“My role is to ensure you continue as best as you can as an organisation called Health Care Aotearoa in a much easier way than you are currently facing,” Jon said.

“We have family health care centres, better sooner more convenient, business cases, clinical leadership. What do these all mean to us as an organisation.”

“Look at the PHO collectives we had 80-90 at one stage we are down to about 32 – let’s hope that’s enough for the time being.”

Current Situation

“We are working through a period of regrouping or re-establishment. We currently have 37 member organisations, 20 are corporate members. We have 68 providers currently on the Te Wana programme.

“We have numerous providers holding social service contracts and we have six youth specific services who are either members of HCA or Te Wana.”

“We recently signed a memorandum of understanding with Community Housing Aotearoa to put their 170 members through the Te Wana programme. We are continuing to have positive and constructive conversations with TPK to put their 25 Whanau ora collectives through Te Wana. It’s all great potential for growth.”

“We have a current contract with the Ministry of Health that has two elements to it – implementing Te Wana and PHO development. We only have three PHOs with HCA at this time so the PHO development part of the contract is likely to go. But we are working with the Ministry to look at other ways to provide value in terms of the direction that they are taking. For example the youth sector, one stop shops and the unregulated workforce.

“There are opportunities for growth through Te Wana, through supporting Youth Services, Alliancing and collectives, and high performing providers.

“We are not fully reliant on government. We are 60% autonomous – a good position to be in. Like Don said yesterday for the bulk of it we’ve got to be our own people and understand what we are about as an organisation and we have to be clear on that.”

Changes needed

Feedback from cluster hui held in Auckland, Christchurch showed the key things that members value is advocacy. “You know the decisions are being made in Wellington you say you need representation there at the highest level.”

“You said you value being part of a national movement, sharing ideas, and being kept in touch with what’s happening across the nation,” he said

Download a pdf copy of the minutes from the Cluster Hui summary

“We need to consider opening up our membership, to change the constitution to reflect more than just the primary health care side of things and to make it quicker to sign up new members.”

“Possible solutions are to form our own National PHO or Management Services Organisations. But we need buy in from you to that.”

Workshop questions and feedback

Jon posed the following questions to the members to discuss in workshops:

1. Do we want to continue as a national organisation?
2. Do we accept constitutional change will benefit HCA?
3. Which fee structure will work best for members?
4. Alliancing – would we be best forming our own formal alliance body e.g. National Primary Health Organisation or Managed Service Organisation.

Workshop groups agreed unanimously that HCA should continue. They endorsed changes to the constitution to widen it up to social sector providers. Feedback around the fee structure was also positive. Participants said they liked the way it was itemised so they knew exactly what they were getting.

They also agreed to investigate the establishment of a National PHO or MSO.

The AGM agreed to:

• change the constitution to reflect the expansion of membership to include community social service agencies alongside primary health services,

• a new fee structure that itemises what they get for their membership ie as corporate, associate and affiliate members, and

• investigate establishing as a national body.

“The feedback from our members is that Health Care Aotearoa is needed now more than ever before. They value HCA advocating for them and, being part of a national movement that shares ideas and keeps in touch regularly,” says Jon Royal HCA Chief Executive officer.

“With swift changes in the Health sector we need to support our organisations that are servicing the vulnerable populations. PHO’s are being pushed into new alliances our members are asking where do we fit where is our protection. We’ve built our reputation on building and supporting these services we have got to continue to do that.”

“We are investigating establishment of our National body that is going to best fit our needs. If we are talking about vulnerable people it’s not only in the health field. A lot of our organisations hold integrated contracts its about us adjusting to meet that. Addressing the social determinants of health is becoming a reality for our organisations.”

“There were concerns around what members were getting for their fees it was confusing. So we’ve provided a clear new fee structure. As part of that we have moved away from a health income focus to Full Time Equivalent staff (FTE) to allow the social sector to fit in to the structure as well,” Jon said.

The AGM also appointed a new Chair Muriel Robson and welcomed a new board member Justine Thorpe who was voted on from its Tauiwi caucus.

• Don Matheson Massey University Professor and founding HCA member reminded attendees to keep advocating for health equity. “HCA has always played an integral role in developing tactics on how primary health care can better serve vulnerable populations. It was a struggle and we were not popular but equity is about advocacy and perseverance.”   Read more

• Trevor McGlinchey New Zealand Council of Christian Social Services (NZCSS) Executive Officer spoke about ways to frame messages in a way that the decision makers can hear them. They work towards a more just and compassionate society in New Zealand with a special focus on those poor and vulnerable New Zealanders.  Read more

• Dr Annie Judkins Newton Union Health Service - spoke about a collaborative community model for dealing with child eczema and understanding and diagnosing rickets within migrant communities. By assembling a multi-disciplinary team with mutual respect for each other roles and a truly family-centred focus they were able to deliver ways to meet their communities’ needs.  Download a PDF copy of her presentation.

• Justine Thorpe Well Health Trust Chief Executive Officer - shared her perspective of the challenges and wins associated with two health organisations merging. Read more.

• Jon Royal Chief Executive Officer Health Care Aotearoa – spoke about the need to enhance HCA work to support and provide added value to its members.   Read more.

Other workshop presenters included:

Shona Johnson a whanau ora kaimahi gave a moving presentation about the journey she took to get one family the care they needed. She showed how a provider centric system of care led her family on a convoluted pathway, both complex and gated. However through the perseverance of her organisation Te Kotuku Hauora o Rangitikei (a Maori primary health and social service provider) and a focus on the whole family they were able to navigate the systems of care and get this family the support they needed.

Ara Swanney gave participants the chance to reflect on their work, identify strengths, clarify goals and identify obstacles. “We all work in the health sector but often forget to look after our own health.”

Sha Panapa explained the importance of getting more Maori nurses in the primary healthcare sector. The Bachelor of Nursing, Maori at Whitireia programme was established in 2009 with the first wave of nurses due to graduate next year. Go to the Whitireia website to read more.

Lisa Ngaia shared how they were able to redevelop the HCA website on a shoe string budget. The aim of the redevelopment was to get a website that was easy to understand, and could be updated and maintained in-house. “The fastest way to learn about the health of an organisation is to visit its website. IT development is increasingly becoming a business requirement to manage information expediently and appropriately.

Tania Forrest spoke about the outcomes of a report on the role of the Community Health Worker in a Maori person’s health journey. It was part of an internationally sponsored research project ‘Revitalising Health for All’. The report found that there is a huge demand for community health workers by Maori whānau. The report found that they were able to relate with the health worker and through that were able to access other parts of the health and social sectors, get transport and help with complicated health information.  They make up 50% of the Maori provider workforce without them Maori providers would be compromised. Download a summary of the Community Health Worker report.

Ian Johnson’s time management software solution workshop had the highest attendance, highlighting the need many providers place on good time management and helpful tools to generate efficiency.

The hui concluded with HCA’s AGM. Read more about the AGM

View the photos from the hui.

The Health Ministry’s drive to reduce the number of PHOs in New Zealand in 2009 has seen them fall from 80 to 32. $25 million dollars of primary health care funding was reconfigured so frontline health services could improve. The success of the PHOs downsizing (PHOmosis) can be measured on a number of levels: financial savings, health targets, and last but not least – health outcomes.

HCA’s national hui was just the forum to hear a provider perspective of their journey along the bumpy road to effective Primary health care.  Well Health Trust Chief Executive Justine Thorpe shared the drivers, lessons and what to look for when you are working in the business of health. While taking into account the values of: social justice, community leadership and accessible models of health care for the vulnerable.

South East City PHO and Porirua Plus were small PHOs (with a registered population of under 20,000 independently or even as a merged PHO). Whilst they were small and committed to serving their community populations the two PHOs had distinctly different ways of working and supporting their communities. A quick merger (approximately 6 weeks) has presented a number of lessons and victories for the new Well Health Trust…

Kaupapa

“One of the victories is that our members didn’t get subsumed into something that wasn’t aligned. We have increased our diversity. Through ethically managed community-based engagement and innovation we continue to make a difference to our vulnerable communities.”

Values alignment and collective support is a sustainable platform for staying alive in an increasingly difficult environment. The values and our kaupapa is what sustains and builds our relationships.

Representation at the decision making table

Justine was HCA’s representative on the PHO Service Agreement Protocol (PSAAP) group. “PSAAP is the national contract negotiation point for the national PHO agreement.”

Although small in representation the voice for the vulnerable was at the table where it counted.  Justine says her role on PSAAP was strengthened by her HCA involvement. Through HCA she was able to network with HCAs other PHOs over email. She says it boosted her confidence and more importantly it gave her the mandate to represent HCAs kaupapa at a national level.

Change management

“Investigating change management concepts and reflecting on experience is extremely important when making change. “SECPHO and Porirua Plus were already working well. But we had to merge and do it quickly over about a six week period”. There were implications…

‘Change management should be about allowing it to happen not forcing it. But if we wanted to be standing at the end we had to do it quickly.” We got stuck a bit during the ‘ storming stage’ of Bruce Tuckman’s model of group development – ‘but our previous relationship held us together.”

‘Each of us had different ways of doing things and we both had to re-think and re-work everything including the governance and control’.

Relationships

“Through the PSSAP process we got HCA got the group to reconsider and acknowledge the importance of relationships in a process where merging or collaboration is required. You really have to let relationships grow and develop before you start making these changes”

“We got agreement to allow the PHOs time to consider their future and consult with their community. The outcome is that Capital and Coast DHB now has four from seven PHOs noting that one PHO now spans across two DHBs.”

Key relationships have been woven throughout the change process, relationships with DHB stakeholders was pivotal “It reflects the value that the DHB has placed on the role of community-led primary health care and is a credit to them,’ Justine said.

• NZ history of health equity
• Recent negative trends
• Global issues and
• Looking forward

Health equity

Health equity is the difference between populations that are unfair and unjust. “Those differences don’t have to be there, we as a society have made choices that allowed those differences to be there and we can decide that they go away.”

“HCA has always played an integral role in developing tactics on how primary health care can better serve vulnerable populations. It’s a struggle and we were not popular but equity is about advocacy and perseverance.”

In our own history he reminded us of those who have made a difference to health equity like Sir Peter Buck – Te Rangi Hiroa and Maui Pomare who turned around Maori life expectancy early last centrury. Then there was Lord Nordmyer’s and McMillian’s struggle to introduce a national health service based on their work in a small hydroelectric dam township in North Otago. Known as the Kurow cure, their idea was to provide free health care, with a focus on prevention and involving the people that it’s about. Their idea was attacked as creeping socialism and was resisted by the medical for a few decades.

He showed how life expectancy trends for Maori improved up until the 1980’s where it plateaus for around a decade. He explained this was not only due to health sector issues but also economic changes, the rise in unemployment and a drop in benefits.

View the life expectancy graph.

“In society we made these adjustments and the people that paid the price where those at the bottom who often paid with their lives.”

HCA appears around 1994 and things start to improve again.

HCA prospered and played an important role in developing an idea on how primary health care could happen and the life expectancy figures began to improve again.

He says in the past three years the health system has not been performing well and we are again at a time of crisis.

But for a moment we saw it was possible. “We thought maybe we can do it, we know we can do it, don’t forget that we can do it.”

“One of the reasons is we’ve stopped discussing the importance of equity.”

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Recent negative trends

Recent trends show there is a mismatch between what people need and the services that they are getting. Those high needs groups are in contact with their PHO less often than the non-high needs group. Even if it were the same it wouldn’t do it. You need 10-20 many times more services for the people who need it to make a difference.

“These statistic are a telling story of the inverse care law – the relationship between need and services and how that is mismatched.

View the high vs non-high need contact graph.

Ambulatory Sensitive Hospitalisation ASH figures are an important indicator because they show that people are not getting access to primary care when they need it. Unfortunately they have been removed as a government target and they were a proven way to measure inequity. Latest ASH figures show the gap between rich and poor is widening again and since 2009 statistics have worsened for Maori and Pacific people.

View the ASH figures graph for 2009 – 2011.

HCA must continue to hold true to its kaupapa to continually challenge the unfair and unjustifiable difference in health between groups of people in New Zealand.

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Global issues

NZ is also dropping down the ranks in international equity ratings. When we compare ourselves with countries like UK, USA, Australia, Canada, Germany, and the Netherlands we are not doing well especially in terms of equity. Overall we are ranked only 5th, just ahead of the USA and Canada who both have poor health systems.

View the Commonwealth fund graph.

Globally the issue of equity is increasingly been seen as something that a system should aspire to.

We are beginning to question the ‘greed is good’ ideologies. Life expectancy in rich countriues is no longer related to the average national income per head. Economic growth or GDP per capital only has an impact on your life expectancy up to a point.

Statistics show that in a fairer society you have fewer social and health problems, like life expectancy, math and literacy, homicides, imprisonment, teenage births, trust, obesity, mental illness and social mobility. Its not a smart way to run a modern society.

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Looking forward

“HCA should have faith in its own models of care and your own ways of doing things, its extremely important. Keep true to your own kaupapa difficult though that is. Particularly the relationship with communities the bicultural nature and seeing the communities as part of and not separate from you.”

“Don’t confuse the ‘e’ words – equity with efficiency. We must be efficient at addressing inequity.”

We need to explore new alliances. New Zealand Medical Association has come out with a statement on equity and The New Zealand Council of Christian Social Services is doing great work framing the inequality debate.

The global financial crisis is helping us to reassess the meaning of life the future is up for grabs. We need to replace GDP as the main indicator of societal progress.

“Worldwide there is a growing feeling that the systems are getting less fair. Some are doing well and other aren’t. Giving communities the voice for that is important.”

View the income inequality graph.

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• understanding and working with a national led government,
• a more equal society, and
• what’s coming up for the vulnerable.

Understanding a national government

Trevor says the five years in his role has been a real learning curve. “You think that if you go and tell people that the evidence and practice shows a certain approach will make a difference, then the decision makers will listen, but we have learnt that’s not the case.

He says they have had to work out how they can have a conversation. “We have been lucky because our mainstream Christian leaders give us an opportunity to get in to talk to the leaders and continue that conversation.

“This government talks about themselves as compassionate conservatives and they sincerely believe that in a market driven economy the poor people will be better off.

“They talk about Big society – smaller government. which means paying less taxes – less taxes means a better market place.”

Both NZCSS and HCA members can see how this system hasn’t worked for the most vulnerable. If we have a system that is about empowering people to be better off and more included in our society then they will be. But if you have a system based on profit and the most growth, that system will keep people down.

We need to challenge some of those ideologies that keep getting framed as mainstream like “people are on benefits because they don’t want to work,” or “there are plenty of jobs if you have the right attitude”, “if you don’t have lower taxes for companies and people on higher incomes they are all gonna jump over the ditch”, “private companies always do a better job than the government”, “Market forces will give everyone the best result”.

Centre New Zealand believes this stuff and it influences how they vote. We need to get them to question this and become more informed.

“There is no proof that these things are true but because its framed this we way and we absolutely believe it, everything its about making that thing happen. It’s not always a rational decision.”

A more equal society

What we’ve done is create a country from one of the most equal about 20 years ago, the Egalitarian society to now, one of the world leaders in income inequality.

“In countries where there is a lot inequality everyone gets hurt, we are less healthy, there are more social problems, our children get hurt the hardest, and the impact on Maori is huge.”

“The good news is if you look overseas at the more equal countries they are working together better. It’s better for everyone if the difference between highest and lowest is fair. Reduced inequality helps reduce health problems, mental illness, obseity, high imprison rates. Our kids are the first to benefit. Once you start bringing the bottom up, things for those 250,000 kids in poverty starts to improve.”

“We actually can do something about it. Sometimes we think we can’t but we can. We are asking

how do we bring people together? We want a healthier, happier, more productive and greener society where we are all better off. We are asking people to choose to build a fairer society where the income gap between rich and poor is closer together not further apart.”

He encouraged the hui to get behind the Closer together – Whakatata mai and check out the website http://www.closertogether.org.nz which is packed full of information and a call to action.

“We are gathering names to support this kaupapa and if we can get enough supporting, when the pollsters and focus groups ring up we want people to be saying well actually I think we should be closer together

“I’m asking you to be a champion for income inequality. The website is packed full of information and you can tick the take action button. We’ve written to all leaders of political parties. After the election we will continue to focus on this and continue to look at managing the impact of welfare reform.

“This particular government is interested in what the punters on talk back radio are saying they like to fly a flag before they do anything in policy to wait and see what kind of reaction they will get before they go ahead.”

Next time the polsters and focus groups ring up we want people to be saying well actually I think we should be have less income inequality we should be closer together. 

What’s coming up for the vulnerable

The welfare reforms are going to make it harder to get a benefit. But fewer people will seek one not because more people have got jobs. The welfare reforms are going to create greater pressure on charities. This is a real threat that we need to be aware of and we need to be thinking about what we do together. What is the information we need to gather to speak back into this conversation. What is the impact of this on our communities?

There will be stronger work tests and harder sanctions like:

• sickness beneficiaries assessed for work of 15-30 hours a week.
• sole parents to return to part time work after youngest child is six and back to full time work once they are 14
• reapplying for your benefits after 12 years

They talk about future focus but we have over 177,000 children in poverty in benefit dependent families, and another 50,000 in poverty in working families. If we focus on their health and education our whole communities will be better off in the future.

The government is saying their will be more child care or OSCAR programmes but will the supports be in place before the law reforms come in.

The trade union movement had set up similar services in Newtown in 1987 and Porirua in 1990but met resistance from local GPs in moving the concept to the Hutt Valley.

Jim Kebbell, who was employed by the unions to set up a Hutt Valley service, said it would neverhave got off the ground if it wasn’t for the determination of the Pomare andPetone communities and the support of then-mayor Glen Evans and the new Area Health Board primary health manager Warwick Frater. ‘‘The Hutt Council, under Glen Evans, was hugely supportive of community development initiatives and combined with a local health authority that was putting a greater emphasis on primary health care, it was all good for our initiative.

‘‘Warwick Frater and Jan Ewart seconded a public health worker to do the demographic work, the Service Workers Union surveyed its membership in Petone and Pomare and within a short period of time we had a proposal for a new primary health service,’’ Mr Kebbell said. The service started in the Pomare Community House in September 1991 with a full time nurse, Iunita Vaofusi, a part-time GP, David Bailey, and a part-time manager, Peter Glensor. Mrs Vaofusi remembers the first months of the service trying to see new patients at the same time as other activities were occurring in the community house. ‘‘The set up of our service was totally different to what I had experienced in the children’s ward at Hutt Hospital. We didn’t wear uniforms and we had very few resources but we welcomed heaps of low-income families that had a desperate need for our services,’’she said.

Many of the people who first enrolled at HUCHS had no regular GP because they could not afford the charges. ‘‘David Bailey and I worked very hard to set up quality systems and protocols that we followed in regard to diagnosis and treatment, but also heavily emphasised patient involvement in their own health care,’’ Mrs Vaofusi said. She was also impressed with the ‘‘nurse practitioner’’ title she was given, ten years before the Nursing Council reserved it for nurses with high academic qualifications. ‘‘The philosophy of our service was the respect for the independent role of the primary healthcare nurse as an equal partner with the general practitioner.

This was a revolutionary change in status for nurses and one that I am proud of.’’ In early 1992 HUCHS opened up a second centre as part of the Te Huinga o te Whanau building at the eastern end of Petone’s Jackson St, with GP Mary Basire and nurse Siloma Masina headingthe health care team. Part of this primary health team, for the first time in the Hutt Valley, was a community worker funded through a COGS grant. Muriel Tunoho worked with HUCHS’ Petone patients to build up local support networks and organise around patient issues. The HUCHS maternity team started in 1993, staffed initially by two midwives. They were doing shared care with the GPs, but even after the GPs stopped doing births the midwives would meet weekly with the doctors, nurses and community health worker to share information and plan care for the women and families they were supporting.

Sally Nicholl, currently the HUCHS manager, but previously a HUCHS midwife, said that the HUCHS maternity team was at the centre of the community development work. ‘‘We worked as a team, visited our women in their homes and involved them in the weekly antenatal classes, the annual mother/babies Christmas parties and in other activities that were occurring in our service.’’ HUCHS has not been immune to funding cutbacks and Government change of policy pressures. Mr Glensor said it was set up during the time of the then National Government’s attack on benefit levels and the introduction of the Employment Contracts Act, which devastated unions and cut wages for the lowest income earners. Later reductions in funding for the service meant that its subsidy for after-hours care was radically reduced and the closing of the maternity service occurred in 2009.

These moves were offset by the DHB finally accepting responsibility for late night after hours care, the construction of a new Pomare building housing an integrated family health service and innovative measures that combined hospital specialists working with the Pomare primary health team. HUCHS chairwoman Muriel Tunoho said their service had been created out of a need for low income people to have a health service that met their needs and was accessible to those who relied on the hospital Emergency Department for care. ‘‘Even though 20 years has passed our service is still trying tosupport good health for our patients despite the housing, employment and low-income issues that in many ways are worse than when we started [including the current battle over Pomare state houses].’’

Well its nearly Christmas and most (if not all) of us will be looking forward to grabbing a break from the rigours of work undertaken over the past year.

 It is clear from reports and general discussion that the HCA membership has been through a period of upheaval, and continues to face challenges particularly as changes are made to the health system at the highest level, which are impacting on members ability to deliver services, one way or the other.

 It is equally clear that Health Care Aotearoa is needed more so now than ever before, to ensure the focus on inequities is kept to the fore as these changes occur. Professor Don Matheson, in his speech to attendees at our recent national hui, urged HCA members to continue to hold true to the kaupapa because “unfortunately, equity is no longer on the agenda.”

 And when asked the question of you “do you want to continue as a national organisation” the answer was a resounding YES! This is heartening.

 What continues to be valued most by you all are; advocacy at the national level, collegiality and the opportunity to share experiences and, most importantly, regular communication and being privy to the latest information nationally and internationally.

 The ‘engine room’ will remain focused on these areas, and ensure we do everything within our limited resources to provide what is valued most by its members.  

 The next 6 months for Health Care Aotearoa will be a critical period as the elections are over and the government makes tracks to embed its policies over the next 3 years. One of the contracts we hold with the Ministry (i.e. PHO development) will definitely not continue and HCA is arguing a case to develop ‘high performing providers’ amongst our members. This will mean developing and implementing practices (e.g. Results Based Accountability) and behaviours that can show improved efficiencies as well as increased effectiveness. This aligns well with the whole HCA kaupapa and the type of support offered to the membership.

 The other component of our contract with the Ministry involves implementing the Te Wana quality programme.  There has been a significant amount of effort put into transforming the Te Wana Quality programme and strengthening it to better meet current and potential provider needs and expectations. This has meant working closely with our accreditation body QIC (Quality Improvement Council) based out of Australia. We are on track to be re-accredited as a licensed provider of the QIC programme, by March of 2012.    

 We should know over the next few weeks how the Ministry of Health sees HCA fitting into its programme. One of the big challenges facing HCA is that we are heavily reliant (at 41%) on government funding to survive. If we don’t get funded at that same level going forward, some reconfiguration will have to take place, as well as a concerted endeavour to grow both HCA membership and providers signing up to the Te Wana programme. Actually the team at HCA has already anticipated this and have been vigilantly promoting the benefits of HCA (including the Te Wana programme), and building relationships with potential stakeholders such as Te Puni Kokiri (with a particular focus on implementing Te Wana throughout its 25 Whanau Ora Collectives), Corrections, Community Housing Aotearoa, Te Ara Taiohi (youth focus) and National Hauora Coalition, to name a few. Recently agreed changes to the Constitution that opens up membership to other sectors, will enhance our ability to attract more members.

 Finally, can I say how much I enjoyed being a part of the national hui. Whilst the numbers were down, the passion and commitment to the HCA philosophy was very strong. I will be focused over the next 12 months to re-building old associations, engaging in new opportunities, and strengthening current relationships. And its now up to the ‘engine room’ to provide a sense of direction and ensure you are supported by HCA, respected by the funder and, more importantly, treasured by those populations the membership serves. I would consider this approach successful if over the next year:

• ·         The new funding level from the Ministry of Health does not drop lower than 20% of HCA current level
• ·         Our HCA membership has grown by 10%
• ·         Income from new providers on the Te Wana programme has increased by 15%, and
• ·         By September 2012, a minimum of 75% of membership are happy with the support provided to them by HCA ‘engine room.’

Heoi ano koutou ma, kia pai to koutou waa whakataa kei te heke mai. Ae hoki,  nga mihi mo te kirihimete me te tau hou.  Pai marire.

“Although it was a smaller gathering than previous years participants believed it was a very interesting and important opportunity to review our achievements to date, reconfirm the need for HCA to continue and discuss ways to refocus the organisation for growth,” said HCA Chief Executive Jon Royal.

Around 70 HCA members were inspired, moved to tears, entertained and informed by a wide range of speakers and MC Pahia Turia over the two-day long hui. It concluded with HCA’s AGM. Read more about the AGM

Speakers included:

• Don Matheson, Massey University Professor and founding HCA member – ‘Opening address’
• Trevor McGlinchey, New Zealand Council of Christian Social Services (NZCSS) Executive Officer ‘Support for vulnerable people and their communities’
• Dr Annie Judkins, Newton Union Health Service – ‘A model of care in child health’
• Justine Thorpe, Well Health Trust Chief Executive Officer – ‘A provider journey’
• Jon Royal, Chief Executive Officer Health Care Aotearoa – ‘A member driven Health Care Aotearoa’
• Shona Johnson, Whanauora kaimahi for Te Kotuku Hauora o Rangitikei ‘A person’s health journey’

Workshops presenters included:

• Ara Swanney, Well Health – ‘Community Health and Wellbeing’ – What about the workers?
• Sha Panapa, Whitireia Polytechnic – ‘Maori Workforce development’
• Lisa Ngaia, HCA – ‘Website development for non-profit organisations
• Tania Forrest, HCA  – ‘The role of the Community Health Worker in a Maori person’s health journey’
• Ian Johnson, Enfinit Software – ‘Time management software solutions’

Read a short exercept of their presentations/workshops below.

Don Matheson, reminded attendees to keep advocating for health equity. “HCA has always played an integral role in developing tactics on how primary health care can better serve vulnerable populations. It was a struggle and we were not popular but equity is about advocacy and perseverance.”Read more

Trevor McGlinchey spoke about ways to frame messages in a way that the decision makers can hear it. NZCCS vision is to work towards a more just and compassionate society in New Zealand with a special focus on those poor and vulnerable New Zealanders.Read more

Dr Annie Judkins speaking to a HCA member.

Dr Annie Judkins, shared her unrelenting enthusiasm and commitment to finding models of care that work for their clients. She spoke about a collaborative community model for dealing with child eczema and understanding and diagnosing rickets within migrant communities. She demonstrated the importance of community action and involvement in promoting family well-being. By assembling a multi-disciplinary team with mutual respect for each other roles and a truly family-centred focus they were able to deliver ways to meet their communities’ needs. Download a PDF copy of her presentation.

Justine Thorpe and Ara Swanney.

Justine Thorpe and Ara Swanney shared their perspective of the challenges and wins associated with two health organisations merging. South East and City Primary Health Organisation (SECPHO) and Porirua Health Plus Primary Health Organisation merged to become Well Health Trust last year.

Jon Royal, spoke about the need to enhance HCA work to support and provide added value to its members. “The government is directing community organisations to integrate both within health and across the health and social service sectors. We need now more than ever to provide strong advocacy at the national level for more equitable service provision, as well as better communication amongst ourselves including the ability to share best practice.” Read more.

Te Kotuku Hauora o Rangitikei staff member Shona Johnson.

Shona Johnson a whanau ora kaimahi gave a moving presentation about the journey she took to get a family the care they needed. She demonstrated how a provider centric system of care led her family on a convoluted pathway, both complex and gated. However through the perseverance of her organisation Te Kotuku Hauora o Rangitikei (a Maori primary health and social service provider) and a focus on the whole family they were able to navigate the systems of care and get this family the support they needed.

Ara Swanney gave participants the chance to reflect on their work, identify strengths, clarify goals and identify obstacles. “We all work in the health sector but often forget to look after our own health.”

Sha Panapa explained the importance of getting more Maori nurses in the primary healthcare sector. The Bachelor of Nursing, Maori at Whitireia programme was established in 2009 with the first wave of nurses due to graduate next year. Go to the Whitireia website to read more.

Lisa Ngaia shared how they were able to redevelop the HCA website on a shoe string budget. The aim of the redevelopment was to get a website that was easy to understand, and could be updated and maintained in-house. “The fastest way to learn about the health of an organisation is to visit its website. IT development is increasingly becoming a business requirement to manage information expediently and appropriately. For a copy of the HCA website user guide email admin@HCA.org.nz

Tania Forrest spoke about the outcomes of a report on the role of the Community Health Worker in a Maori person’s health journey. It was part of an internationally sponsored research project ‘Revitalising Health for All’. The report found that there is a huge demand for community health workers by Maori whānau. The report found that they were able to relate with the health worker and through that were able to access other parts of the health and social sectors, get transport and help with complicated health information.  They make up 50% of the Maori provider workforce without them Maori providers would be compromised. Download a summary of the Community Health Worker report.

Ian Johnson’s time management software solution workshop had the highest attendance, highlighting the need many providers place on good time management and helpful tools to generate efficiency.

View the photos from the hui.