2. The Network
Behind the Science
• Pathologists
• Medical Scientists
• Economists
• Business Analysts/system researchers
3. Professor Robin Fraser
• Pathologist
• HOD Otago Uni
(Pathology)
• Director of
Christchurch
Medical
Research
Foundation
(CMRF)
4. Lipoprotein metabolism
Size does matter
• Liver sieve research
• Cholesterol – high density(from out to inside the
liver) and low density (produced inside the liver)
• Size of the liver capillaries should be100nm
• Smoking, alcohol and more close down capillaries
• When capillaries are 50nm low density cholesterol
can not leave the liver
• Double dose of cholesterol leads to liver cirrohosis
• Structure – Size does matter
5. Networking efforts
• Geologists – ice age – death of citrus - scurvy
• Astrophysicists – predict climate change – decrease
in skin cancer – increase in Vit D deficiency. Increase
in mosquitoes – increase in malaria
• Biologists – structure of the body
• Molecular pathologists/Protein chemists – to
understand shapes of molecules altered by the
charge of a particle as small as an electron
• Astronomers – asteroid collision killed the dinosaurs
(not mass suicide as some might think). Are some
viruses from outerspace?
8. Sir Peter Gluckman
• Chief advisor to the
Prime Minister(along side Dr
Ian Ferguson)
• Scientific growth +
Development
• Paediatrics +
perinatal biology
• Endocrinology
• Founding director of
the Liggins Institute
• Rutherford medal,
Royal Society
9. Growth and Development NZ
• Network of development
• ‘Building Innovation’ report (science based), where and how
to invest
• Increase investment in research
• Understanding our identity (flora, fauna, natural resources,
marine estate, better use of conservational science)
• Future niche – production of ‘nutriceutical’s and health foods?
• Defence – bio-security (incl. sheep, cattle, rye grass and clove)
• Geological and associated engineering (e.g. earthquake)
10.
11. • Economist
• Researcher for Morgan
Foundation (charitable trust
-reducing the wealth disparities
between people)
• Co-Creative Director of
the Wellington Improv
Troupe (WIT)
• Co-author of ‘Health
Cheque’ (issues of our public
health system)
• Prescription for change
(follow up book-explores the
changes that need to be made to
improve our current system)
Geoff Simmons
•Our problem with food,
(upcoming book, impact of
nutrition on NZ health)
12. We are crazy and the economics of
healthcare are crazy
Simmons claims:
• Extra spending on healthcare so far has had no benefit
• Whoever shouts loudest gets treated first
• Most of the money gets spent on the last few months of a person’s life
• Greater expectations, expensive new technology, ageing population with
chronic diseases = $$$ spent at bottom of cliff
• Children are left behind as they can’t speak for themselves
• Specialists – ‘if you’ve got a hammer, everything looks like a nail’
• More Specialists vs GPs = poorer health outcomes
13. • Healthcare needs to focus on reducing costs (?introducing incentives
into workplace)
• Primary providers need to manage chronic conditions better (cost of
covering ass goes up)
• Obesity is now over taking smoking in health issue, so nutrition should
be a main focus (hence his new book)
14. Remedies:
Prescription one
• Concentrate on 1° healthcare/prevention
• Need public health leadership
• Spending on prevention doesn’t save $$ but has much better patient
outcomes
• 1°healthcare interventions = 4x patient outcome benefits of 2°
healthcare (hospital)
• Diet is #1 killer in NZ
• Presently- most people get no care until last few months of life, when
mega bucks are spent
15. Prescription Two
• Rationing healthcare
• Not giving treatment to people who don’t yell for it
• The poor and the voiceless miss out
• Pharmac model – prioritise treatments that get the best health outcome
per $
Overseas models
• HFA, NHS, Netherlands health system
• All suffer from political influence
16. Prescription for Change
• Manage demand—reduce pressure on the
system to provide treatments
• Prioritise—make sure treatment goes to those
with the greatest need and ability to benefit
• Make delivery more efficient by giving health
professionals the ability and incentives to
make the system work better
(nurses crucial to administer prescription for
change)
17.
18. Professor Jeffery Braithwaite
•Health services and systems
researcher
•Well known for bringing
management and leadership
concepts and evidence into the
clinical arena
•Published more than 300
refereed contributions, and
500 total publications about
organisational, social and team
approaches to care
•Foundation Director of the
Australian Institute of Health
Innovation
•Consulted to the World
Health Organistation (WHO)
19. The Leader as a Systems Thinker
Management Leadership
Gets things done Strengthens connections
Accomplishes objectives Exercises influence
Handles organisational functions Motivates, inspires, persuades
Structure Culture
Process Strategy
Performance Vision
20. When change is needed………
Re-structuring
(Structural change)
• Top-down change is ineffective
• Changes may be out of touch
with the work
• Trying to fit round pegs in
square holes
• Disaffection amongst staff
• Divisions amongst staff
Nurturing
(Cultural change)
• Bottom up involvement required
• Engage staff in decisions
• Use present staff’s qualities
• Promote positive workplace
• Promote teamwork
vs
