... I trusted them."

By 2016 her symptoms hadn't gone away. Tuitama said she'd had several GP appointments before she was referred to a specialist for a colonoscopy, which involves a camera inserted through the anus to inspect the bowel.

She waited another year for the colonoscopy. By then it was too late, the cancer had spread to her liver.

"Getting told you have cancer was like a movie. It went into slow motion, I was with my husband and I just said to the doctor, 'Can you say that again?'"

From there, she was on "a treadmill of the cancer beast machine". She had surgery to remove a third of her colon and endured 12 rounds of chemotherapy over six months.

However, her cancer continued to spread through her lungs and liver. She had more treatment, then the disease came back for the third time. Now, she's "in the clear" but it's likely the cancer will return.

"It's been five years of cancer ... the impact is devastating to say the least. I had to stop work ... so all of that kicks in, on top of your children being told, 'Your mother's got stage four cancer'."

The eldest-of-nine was urged to get her family checked. Her little sister, who was in her 40s, also discovered she had cancer.

"She was caught earlier ... she wouldn't have been picked up if I wasn't already in the system," Tuitama said.

There were many ways Tuitama's cancer could've been detected earlier, she said.

"The thing about me being a Samoan woman, there's an assumption that it's my fault that I've got this, that stigma of Pasifika, Māori, 'Why don't they look after themselves', that's not the case. You need to look at the inequities that exist because of where our people are placed.

"If you are going to provide access, make the language understandable, I'm not just talking about just in terms of ethnic languages, I'm talking about everyday language like 'stage four'."

The system didn't speak to Tuitama so she started a support group called Alofawholeness for people facing cancer.

"I'm an educated woman and I couldn't navigate the system."

Bowel cancer survivor Roz Tuitmama, 57, says the health system stigmatised her and she hoped that would change. Photo / Supplied

GP not sold on 'new system'

Auckland GP Marcia Walker said major change was needed to address the country's "healthcare crisis" and she wasn't convinced this "new system" would fix it.

"They're funding a bandaid on a haemorrhage that's been going for the last decade, and then asking us to try to keep the patient alive with just more band aids. No, no, if you're talking about system reform, do it properly ... primary care is now at that point where we are falling over," Walker said.

"That's translating to increased pressure at EDs and even worse wait times and patient harm and we knew this was going to happen."

She said government funding needed to be taken from hospitals and given to GPs and community care.

"It's a bold move but right now we are just tinkering with more of the same sh** ... If you invest in community care, you'll save money spent on hospitals."

"All the average New Zealander cares about is can they get into their doctor in a timely fashion? Can they get their referrals done quickly if they need them? Can they get their X-rays and ultrasounds done quickly, if they need them? Those are things that are important, and I'm not sure that any of that is going to be addressed by these changes."

Anaesthetist on hospitals

Middlemore Hospital anaesthetist and wellbeing lead Joanna Sinclair said she's concerned by the lack of Government consultation with doctors and nurses before implementing changes.

She said she was seeing "really high levels of burnout" and urgent action was needed to retain and recruit staff.

Middlemore Hospital anaesthetist and wellbeing lead Joanna Sinclair was realistic change wouldn't come overnight but remained hopeful. Photo / Supplied

Sinclair said "the daily grind" and lack of resources for patients took a massive toll on staff.

"I started to lose compassion for my patients. I just wanted to be at home with my family and get some time out of the craziness of medicine, so patients were what was getting in the way of that," she said.

The IT system between hospitals needed a massive overhaul, she said.

If a patient is rushed into theatre from ED and they don't live locally, the doctor can't easily look up their medical history before they operate, she said. If they could it would save time.

While she's realistic that change wouldn't happen overnight, she remained hopeful. She had been given funded time to help bridge barriers between frontline staff and management, and focus on collaboratively addressing staff burnout.

This was a great opportunity to make a difference, she said.