Jay Kuten: What's to be done about our health care system

The adverse mortality statistics for Maori reflect not only the inadequacies of our medical system but, in the largest sense, they reflect on the care all of us receive. In that sense, Maori are the nightingales in our coal mine. We are, after all, whatever our origins or ethnicity, New Zealanders. What happens to Maori happens to us all. Those who can't see this are unaware of the realities of modern medicine.
In these essays on medical care, my focus has been primarily on the issues involved but also, if indirectly, possible solutions. It's necessary to do more, to reflect on the famous question: what is to be done?
To reiterate, we all have a stake in the District Health Board (DHB) and the hospital. We need it to succeed and to continue to provide good quality health care as a regional medical specialist facility. We also need to have a skilled cadre of general practitioners and nurses in the community to help our population to maintain its health.
Part of the change that is needed has to do with altering biases and attitudes, some of them inherent to the ordinary training of health care workers as a byproduct of immersion in scientific study, which tends to objectify people.
A significant change needs to be instituted in decisions that hamper the science that underlies medical care. The sort of defensiveness which I encountered in trying to find a rationale for the clinical decisions at the A&E is the antithesis of science. Science relies upon openness, upon transparency and vigorous debate.
Serious reconsideration needs to be given to a policy which punishes patients for visiting the A&E in error when requiring GP care. The approach of identifying overusers of the A&E and meeting them more than halfway should be given a chance.
The encouragement of family participation in the medical process and an effort to be more welcoming may go a long way toward improving health care outcomes for all the community.
My attempt to learn about the problems of Maori mortality statistics and to better understand how our system works - or not - led me to a conclusion that is almost a cliche. It's from Paul Newman's movie Cool Hand Luke: "What we've got here is a failure to communicate."
A significant portion of the communication problem has to do with human factors. But a part is strictly technical and requires a technical fix. If you have a GP, whether in solo or group practice or with Te Oranganui, she or he almost certainly has access to a computer. But that computer is unlikely to be able to access the results of your laboratory tests or the results of any complex examination such as an MRI. That's because the various software systems in use, whether in hospital or outside, have limited ability to communicate with one another.
The systems are incompatible.
The situation is itself a near-tragic metaphor for the problems of the whole system. The DHB needs to invest the requisite funds to ensure that every medical practice in Wanganui can securely and conveniently have access to test results within 24 hours of their completion.
A technical fix by itself will not come close to solving the problem, but making that one significant alteration would be money well spent by the DHB in terms of providing better health care outcomes and reducing the need for complex care in hospital.
Where complex hospital care becomes necessary, rapid provision of test data ought to make for better treatment outcomes as our doctors receive the best guidance for the decisions they must make in our interest.
I'm neither looking for miracles nor expecting any. But a few simple steps will do for now. I'd be happy to discuss any and all of these issues and suggested solutions with clinicians from the DHB.