I went to hear him speak in Wellington, drawn perhaps to a heretic because heresy usually has the most profound observations.
Decades ago, Rob Campbell was the darling of the left, a charismatic unionist with the intellect to take apart the establishment. From unions, he became a champion of an economy in which markets are made to work for the people.
It is revealing what people do when their leadership jobs end.
Jacinda Ardern signed up with the Speaker Booking Agency for ‘’paid corporate appearances only’’. She is heading overseas to front the Christchurch Call and the Windsors’ royal environment awards. Not child poverty and affordable housing then.
On leaving, she said that ‘’Government isn’t just what you do, it’s how you make people feel’’.
I am sure Health Minister Ayesha Verrall wishes Campbell would take up international speaking gigs.
Unfortunately for her, he is prepared to keep making her feel bad: Public sector leadership is failing, unaccountable, self-serving and needs to change, he says.
He is aware that he echoes National's critique of the new health entity: It's too centralised, lacks clear definition and does little to improve frontline services.
But those of us who actually believe in public service and want the public health system to work should be the strongest advocates for making it efficient and effective. When we leave it to the opponents of public service to point out its failings, we leave a false choice between a private model and a failing public one.
Campbell’s critique of Te Whatu Ora starts by pointing out that the problem to which it is the solution is ill-defined. Yet problems in health are obvious: There is a chronic lack of GPs, hospital doctors and nurses, waiting lists are long, there is unequal provision of services to Māori and Pasifika.
If you had a $1 billion to spend, what would you do? Probably not start with a restructure of the district health boards.
The designers of Te Whatu Ora consulted only superficially, if at all, with health workers, unions, local communities, GPs and iwi clinics. Campbell talked to a Māori health provider who told him to ‘’stop calling us ‘hard-to-reach’ communities. We're not hard to reach. You blokes in Wellington are."
The Government has also failed with everything, everywhere, all at once, not just with Te Whatu Ora but with the mergers of TVNZ-RNZ and the polytechs.
In those cases it should have simply merged the boards, given them clear objectives then left them to make decisions. Instead, these top-down models driven by consultants fail.
We have failed to learn the lesson of Covid, which is that Wellington is really good at designing a vaccine rollout that works for public servants in Karori but is not so good at getting it right for Māori and Pacific communities outside Wellington.
Campbell wanted to upskill the Māori immunisation workforce, give them permanent jobs to keep delivering services to their communities. Instead they are being paid out.
Calling the new Māori health authority Te Aka Whai Ora does not change that it is still the Crown. If officials go to a community on the East Coast and tell them to stop smoking they will meet resistance. If that community decides health priorities for itself, it will probably target smoking and target effective ways to deliver the message.
In the late 1990s, another former union leader and heretic became the UK's Secretary of Health. Labour's Alan Milburn realised that the health sector was too big to manage from the top, and so you had to give those responsible for running services autonomy and devolve decision-making to them.
He also realised that you should start with health needs, not who owns the building. He let the private sector invest in bricks and mortar, while taxpayers funded delivery and paid doctors and nurses. His ‘’foundation hospitals’’ were built in response to health needs, instead of starting with the buildings and then figuring out what services could be offered in them.
Alan Milburn, like Campbell, comes from the firebrand end of Labour that believes your job is not to make people feel good, but to do good.
Verrall refused to say this week that health is in a ‘’crisis’’. It's ‘’under pressure’’, she said.
The word ‘’crisis’’ has Greek origins, from a verb meaning to ‘’decide’’, and was first used in medicine. It was that decisive moment in an illness that determined whether a patient lived or died. The assumption behind the word was hopeful, that an action could be taken to save a life. Or not.
Health workers are telling us the system is in crisis....The full article is published HERE
Josie Pagani is a commentator on current affairs and a regular contributor to Stuff. She works in geopolitics, aid and development, and governance.
On leaving, she said that ‘’Government isn’t just what you do, it’s how you make people feel’’.
I am sure Health Minister Ayesha Verrall wishes Campbell would take up international speaking gigs.
Unfortunately for her, he is prepared to keep making her feel bad: Public sector leadership is failing, unaccountable, self-serving and needs to change, he says.
He is aware that he echoes National's critique of the new health entity: It's too centralised, lacks clear definition and does little to improve frontline services.
But those of us who actually believe in public service and want the public health system to work should be the strongest advocates for making it efficient and effective. When we leave it to the opponents of public service to point out its failings, we leave a false choice between a private model and a failing public one.
Campbell’s critique of Te Whatu Ora starts by pointing out that the problem to which it is the solution is ill-defined. Yet problems in health are obvious: There is a chronic lack of GPs, hospital doctors and nurses, waiting lists are long, there is unequal provision of services to Māori and Pasifika.
If you had a $1 billion to spend, what would you do? Probably not start with a restructure of the district health boards.
The designers of Te Whatu Ora consulted only superficially, if at all, with health workers, unions, local communities, GPs and iwi clinics. Campbell talked to a Māori health provider who told him to ‘’stop calling us ‘hard-to-reach’ communities. We're not hard to reach. You blokes in Wellington are."
The Government has also failed with everything, everywhere, all at once, not just with Te Whatu Ora but with the mergers of TVNZ-RNZ and the polytechs.
In those cases it should have simply merged the boards, given them clear objectives then left them to make decisions. Instead, these top-down models driven by consultants fail.
We have failed to learn the lesson of Covid, which is that Wellington is really good at designing a vaccine rollout that works for public servants in Karori but is not so good at getting it right for Māori and Pacific communities outside Wellington.
Campbell wanted to upskill the Māori immunisation workforce, give them permanent jobs to keep delivering services to their communities. Instead they are being paid out.
Calling the new Māori health authority Te Aka Whai Ora does not change that it is still the Crown. If officials go to a community on the East Coast and tell them to stop smoking they will meet resistance. If that community decides health priorities for itself, it will probably target smoking and target effective ways to deliver the message.
In the late 1990s, another former union leader and heretic became the UK's Secretary of Health. Labour's Alan Milburn realised that the health sector was too big to manage from the top, and so you had to give those responsible for running services autonomy and devolve decision-making to them.
He also realised that you should start with health needs, not who owns the building. He let the private sector invest in bricks and mortar, while taxpayers funded delivery and paid doctors and nurses. His ‘’foundation hospitals’’ were built in response to health needs, instead of starting with the buildings and then figuring out what services could be offered in them.
Alan Milburn, like Campbell, comes from the firebrand end of Labour that believes your job is not to make people feel good, but to do good.
Verrall refused to say this week that health is in a ‘’crisis’’. It's ‘’under pressure’’, she said.
The word ‘’crisis’’ has Greek origins, from a verb meaning to ‘’decide’’, and was first used in medicine. It was that decisive moment in an illness that determined whether a patient lived or died. The assumption behind the word was hopeful, that an action could be taken to save a life. Or not.
Health workers are telling us the system is in crisis....The full article is published HERE
Josie Pagani is a commentator on current affairs and a regular contributor to Stuff. She works in geopolitics, aid and development, and governance.
2 comments:
It wasn't that broken but now it wrecked.
Lets face it, our country is in a crisis.
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