PHYSIOFORWARD Conference, School of Physiotherapy, Otago University, Dunedin

E ngā mana, e ngā reo, e ngā karangatanga maha ki runga i a koutou tēnā rā koutou katoa. E ngā uri o Ōtākou, te mana whenua o tēnei rohe, tēnā koutou katoa.

• Thank you for inviting me to this conference.  I congratulate you on achieving 100 years of physiotherapy education in Otago.  This is an exciting milestone, and I wish the School well for the next 100 years.

• I would like to acknowledge the other keynote speakers, Professors Jeffrey Basford, Elizabeth Dean, Bill Vicenzino, Maurits van Tulder and Steven Wolf.  As well, I acknowledge those who have worked hard to put together this event.  Greetings also to you the participants who have travelled, sometimes a very long way, to be here.

• The themes for your conference have been relayed as prevention, intervention, participation and evaluation.  To my mind, these themes run through many aspects of whānau ora, the topic I have been asked to speak about.

Whānau Ora

• Whānau Ora is about family or whānau; the term Whānau Ora literally means healthy family or families.  A sense of whānau encompasses individuals, their immediate and extended families as well as the communities in which they live and work.  Who we are as individuals can be determined within the context of the family around us, those who live with or near us, and those who support us.

• The whānau unit is the main base for taking control and determining the health and wellbeing of all its members.  As a vital source of identity, security and strength, the whānau is also a powerful source of motivation for change.  This is the premise on which the Government’s Whānau Ora initiative is based. 

• The Whānau Ora initiative aims to empower families in need, enabling them to take control of their own futures through setting their own direction and accessing support where needed.  This support involves agencies such as health, social development, education, justice and housing working together to provide wrap-around services and opportunities for families to help them achieve optimal health and wellbeing and their own measure of success.

• At present, there are 34 Whānau Ora collectives across the country representing around 190 non-government providers offering a range of whānau-centred health and social services.  The programme is deliberately designed to be flexible in meeting whānau needs and will work in a range of ways, influenced by the approach the whānau chooses to take.

• For example, some whānau may wish to define their own ways of improving their lives and to work on these with a hapū, iwi or another non-government organisation.  Others may want to seek services tailored to their needs through specialist Whānau Ora providers.  Whānau can choose to have a practitioner or ‘navigator’ to work with them to identify their needs, develop a plan to address those needs and help them access a range of health and social services.

• In 2010 the Government invested $134.4 million over four years in Whānau Ora, with an additional $30 million over four years invested through Budget 2011.  The focus for Whānau Ora has been to support provider collectives in building capacity and capability for changing to whānau-centred service delivery, and on building whānau capacity and capability.

Physiotherapy fit

• So, where does the profession of physiotherapy fit in all this.  As I see it, physiotherapy is already part of the menu of supports contributing to the health and wellbeing of a family.  This is especially so when physiotherapy is linked with disability support services such as Child Development Services, and short and long-term rehabilitation programmes that DHBs or the Ministry of Health may fund for adults. 

• Some of you will be familiar with the coordination aspect of service provision, especially those in multi-disciplinary teams working with individuals and their families to develop a service support plan best suited to their situation. 

• Many will also know that, like Whānau Ora, the Ministry’s new model for disability support being demonstrated in the Bay of Plenty enables people with disabilities and their whānau to have more choice and control over how they would like to live their lives.  This includes people having the option of self-assessment and identifying their own support needs.  Some people may identify that they have a need for physiotherapy.  Local area coordinators, like ‘navigators’, help families and their family members with disabilities decide what is a good life for them, and to make a plan to achieve it through building up natural and community supports.

• I am also aware there are over 1015 physiotherapists who are Approved or Credentialed Assessors able to recommend certain equipment to meet the needs of people with disabilities and their whānau.

• So there are opportunities for physiotherapists to work in the context of whānau ora.  Even when treating an individual alone following injury, or after surgery, there is still the chance to think about how that person is supported, who helps ensure they meet their everyday regime and make progress with their treatment.  My challenge to you is to look for the family beyond, because there is the major source of strength for enhancing a person’s health and wellbeing.

• As health practitioners, you will be aware of cultural diversity among the individuals and whānau you interact with and the importance of supporting them in culturally safe and appropriate ways.  You will also know that the Health Practitioners Competence Assurance Act 2003 requires you to adhere to standards of cultural competence.  If you wish to refresh your skills, you may like to take the Ministry’s online Foundation Course in Cultural Competency.  The course is free to all health professionals until the end of June this year.  It offers modules that provide an understanding of New Zealand’s culturally diverse population, the importance of health literacy and how health professionals can make a difference to outcomes.

Evaluation

• In terms of evaluation, I know is imperative that clinical outcomes are improved and that we must keep within our resources and ensure we get value for money.  But we also need to look at the qualitative aspect of evaluation.  How are whānau managing – better than they did before?  If in their own terms they can say they are maintaining their health and wellbeing and are a few steps nearer fulfilling their aspirations, however long and hard the journey may be, that’s what I would consider a good outcome.

• To this end I am heartened by data collected from a number of Whānau Ora providers showing that participating whānau have high levels of satisfaction with the support that they receive.  I am hopeful that early positive results linked to Whānau Ora continue on an upward trend for whānau-led development and, most importantly, whānau outcomes.

Thank you all.  I wish you well for a successful and enjoyable conference.

Nō reira, tēnā koutou, tēnā koutou, tēnā tātou katoa.