Speech delivered by Hon Dr Jonathan Coleman, Minister of Health , at the Healthcare Congress, Auckland
21 June 2016
Healthcare Congress speech, Auckland
It’s great to be here for the sixth New Zealand Healthcare Congress.
I’d like to thank you all for the work that you do, there’s some impressive stuff happening.
While health systems across the world are facing a range of challenges – an ageing population, tough fiscal times, and while we can do more for patients that creates an affordability issue in itself.
But balancing that out we’ve got some of the sharpest minds in the public and private sector focusing on creating new models of care and developing the technology that is vital in enabling those new models of care.
It’s an exciting time in healthcare as the science is improving and increasing at an exponential rate.
With the right focus we have the ability to deliver a sustainable health system that’s underpinned by technology, that’s built around the patient and their family, where care is increasingly delivered in the community.
A system that focuses on prevention and early intervention which will increase longevity and quality of life for New Zealanders.
That really is the theme of this conference – Technology Enabled Healthcare.
To successively deliver on the health aspirations of New Zealanders, you’ve got to have a clear plan.
The first thing I did as Minister of Health was to ask officials to work on a very clear, laid out plan, which has become the new Health Strategy.
Developing and implementing fit-for-purpose technology and information systems is pivotal to the success of the Strategy’s five themes – people-powered, closer to home, value and high performance, one team and smart system.
The Government’s focus is on delivering more services to New Zealanders on a continuous and ongoing basis.
The Health Strategy sets out a clear path to develop smart systems, with data shared across the sector and potentially across other departments to support clinical decision-making and appropriate interventions.
Health has remained the Government’s number one funding priority.
Budget 2016 delivers on that by investing an extra $2.2 billion in health over four years for new initiatives and to meet cost pressures and population growth.
The Government’s investment in health will reach a record $16.1 billion in 2016/17 – that’s an extra $568 million, the biggest single increase in seven years.
Claims by government critics that health funding has been cut are incorrect. Under this Government health expenditure share of GDP has averaged 6.5 per cent – that’s up from the previous Government’s level of under 6 per cent.
Over the last eight years, the funding of health has kept ahead of demographic pressure and inflation.
In Budget 2016 we’re investing an extra $124 million for Pharmac to provide more access to new medicines, $96 million to provide more elective surgery and $39 million to start the roll-out of a national bowel screening programme.
While doing more elective surgery each year is crucial, we’re also working to quantify unmet demand with the national patient flow system. We’re one of a few countries collecting information of this kind at a national level.
Implementing the Childhood Obesity Plan is a key focus. We’re now one of the first countries in the OECD to have a target and a comprehensive evidenced based plan to tackle Childhood Obesity.
Mental health is also a key area of focus. Mental health and addiction services are responding to increased demand – a 21 per cent increase over the last five years.
The Government has increased mental health and addiction services funding from $1.1 billion in 2008/09 to over $1.4 billion for 2015/16.
Youth access to mental health and addiction services has improved, and adult access rates have remained steady. However we can’t be complacent, we need to maintain momentum to ensure people get the services they need. There’s always more we can do.
I.T. & medical technology
Technology is a significant strategic investment for Government, both from a health and broader social sector investment perspective.
It’s an enabler of Government policy and changing models of care. It has a key role to play in making the health system more sustainable, more productive and efficient, as well as resulting in better health outcomes for patients.
It also has a role to play in supporting wider cross-government interests.
It’s important we have the ability to share information across the social sector to inform future social investments, evaluate the impact of programmes, and ensure that services provided by other sectors contribute to improving the health of New Zealanders.
We need to make better use of the data we already have available to help recognise and identify the most high risk families.
We also need to find a new way to balance privacy with security – that’s going to be a major challenge as we look to free up access to health information so it can be used across the justice sector, the education sector.
We can’t have departments operating in silos, it’s important that all the information is available.
It’s clear clinicians and providers want better access to health information across the system. They want I.T. systems that are well-designed, easy to use and aligned with clinical workflows.
Decision support tools must be available at the point of care, and providers need to know the care being provided to their patients is being coordinated appropriately.
Impact of initiatives
We’re already seeing the impact I.T. and medical technology are having in healthcare.
For example, at Auckland DHB, video links are used to supervise patients taking antibiotics to treat tuberculosis, enabling nurses to spend more time with other patients.
Telehealth services are giving patients and clinicians in remote areas access to the services and training they need. For example, children on the West Coast are receiving support from Canterbury DHB’s paediatric specialists in Christchurch, saving a huge amount of travel time.
Patient portals are another example of how technology has changed the way we do things. Over 136,000 patients from 330 practices now have access to a portal.
Through that portal patients can book appointments, check test results, order repeat prescriptions and email your GP.
We’re also seeing world leading advances in medical devices and technology which are changing the way healthcare is delivered.
Last year Dr Hong won the Clinicians Challenge for his oDocs Eye Care initiative. It’s a world-first innovation that can be used on a smartphone to diagnose people with sight-threatening illnesses.
It performs a similar function to $50,000 worth of eye examination equipment.
Aside from the cost savings, Dr Hong’s innovation makes basic ophthalmology services accessible to people living in remote areas.
To give another example, continuous glucose monitoring devices make diabetes easier to manage by tracking real-time blood glucose readings 24/7, and notifying patients of highs and lows on their smart device so they can take action.
This technology gives users greater freedom to enjoy normal life activities without interruption and to manage their diabetes better.
Digital Health Work Programme
Developing a clear vision for the future of I.T. investment in health has been one of my main priorities.
The Health Strategy and Roadmap provides a framework for the next phase of the Digital Health Work Programme 2020 which builds on the National Health I.T. Plan.
This will ensure we’re well positioned to take advantage of new technology opportunities by encouraging innovation and providing a supportive policy and regulatory environment.
We want to see more patient-centred healthcare, and better use of current and emerging technology to help patients manage their own health.
The Ministry of Health, DHBs and others are working to complete the foundation projects set out in the National Health I.T. Plan, so we can move ahead to the next phase of digital health.
We are creating the foundations needed for information to be securely shared. This includes common clinical workstations, replacement of legacy patient administration systems, shared regional information platforms and national systems.
Single electronic health record
The next phase in the Digital Health Work Programme highlights the importance of digital solutions to support a smart health system – one in which information is captured and accessed in a single electronic health record.
It will provide information via a patient portal and enable clinicians to view comprehensive patient information in one place. It will also incorporate data from population screening programmes.
The information can be securely accessed and updated. The record will be able to be accessed via portals and apps running on a range of devices.
We know that international comparisons suggest countries with better digital systems utilise clinician time more effectively leading to fewer doctors and nurses per bed. In New Zealand we have one doctor and 3.6 nurses per bed compared to the OECD average of 0.7 and 1.9 respectively.
A single national electronic health record system will enable a step change in how the Government can make investment decisions, target public health initiatives, monitor the effectiveness of programmes, and it will allow health to work more effectively with other agencies.
So that we do it once, and do it right, the Digital Health Work Programme will provide further direction. A blueprint of a digital hospital will also be developed for the sector, and will be available by November this year.
I.T. prevention platform
A national whole-of-person I.T. prevention platform will capture information relating to population screening and prevention programmes.
It will have privacy and security features designed from the start, building on the connected health security model. This prevention information will form part of the national electronic health record.
We have the ideal opportunity to make a smart investment in this area as the current prevention systems are at the end of their life and need replacing.
The direction we have set out is challenging, but I know it is a challenge that the sector is up for.
Pharmac – medical devices
There has been a lot of collaborative work by Pharmac, DHBs and suppliers of medical devices to implement a new way of managing medical devices.
It’s important there’s greater consistency of access to hospital medical devices across the country, as well as improving value for money.
Pharmac has made significant progress in negotiating national contracts for hospital medical devices. These contracts improve prices for DHBs, while essentially keeping the same range of devices available for use.
This work will have challenges as it progresses, particularly as Pharmac evaluates whether a more select range of devices in some categories would provide better value.
Pharmac has a strong focus on engaging with relevant clinical communities, and that has to continue.
For example, Pharmac recently changed its coverage of work in the wound care area in response to feedback received.
It’s critical that the professionals using devices on the frontline have confidence in Pharmac’s work.
The overall focus here is on generating the best possible health outcomes. Amongst the challenges along way, we need to keep coming back to making the best use of resources to benefit New Zealanders.
Therapeutic products regulatory regime
The Government is developing a new therapeutic products regulatory regime.
As well as replacing and modernising the regulatory arrangements for medicines, the regime will provide regulation of all therapeutic products, including medical devices and cell and tissue therapies which are currently not fully regulated.
Currently regulations require medical devices to be notified to Medsafe but this does not include pre-market evaluation and approval of medical devices.
The new regime will be flexible enough to ensure effective control over the quickly evolving technology used in therapeutic products while being efficient and cost-effective.
For medical devices the international trend is toward the regulator accrediting third parties to undertake the full evaluation of products. The evaluations of third party Conformity Assessment Bodies are then assessed by regulators as required.
Third parties are able to specialise in assessing a particular type of medical device or against a particular set of standards and are better able to keep pace with technological advances.
This is the European model and is increasingly being adopted by other jurisdictions. It’s the Government’s intention that New Zealand should follow suit.
Looking to the future, the sector needs to continue to adapt as technology changes how health services are delivered.
We need to be at the cutting edge of these medical and I.T. technologies, so we can quickly and accurately evaluate the health benefits they can offer and the efficiencies they can bring to the health system.
We’re just scratching the surface of what innovations such as nanotechnology, genomics and robotics can offer to complement clinical treatment.
Take genomics. In recent years there’s been an extraordinary leap in knowledge of the human genome and its role in health and disease. We can now sequence a person’s entire genome, which is a game changer when it comes to predicting disease and tailoring treatments more precisely.
The $97 million extra funding for health research announced as part of Budget 2016 also cements this Government’s commitment to an integrated system that will deliver new medicines and new technologies, to improve the health of New Zealanders and also for export overseas which has enormous potential.
The direction we have set out is challenging, but I know that many of you in this room are leaders and champions of the innovations and changes ahead.
I wish you all the best for the next two days as you explore how technology can continue to be a key enabler to support the provision of health services both now and into the future.
Media contact: Kirsty Taylor-Doig 021 838 372