1 September 2017
IBM’s Watson could be an inspiration to New Zealand’s health decision makers. No longer just winning Jeopardy, Watson has recently been getting really good at designing cancer treatments. Watson for Oncology is designed to help physicians diagnose and treat their patients and is another tool helping to efficiently and reliably assess patients. Other tools such as mining medical data, 3D printing and studying genomics-based data for personalized medicine are all part of the revolution in modern healthcare globally.
Tomorrow morning (Saturday), as part of their election coverage, TV3’s “The Nation” is hosting a Health Debate between the Minister of Health Jonathan Coleman and Labour’s Health spokesman David Clark. I’m on the panel along with Laila Harre and we’ll be asked to comment on the promises and policy initiatives of the National and Labour parties. I’d like to think we might hear a vision from each of the doctors – one medical, the other PhD – about the new era of healthcare. Such concepts as patient-centric care, integrating technology and information to produce individual health plans, promoting wellness rather than treating sickness, but I anticipate that ‘vision’ is too much to expect.
In part, I blame New Zealand’s very short electoral cycle which punishes long term planning and promotes short term tinkering to ‘fix’ the current system. I doubt we will hear about innovative 21st century healthcare. We’ll hear plenty though about which party will pour the most money into the black hole of health.
New Zealand had an enviable public health system in the 1960’s – 1980’s. But despite well trained and passionate healthcare professionals the system they now work in has failed to produce population health gains alongside advances in knowledge, information and technology. We have excellent emergency care in New Zealand, but for those with chronic conditions such as arthritis, diabetes, COPD – the list is long – requiring treatment by specialists and new innovative medicines, our rationed system dictates how long their wait will be for traditional care. Unless that is, they can afford health insurance or have the means to pay themselves.
What I would like to see from the Health debate is our politicians competing to be the first to:
- Reduce the 20 District Health Boards to four- Auckland and North, Central North Island, lower North Island and South Island. Administrative cost savings and savings from fewer Board members would be used to treat people.
- Improve the treatment for those with mental illness – some announcements have been made already but it isn’t clear exactly what the public can expect other than “more money”.
- Invest in more medicines. PHARMAC does an excellent job of getting medicines at good prices but too many patients are missing out on medications that improve health, save lives and are available in other first world countries. Studies show for example that for every dollar invested in new cancer medicines a dollar is saved downstream in the NZ health system AND patients benefit by a 5% reduction in mortality for each innovative cancer medicine that is publicly funded.
- Focus on patient-centric Primary healthcare using personalized and innovative technologies such as human genome sequencing. Just making doctor visits cheaper won’t in itself produce early diagnoses and treatments (medical, surgical and medicinal). Prevention of chronic conditions which are costly should be the goal.
- Embrace and invest in the global trends of innovative personalised technologies that can assist clinicians to tailor healthcare to the needs of individual patients across primary, secondary and tertiary care.
- Bridge the gulf between the way in which illnesses and accidents are treated. Medical conditions should be treated promptly, no matter how the condition occurred. Take the best of ACC and the Health and Disability system to provide the best care.
- Planning the Health workforce for the future. Multi-disciplinary teams, addressing the aging GP workforce, training and using Nurse Practitioners in specialist areas would all be a good start.
A 2010 Treasury report showed the cost of illness of those unable to work in New Zealand was $11.5 billion. This figure doesn’t appear to have been reviewed but it’s worth noting that we currently spend around $16 billion on the public health system. Treating and curing people is crucial. Hopefully the politicians likely to be in charge of our future health system have solutions to keeping people well and contributing to society. I’m waiting to hear.