Speech to Launch the Hospital Services Plan

Good Health Wanganui

Thank you for the opportunity to launch the Hospital Services Plan here at Wanganui Hospital.

Wanganui is a highly appropriate place to launch this document. Your experience here is typical of the experience of many communities, especially the smaller rural and provincial ones.

You care greatly about having access to your hospital services, you have worried about losing services, and you have seen changes in those services. Some of those changes have not been welcome. Others, such as the new children's ward here, have been very welcome.

I hope that this Hospital Services Plan will put an end to unnecessary concerns about hospital services for your community, and many others like it.

That is a strong claim, but this is a very important issue. If there is one thing I have learned in my time as Minister of Health, it is that the public of New Zealand do want certainty about their health services, particularly their hospital ones.

This Hospital Services Plan was written in response to that need for certainty and security. People need to know what quality and type the services are, where they are going to be, and that they can be reached in time when needed.

This document does give you that information.

It makes it clear that the Government sees a national network of hospital services as a vital component of our public health service.

We are in the middle of a massive programme of upgrading our public hospitals. We've invested almost $1 billion - $920 million - over the last five years modernising hospitals and their equipment. We plan to invest up to $1 billion more in the next three years. That's more than replacing the value of our public hospitals in a brief eight years. This process has involved closing facilities down that were never going to work, and putting a huge investment into the hospitals that we are going to have.

Now, we can commit to keeping hospital services where they are, for the next three years.

That is not to say there will be no change at all, but we can work to improve health services and eliminate waste, without the fear of losing the hospital.

I am well aware that this Hospital Services Plan is not what many people had feared it might be. It is not about further centralisation. It is not about creating a "super hospital" or two in place of many smaller ones.

Centralisation has been a great worry for many people for one simple reason. They were afraid they would lose access to what services they have.

The Government agrees. That would be a problem. That is why it's not going to happen.

Concerns about centralisation are sensible ones, and we have been listening to them. No-one actually knows how you can best provide services in Gisborne, or Wanganui, or any number of smaller towns and cities, if you take away their hospitals. So it's not just a political kind of response, it's a rational, human response. It's about looking after 40,000 people as best you can.

That is why this document is not about super hospitals and dramatic changes. It is about security and continuity, because that is what people tell me they need and I agree.

I have been listening to communities right across New Zealand. Their hospital represents for them values which are at the heart of their community - security, safety, caring and civic pride.

People who have seen changes in their hospital services may well ask why the process was started at all.

There is a simple answer to that. Some change did have to happen. As the Hospital Services Plan itself outlines, there are many pressures upon and opportunities for our health system. We have to respond to these as best we can. We are doing so by trying to make services as fair, as accessible, as good and as efficient as we can. If we don't, everyone loses out.

However, some of the proposals that were bandied about were just silly. You just can't cut surgery for communities of, say, 75,000, without cutting access for those people. That's why we've rejected those kinds of ideas. It does mean that smaller centres cost the Government more to run than the large urban ones. But it also means that smaller communities have the same sort of access, within reason, as the larger ones.

That is why we spent $13 million this year on a premium for rural hospitals.

We are willing to pay the price to ensure people have the access they need.

I also believe that in many cases a lot of the necessary changes have in fact brought about better services for local communities.

I am a strong advocate for locally developed solutions, such as the many new health centres that are springing up all over this country. These centres provide a range of different services, and there is a good reason for that. The reason is that they have evolved in response to local needs. Local communities and health providers have looked hard at what they do, and what they need to do to keep good access and quality of services, and they have come up with their own answers.

What is particularly heartening is that many people have now moved beyond arguing about which particular buildings should be called the hospitals. They are now looking at how to fit services around the needs of the people they serve.

Another heartening aspect of this process is that it requires health providers, such as the local hospitals, the GPs, the district nurses, the physiotherapists and the pharmacists, to really start talking and working together. That can only be to the benefit of the patients they have in common. It hasn't happened nearly enough in the past.

My hope is that this Plan will encourage many of you. It won't just explain how the Government is putting people before money. It won ?t just outline what work is going on where to ensure quality, access, efficiency and fairness. It won't just give you a good idea of what services we have and where they are.

My hope is that it will give you courage to keep coming forward with your good ideas on how to improve what we already have. You can talk about better ways of doing things, because your ideas won't threaten the existence of your hospitals.

This Plan says that from now on change will be evolutionary. I hope that future change will come from the bottom up. It will be generated by the local perceptions of local needs, by local creativity and motivation. It will come from people having a good idea about how to do things better, and then being able to do them better.

We can do a better job for many New Zealanders, particularly those who suffer from chronic health problems. I am thinking of our many older people who have complex health needs, and people with acute mental illness. They need us to concentrate on organising our services better, which we can't do if we are worried about keeping the hospital.

If the Hospital Services Plan does encourage local participation, then it will have been a useful stepping stone towards even better health care and better service. Whether it proves so useful is now up to us, local people, health providers, and policy makers, working together.

Thank you.