Making the Right Investments

Many of you will remember that just before Christmas last year, we decided not to proceed with the redevelopment of the Manukau Health Park as originally envisaged in our Clinical Services Plan. We reached this decision after re-evaluating our options and considering whether making such a significant investment to build the ‘Sylvia Park’ of healthcare would really deliver the kind of change that we need to see.

The conclusions we came to were clear. Redeveloping the Manukau Health Park in the way we had hoped isn’t affordable and won’t deliver the right solutions for the challenges we will face going forward.

We do know we have to revitalise our Mental Health, Health of Older People and Rehabilitation facilities. We also need to expand outpatient and elective surgery capacity. Those needs haven’t changed but the way in which we meet them has to be different. Rather than just replacing buildings, we need to think about what the right models of care are to deliver services in the best way.

To help identify our investment priorities going forward we have instead been consulting with clinicians, both inside and outside the hospital. They pointed out that our highest investment priority should be information and communication technology (ICT) because a modern healthcare system needs to be well connected to function efficiently and effectively. Some years ago we were leaders in this area but rightly had to prioritize rebuilding Middlemore Hospital. Now we need to focus on getting that leading edge back, making ICT more of a priority and integrating our information at the same time as we integrate our services.

Clinicians have also been fundamental in helping identify other investment priorities. At a recent Executive Leadership Team meeting, we reviewed a paper from our Deputy Chief Medical Officer and Clinical Director, Surgical & Ambulatory Care, Dr Wilbur Farmilo, which presented clinical recommendations on our priorities for the next five years as:

  1. ICT
  2. Acute Mental Health
  3. Radiology
  4. Outpatients in Localities
  5. Rehabilitation, Health of Older People and Spinal services
  6. Outpatients at Manukau SuperClinic
  7. Elective Surgery
  8. Laboratory
  9. Women’s HealthBuilding, Middlemore

These still need to be formally ratified by our Board but were considered informally at its meeting last week.

We now have to think through innovative ways of financing any future capital developments and service growth. Partly because of the Canterbury rebuild, there’s very limited capital available for the health sector and that is likely to be the case for some time to come. But we can’t simply stand still in the meantime and wait for things to improve – we still need to revitalise key services and progress our strategies. A team led by Louise Zacest is driving this work and it has been renamed the Health System Integration Investment Programme to take the emphasis off the development of a particular site.

Speaking of system integration, we will soon be launching Phase Two of our 20,000 Days Campaign following the conclusion of what looks to be a very successful First Phase. In order to select the interventions for Phase Two, we had a bit of fun with a ‘Dragon’s Den’ style event. Before you view the video of this, I should point out that I really do talk about more than just the number of bed days and money saved (contrary to popular opinion)!

Finally, weight loss seems to be a recurrent theme on this blog as I endeavour to lose enough to fulfil my ambition of jumping out of a plane. Needless to say it’s still a work in progress for me, so it was with some envy that I watched my son, Owen, do precisely that for his 16th birthday last weekend. The only word he could say afterwards, and which I can repeat here, was “awesome”.

I look forward to talking to many of you at my ‘Coffee with the CEO’ event on Tuesday next week (May 14). All staff are welcome to drop in for morning tea with me in Room 106 in Ko Awatea between 10 – 11am. See you there.



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.

2 thoughts on “Making the Right Investments”

  1. Hi Gerraint – great to see ICT investment highlighted as an important focus area our ability to invest in this area is not only critical for enabling new models of care but also to curb the trend that our IS team is increasingly bogged down in patching and upgrading the myriad of aging systems rather than innovative new developments. Smarter ways to partner with suppliers at a more strategic level will be critical to this to support a long term holistic view to the objective rather than small fragmented innovation which continues to proliferate and multiply the number and complexity of the systems landscape we have in use.

    Loved the “Dragon’s Den” – proof that there is nothing wrong with a bit of fun while tackling these big challenges.

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