Whole team crucial to healthy success

01:18, Feb 04 2014

It takes more than doctors and nurses to make a health system work, writes Jenny Black

I often get asked: "Why all the bureaucracy - all the managers? Why can't we have more people on the front line to reduce the waiting lists of both surgery and outpatients - we just want to be seen and get treatment."

So who are the staff behind the district health board's doors?

Everyone knows there are doctors, nurses, physiotherapists, midwives, occupational therapists, dietitians and many other health professionals. We can't do without them. They are highly trained and their skills are needed to help people to return home and live healthy, independent lives.

But they need to be supported by others.

I see the health workforce as a bit like the All Blacks - the high profile lot who score the points, get the kudos (wedding photos in the women's magazines, big contracts).


Then there are the not so high profile but just as talented bunch, who do all the engine work to make things happen. These are followed by the bench - needed in emergencies, but not every day. Then there are people with management skills - people to organise, sort the funding and look after the team.

At the Nelson Marlborough DHB we have to work as a team, otherwise everyone would go round in circles. The number of clinically trained staff - doctors, nurses, allied health workers - is about 70 per cent of the total 1853 full-time equivalents.

The other 30 per cent are made up of about half support staff and half management and administration, all of whom are dedicated to help produce the results of helping people return to good health.

One group of people deserves special mention - the hospital food service workers, laundry workers, orderlies, cleaners, housekeeping staff, and the community care workers. They are all generally on lower wages but each has a role to play in making the patient or client more comfortable.

The work this group does, often with the community's most vulnerable people, makes life better for everyone.

This group doesn't always get the accolades it deserves. Next time you run into one of these workers, smile and say thanks.

And, yes, there are managers who are professionally trained in their special fields - finance, human resources, business analysts, health planners - we wouldn't want our clinical staff doing those things instead of what they are trained to do. We need to manage this large organisation - 2400 people, $420 million, two hospitals and 200-plus other contracted providers to help achieve our goals.

While I agree that too many managers create unnecessary bureaucracy and inefficiency, without enough of them gaps in the health system soon begin to show.

We may not understand all of the intricacies of every management position, but we rely on the managers to make sure we meet our commitments under the many acts, regulations, policies, procedures and guidelines that are there to keep patients and staff safe while delivering quality health services.

I don't think any of us want to reduce the quality of care or reduce the safeguards for patient and staff safety.

I'm sure Richie McCaw and Dan Carter would agree - they can't get the results on their own. They need the whole team working together to get the results. Our DHB is no different.

Jenny Black is the chairwoman of the Nelson Marlborough District Health Board.

The Marlborough Express