Good morning. Kiaora tatou.  I'd like to start by welcoming everyone to the 2009 Royal Australian and New Zealand College of Radiologists' scientific meeting - and extend a warm welcome to our radiology colleagues who've come from around the world to join us today.  I would like to specifically thank the New Zealand Committee for inviting me to open the proceedings here in Wellington.

As many of you know, the new National Government is committed to building and sustaining a strong public health care system that provides "better, sooner, more convenient" health services for all New Zealanders. 

We want reduced waiting times, better individual experiences for patients and their families, improved quality and performance, and a more trusted and motivated health workforce.

We want a health system that doesn't just react to the health problems of today, but adapts to meet the very big challenges of the future which are facing  health systems all over the world.

Like many countries, New Zealand is experiencing increasing pressures on the demand for health and disability services and on the workforce that provides these services - we have an ageing population and an ageing workforce, a global job market for doctors and nurses we have to compete against, not to mention increasing costs and all of it in the middle of the worst worldwide recession in nearly a century.  

But I should tell you, I asked to be Health Minister in the new National government. I am told that was considered unusual - on both sides of the House. But I am very happy to be the National Minister of Health and I have some pretty firm ideas as to how, together, we in the public health system, can do something about all this.

Today I'd like to take this opportunity to share with you some of my thoughts on how important your skills will be to help address those challenges, how you as senior clinical leaders can contribute to a public health system that is adaptive, innovative and forward- looking.

Globally, clinical leadership is recognised as a fundamental driver for better health outcomes. In contrast this government inherited a health system where the influence of clinicians on patient outcomes here in New Zealand was less than it had ever been before.

This failure to engage the very people with the right expertise - doctors and nurses who know the patients' needs best - was seriously eroding your ability to provide patients with the care they needed.

Stronger and more direct clinician involvement means more service and better quality.

We trust and value our health professionals - enough to engage you in the very important decisions about the future of health services.

And that is why one of my first actions as Health Minister in the new National Government was to commission a significant report called 'In Good Hands' to guide District Health Boards in introducing greater clinical leadership into the public health system.

The 'In Good Hands' report provides guidance to DHBs on how they can institute a more participatory and less top down approach for their doctors, nurses and other health professionals.

This Government is serious about re-engaging doctors and nurses in the running of front line health services and we have instructed DHBs to act on this report.

I also recently announced the National Cardiac Surgery Clinical Network - a team of the country's leading heart surgeons who will lead much needed reform of New Zealand's cardiac surgical services.. 

We need better planning to improve the rate and availability of cardiac operations across the country and the best people to do that are the experts in this area - the heart surgeons themselves and their teams.

Greater cooperation and coordination between our senior clinicians across the country will improve frontline surgical services for all New Zealanders and I plan to instigate and encourage more national clinical networks.  

This is not to say that we want doctors and nurses to stop doing what they were educated to do and become managers. And we do acknowledge that many managers are also clinicians. But we do want to use the wealth of frontline experience you have accumulated to improve quality of care and rebuild confidence in the public health system.

In your speciality - diagnostic radiology - accurate diagnosis is fundamental to the subsequent treatment and care of the patient. Radiology is a fundamental component of diagnosis and treatment for many patients that journey through our public health system.

Unfortunately because our systems and care pathways are not streamlined, patients face delays for diagnostic investigations - which then that adds further delay to the start of appropriate medical care.  This is frustrating for the patient, for their general practitioner and for clinicians such as your selves. 

This is why I want to look at options for speeding up general practitioner access to necessary diagnostic tests.  This is a considerable challenge because this will not be achieved by doing more of what we do today in the same way that we do it today. 

Transformational change is going to be required to speed up access to diagnostic tests.  Clinical leadership - in particular your clinical leadership alongside that of your primary and secondary care colleagues - as well as innovation and system re-design are fundamental in achieving this.

Sometimes we've done it and done it well. 

I am very pleased to note that some of you here today were heavily involved in one successful project to improve access to diagnostics. The fourteen 'diagnostic pilots' recently showcased, proved that through clinical leadership, innovation and care pathway re-design, positive outcomes can be achieved for both the patient and our public health service. 

For example, the Canterbury, Nelson and Northland District Health Board pilots for non maternity ultrasound, CT scans and diagnostic breast imaging all led to shorter waiting times for those tests and a reduction in inappropriate First Specialist Assessments.  All at little or no cost to the public health service.  These were all good examples of clinically led change that could be readily adopted by services across New Zealand. 

It will be through your continued clinical leadership that we can ensure the benefits of initiatives like these can be realised more consistently across our public health service to help us achieve "better, sooner, more convenient care".  As identified the report ‘In Good Hands', supporting clinical leadership means capitalising on your drive for improvement, your intellectual flexibility and your ability to lead change and to work collaboratively with both your primary and secondary care clinical colleagues.

There is much to be done, the pressures of our aging population and chronic disease mean we need to do more and our economic situation means that we will have to do more with similar levels of resources we have today.  Furthermore our economic situation means that we do not have the luxury of time to make gradual improvement.  Accelerated change is required across the sector.

Since the discovery of X-rays 1895 radiologists have been at the forefront of innovation in health care;  ranging from the introduction of new technologies that have vastly improved imaging and the implementation of PACs systems, to the development of the wide range of procedures in interventional radiology that mean some patients no longer have to have surgery.  I understand that there is current debate about CT Colonography and the potential applications of this diagnostic test. Some of you may be involved in that debate demonstrating your commitment to ongoing innovation.

With your innovative history I expect that you will continue to play a leading role re-designing and streamlining our public health services as we move towards "better, sooner, more convenient care".

Thank you once again for inviting me to speak today and I hope that you all enjoy a productive scientific meeting over the course of the next two days.