creating a common vision… a public sector perspective
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Creating a common vision… a public sector perspective. Kathy Spencer DDG, Sector Policy Ministry of Health. Health Issues. Smoking: 5,000 deaths this year. Maori. Pacific. Other. Health Issues. Smoking: 5,000 deaths this year. - PowerPoint PPT PresentationTRANSCRIPT
Creating a common vision…
a public sector perspective
Kathy SpencerDDG, Sector
PolicyMinistry of Health
Health Issues
0
10
20
30
40
50
60
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Year
Percent
MāoriPacific peoplesEuropean/Other
Smoking: 5,000 deaths this year
Maori
Pacific
Other
Health Issues
Diabetes: affects 200,000 people - only half of them diagnosed – 3 x more prevalent in Māori and Pacific
Cardiovascular disease: 40% of all deaths - burden greatest among Māori and Pacific
Cancer: next leading cause of death – significantly worse outcomes for Māori and Pacific
Mental health: 21% have had a mental disorder in the past 12 months – worse for Māori and Pacific
Smoking: 5,000 deaths this year
What are we trying to achieve?
Reduce obesity
0
5
10
15
20
25
30
35
40
45
Maori Pacific Other
Improve nutrition
Increase physical activity
Reduce the harm caused by tobacco
Reduce cancer waiting times
Improve diabetes services
Reduce avoidable hospital admissions
Improve mental health services
Improve immunisation coverage
Improve oral health
Improve elective services
Reduce Ministry administration costs
Plus…
For all New Zealanders:
access acceptable services
when needed
regardless of ability to pay
comprehensive
A mixed system Public funding & provisionHospital – acute, electives above thresholds, outpatients, maternity
Community nursing
Screening
Community mental health
Public funding, private provision Some elective surgery
Most ACC-funded electives
Child and adolescent dental
Maternity services
Mixed funding, private provisionPrimary care
Laboratory services
Pharmaceuticals
Physiotherapy
Aged residential care
Private funding & provisionElective surgery below public thresholds
Some specialist services
Adult dental
Provider Selection Protocols First and foremost, choose the most effective
option to achieve health gain
Continue to build Maori & Pacific capacity
Significant shift to a non-govt provider
demonstrable benefits to patients
engage with health professionals currently delivering service
Include in plans
Information provisions
Conflict of interest provisions
Private Involvement Protocols
First and foremost, a direct benefit to publicly-funded patients/people with disabilities
Spare capacity
Patients to be advised of publicly-funded options
If DHB staff involved, needs to be within range of current services
Public disclosure
Conflict of interest provisions
The protocols have…
Been challenged and modified
Are they…Right?
Well understood?
Being applied?
Differences – client groups….
Hospital use in last 12 months
0
5
10
15
20
25
Maori Pacific Other
% Public
Private
But also common ground….
We all need energy. But are we consuming too much for our lifestyles?Someone once said that being overweight was “a normal response to an abnormal environment”. In today’s busy world….
Killer - Joules: the calorie curse
Areas to work onClarity of scope of services funded
Common understanding of protocols
Workforce
Recruitment & retention
Use flexibly
Training
Develop new roles
Remuneration – form (incentives) and level (costs)
Management of dual practice
Equity and access issues
Effect on demand