Primary health's role in 'better, sooner, more convenient' care - Dr Bev O'Keefe

National Health Board member Dr Bev O'Keefe* shares her views on the role of primary health in 'better, sooner, more convenient' health care.

'Better, sooner, more convenient' health care is about the health sector operating as a single system delivering services closer to home, and centred on the needs of the patient. The role of the National Health Board (NHB) is to remove as many barriers as possible to help clinicians and health care sector management work together to embrace these changes.

Barriers may be at many levels - at the District Health Board (DHB) level, or with health professionals uncertain about change, or related to the way services are currently funded and contracted.

Patients need to be cared for in hospitals only for conditions that cannot be managed outside hospital, which means we need to have a non hospital-based sector able to offer a wider range of services.

Some things currently being done in hospital can be done very well in community settings, and some things that, historically, have been done by a GP, may well be better done by a practice nurse or another member of the health care team.

However, the reality is we are faced with a workforce that's under significant pressure, and we're going to have to look at smarter ways of working to ensure the right people are doing the right job in the right place.

We know that people within the health sector, and particularly within the non hospital-based sector, have huge capacity for innovation, and that there are some fabulous projects, programmes and models in place in many areas around the country.

One of the things we want to do is facilitate a process where these good ideas can be shared across the wider health sector. This may require new ways of relating to one another within the health sector. Change is happening, but we cannot reform relationships overnight.

I'm pleased to say that more conversations are already occurring between professional groups, such as GPs, pharmacists, hospital doctors, and midwives.

One of my priorities is to look at what the Board is able to do to break down barriers so that these conversations can translate into more co-ordinated services for the benefit of patients.

These are small beginnings, but this is all about reforming, reframing, and building new relationships. And it's really exciting when you're committed and you open doors to discover that the people on the other side are really keen to talk to you.

*Following three years as deputy chair of the Independent Practitioners Association Council of New Zealand (IPAC) Bev O'Keefe became Chair in 2006. Since February 2009 she has held additional executive roles, and has continued as Chair since IPAC joined with the General Practice Nursing Alliance and rebranded in February 2010 to become General Practice NZ.