Health Workforce Advisory Committee document launch

I am very pleased to be able to launch the Health Workforce Advisory Committee’s second report Framing Future Directions.

Shortly, the chair of HWAC, Professor Andrew Hornblow, will talk in more detail about the committee’s report, but the first thing I want to say is that such a diverse and strong turnout from the health sector today indicates just how much interest there is in workforce development and in HWAC.

During the 1990s health workforce planning was so badly neglected that someone had to take responsibility for developing a strategic approach to creating a unique New Zealand health workforce.

Framing Future Directions is the first health workforce document to do so. I fully endorse the priority areas identified by HWAC and the approach they are taking to their work.

I also endorse their planned consultation process over the next four to five months leading to a national health sector summit next March. That is the opportunity to flesh out far more of the detail needed to make the strategies come to life.

Many of you may have been expecting such a document today, a report detailing, for example, the numbers of practitioners required to work in various areas.

I think you will soon appreciate why this document doesn’t do that. The first thing we need to do is to get out of the ‘crisis management’ mode and to start thinking about how we can do things differently.

Our health workforce is the best health asset we have, and that’s why it makes sense to value it, retain it, use it effectively, and increase it.

As the document states, the “changing demographic profile of New Zealand is also driving health workforce changes. There is an increasing demand for a workforce that is culturally appropriate and knowledgeable to deliver acceptable services to diverse communities.”

Our New Zealand Health Strategy requires us to start taking a new approach to health service delivery and Framing Future Directions aims to engage the reader and the whole health sector in the debate about what this means for the health workforce.

I don’t underestimate the huge task that I have asked of the committee. Health workforce issues are complex, challenging and steeped in history. HWAC has picked up this challenge and is working hard in a collaborative way with DHBs and the Ministry of Health.

DHBs are now giving workforce issues a high priority and work is under way to develop a national database. The Ministry has also made a major contribution in various ways, such as with the Health Practitioners Competence Assurance Bill and through operational initiatives, particularly in the mental health area and nursing.

An example of the latter, of course, is the $8.1 million I announced in June this year for a primary health care nursing innovation fund.

Now HWAC is going to start working in far more depth with the rest of the health sector as well.

I am delighted the first chapter in Framing Future Directions addresses opportunities and challenges for the primary health care workforce. This is an issue I have also been raising around the country in recent weeks, and I am sure this chapter will spark debate among health professionals and the public.

More than $400 million of new money has been set aside over the next three years to begin implementing the Primary Health Care Strategy. So there is money there to make the new system work.

We just need to ensure it is spent on initiatives to help the workforce achieve the strategy’s goals.

Chapter 2 focuses on another important environment, the hospital. The proposals to develop healthy working environments in hospitals are challenging, but they are crucial if we are to address workforce problems our hospitals now have.

The report promotes clinical leadership and shared clinical governance, devolving decision-making where possible to the front line, setting up feedback systems involving all staff, and establishing partnerships that value both management and clinical culture.

These initiatives need not be costly in overall terms. The cost of replacing any health professional is estimated at anything from tens of thousands to hundreds of thousands of dollars, depending on the level of specialisation and training.

That is why it is so important to retain health professionals, and help them develop successful and satisfying careers.

A chapter on the Tertiary Education Strategy outlines opportunities for the health and education sectors to work together in a more collaborative way. This chapter raises issues that need to be debated and agreed between the sectors and encourages collaboration at all levels.

It will be extremely important for the health sector to achieve an effective interface with the Tertiary Education Commission. A good example, of course, is the continuing work being led by my colleague Tertiary Education Minister Steve Maharey on the issue of student loans, scholarships and bonding.

Issues concerning the Maori and Pacific workforce are also addressed in the document. Clearly there are shortages in both workforces, and HWAC, in consultation with both sectors, discusses some interesting and challenging options for workforce development.

I am also particularly pleased that the committee is taking a keen interest in developing a support workforce that meets the needs of people with disabilities. This workforce has been neglected and poorly understood. It is high time we started to value it and maximise its contribution.

HWAC talks about ‘cairns’, about placing one building stone upon another building stone so we can all see the way ahead.

I feel genuinely optimistic that we are now creating those building blocks in terms of the New Zealand workforce that we need. The process is evolutionary, well considered, evidence-based, and aimed at putting in place the workforce we need in the future.

It is not about a quick fix for the mismanagement of the past.

It is not about one sector of the health workforce, as opposed to another.

And it is not about simple number issues.

It is about building a unique New Zealand workforce, capable of providing quality services in the most appropriate way to meet our needs in the years ahead.

I am now going to hand over to Andrew Hornblow, but before doing so I want to congratulate the committee on its work to date, and to commend Framing Future Directions to you. I’m sure it will generate much debate and I look forward to the summit in March next year.

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