Reaping Returns on Long Term Investments

As we move into March, there’s a lot I want to acknowledge and celebrate with you today. I strongly agree with Einstein’s belief that “compound interest is the most powerful force in the universe”. What this means is that over time, high levels of performance build up into a huge bank of excellence that pays dividends in the long-term. It’s particularly important in health, especially at this time of year when we’re doing our financial planning, to ensure we make the best use of the resources available in order to bring about the greatest returns in the long run. Today I want to share some wonderful examples with you where we’ve done just that, and are beginning to reap returns in the form of improved health outcomes for our community.

Firstly, I was pleased this week to read a recent media release from Statistics New Zealand which identified that New Zealand’s number of infant deaths (under one year of age) and infant mortality rate (deaths per 1000 live births) both dropped last year. In fact, the infant mortality rate in 2012 was the lowest ever recorded. What was most heartening for me, however, was the line that read: “the lower infant mortality was due to a decrease in the number of Maaori infants dying” and the acknowledgement that the mortality rate for Maaori infants dropped from 7 deaths per 1000 live births in 2011 to 4.7 in 2012. The same downward trend was true of Maaori neonatal mortality rates (infants under four weeks old) and Maaori post-neonatal mortality rates (infants aged four weeks and over) when compared with 2011.

The death of any infant is a tragedy and without question, we need to further improve these statistics. We also have to treat yearly fluctuations with caution in favour of longer-term trends (New Zealand’s infant mortality has dropped from 28.4 in 1952 to 4.2 last year). Even so, this progress in the right direction is welcome news. Given that so many Maaori births are in Counties Manukau, we play a significant role in the improvement of these statistics. In fact, we’ve recently taken steps to review our Maternity Services in order to improve the health of our mothers and babies. In light of that review and our ongoing efforts to improve our services, I just want to acknowledge our staff who are working hard to change these key indicators which for so long were considered very difficult to shift. You are making a difference.

I also want to mention the national health targets and CM Health’s Quarter 2 performance. Yet again we have maintained our record as one of the highest-performing district health boards in the country, regardless of size. It’s great to so clearly see our progress in a number of key areas – shorter waiting times in the Emergency Department and improved immunisation rates are undoubtedly positive things. But I think the real story of the targets is the fact that we’ve maintained our high level of performance, not just over the last quarter but over the last few years. Again, we’ve demonstrated the value of sustained high performance and its ability to improve our patients’ lives.

This brings to mind a recent meeting I had with Sir Stephen Tindall of the Tindall Foundation, which has for some time helped finance activities to grow our own Maaori and Pacific workforces. This includes our Health Science Academies, which encourage students to pursue health as a career. We were reflecting that after just three years of Academies in three local schools, there will be approximately 160 aspiring healthcare professionals involved in tertiary education where previously there would have been none. The small cost of the intervention ($4000 per head) will likely have a huge return over these students’ lifetimes in terms of shaping, and helping them realise, their dreams as well as enabling them to enjoy a professional career, with all the benefits that will bring to them and their families. It also sets a clear precedent, not only that it can be done but it is being done in places where we previously thought it would be extremely hard or even impossible. I think it’s the ultimate example of the powerful force of compound interest.

Over the last few years, I’ve blogged occasionally about going green and our work around environmental sustainability. It’s all come together this week, with CM Health receiving its CEMARS (Certified Emissions Measurement and Reduction Scheme) accreditation at Ko Awatea on Wednesday night. This means that we’ve measured the carbon footprint of MMH and MSC, and committed to reduce our emissions in order to lessen our organisation’s environmental impact. Congratulations to the Environmental Sustainability team on achieving this milestone. I’m looking forward to seeing the long-term benefits of this initiative. 

Finally, you may also have heard about CM Health’s work leading the national Target CLAB Zero initiative to eradicate CLAB from New Zealand hospitals. If you haven’t already read it, check out this article from New Zealand Doctor, which showcases the improvements we are seeing as a result of our high performance in this area.

On a personal note, I’m pleased to report that I had an absolutely wonderful wedding in the weekend and I will fondly remember the day, which my wife and I enjoyed in the company of close friends, for some time. I did, however, spend the first day of my ‘honeymoon’ packing to move house, proving that being a CEO isn’t all glory and glamour!



Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

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