Since publishing Health Cheque we have been inundated with responses from people in the health sector. We decided to follow the book up with A Prescription for Change – three ideas to help NZ’s public health system meet the challenges of the coming decade.
You can access this free document at www.healthcheque.co.nz
The three ideas are:
manage demand—reduce pressure on the system to provide treatments;
prioritise—make sure treatment goes to those with the greatest need and ability to benefit; and
make delivery more efficient by giving health professionals the ability and incentives to make the system work better.
Here are a few reasons why I think nurses will need to get behind these ideas before they can happen.
The demand for change has to come from within the sector. The public doesn’t realize the pressures the health system is under; and politicians don’t want them to know. They don’t want to face up to the reality that we can’t afford to give everyone all the treatment they want. The public will only believe there is a problem, and that money alone isn’t the answer, if people within the health sector stand up and tell them. We have to educate the public before they will demand change. Only then will the politicians be brave enough to follow.
We all know that the current system is unsustainable given increasing demand, the ageing population, chronic disease and technology improvements. Change is a matter of when, not if. So people within the sector need to get involved and thinking about change now, so that we can do it in a way that works. Too often the health sector has been a political football, and staff have suffered as a result. It is time to create a way forward that everyone can buy into, so that future upheavals can be avoided.
Future demands, particularly chronic disease and the ageing population mean will mean changing the way we deliver healthcare. We will need more and better case management. This is partly about educating patients to look after themselves, partly to manage their expectations and partly to ensure the care and treatment is holistic. Nurses will take on this role, making them central in the new world of healthcare delivery.
Nurses can see things from a broader perspective. Because of the specialised nature of most doctor training, it can be difficult for them to think about how the health system works together as a whole, and how resources should be prioritised. A good example of this is with end of life treatment and care. Too often the system tries to cure old age, instead of stepping back and considering how to manage the whole end of life experience. Sometimes it might be better to treat less and care more; managing this process requires working closely with patients and investing more in caring rather than curing. Again, nurses are in a position see the value of this investment.
These are just a few reasons why nurses are central to achieving the changes our health system so desperately needs. It’s time to swallow the bitter pill to make sure we keep a public health system we can admire.