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The Health Quality & Safety Commission (the
Commission) has today released part 2 of its investigation
into the effects of the COVID-19 pandemic on health care
services in Aotearoa New Zealand.
A window on quality
2022: COVID-19 and impacts on our broader health system
(Part 2) | He tirohanga kounga 2022: Me ngā pānga ki te
pūnaha hauora whānui (Wāhanga 2) (Window 2) follows a
previous report ( Window
1) published in December 2021 and was researched and
produced by the Commission in partnership with clinical and
academic experts and agencies, health care workers,
community workers and consumers.
Dr Janice Wilson,
Commission Chief executive, says the pandemic’s effects on
Aotearoa New Zealand’s health system, our population’s
mental health, health care workforce and experience of care
for disabled people are examined in the report.
While
a partial and curated view of the impact on the health
system, the report identifies both positive findings and
challenges.
‘Despite the lockdowns to fight the
Delta wave, our levels of freedoms over the pandemic have
remained higher than nearly all countries and are comparable
with Scandinavian countries,’ Dr Wilson
says.
‘While there has been an increase in mortality
since the spread of the Omicron variant in the community,
due to the lives saved during the initial phase of the
pandemic in 2020 Aotearoa New Zealand is almost unique in
having no excess mortality over the last three
years.’
Dr Wilson says the pandemic affected rates
of immunisation of babies, particularly Māori and Pacific
infants, and babies in families living in poverty. Cancer
screening coverage has been affected, emergency departments
are experiencing greater pressure, and access to and numbers
of planned care procedures are down. However, the report
singles out cancer care as having been less disrupted than
in many comparable countries.
The report also examines
the effects of the pandemic on people’s mental health
along the life course, and effects on our health care
workforce. A dedicated chapter examines the experience of
primary care for disabled people, and changes in the number
and type of complaints to the Health and Disability
Commissioner.
Our experience of and response to the
pandemic was different and more successful than most other
countries.
‘We were able to keep COVID-19 out of the
country long enough to vaccinate strongly and save many
lives,’ says Dr Wilson.
‘However, the arrival of
the Omicron variant exposed long-standing, fundamental
weaknesses in our health system, the first being the
long-standing mismatch between the demand for health
services and the ability to meet that demand.
‘The
second weakness exposed was the entrenched inequities in
health status, health care quality and outcome experienced
by Māori, Pacific and disabled peoples.’
Dr Wilson
says the mismatch between demand and supply led to a focus
on finding different ways to do more for less, which meant
our system had less in-built resilience and capacity to
adapt to crisis.
‘In a nutshell, there was little
slack in the system to cope with external
shocks.’
Looking ahead, appropriate funding of
health services must be balanced with a focus on efficiency
and equity.
‘Insufficient resources in one part of
the system can create waste in others, as patient flow
through the system breaks down. A wider system view is
needed to avoid this.’
Dr Wilson says the power of
local communities, which worked so successfully in Pacific
and Māori responses to lockdowns, vaccination and wider
need in the community highlighted a unique opportunity for
this country.
‘Opportunities exist in system-wide
quality improvement approaches that combine established
methodologies of collaboration and measurement for
improvement with the strengths of consumers and local
communities,’ she says.
Childhood immunisation,
acute care and planned care have been powerfully affected by
the pandemic and could benefit from an approach which
includes collaborative expertise, local freedom and strong,
innovative measurement, Dr Wilson says.
Read the full
report here. https://www.hqsc.govt.nz/resources/resource-library/a-window-on-quality-2022-part-2-whakarapopototanga-matua-he-tirohanga-kounga-2021-wahanga-2
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