Leadership need in health sector

By Tom Clarke

More leadership is needed among health professionals, says Dr Robin Youngson, Auckland Hospital specialist anaesthetist who has just become chief executive of the newly-established Clinical Leaders' Association (CLANZ).

Dr Youngson was the prime mover of the association's establishment which, he says, has received enthusiastic support from health professionals.

He says people in the public health sector are dissatisfied with many the outcomes of the reforms in the public health system over the last decade, and think there is a gap in leadership.

"The reforms have emphasised competition rather than collaboration," he says, "and a lot of public health professionals do feel a very powerful need to start to get back to sharing ideas and experiences."

"While there have been great benefits from the reforms, we need to get back to a more collaborative ethic where we can break down the barriers and work together to help each other."

Dr Youngson says there is a feeling that the health service has been taken over by professional managers and that it has become remote from patients.

To move ahead, health professionals want to form "partnerships with managers," merging their financial and business disciplines with the professionals' focus on patients.

CLANZ will work closely with the Government. To take the stance that the Government is "wicked and is trying to destroy the health service," is a hindrance, he says.

"You have to assume that the Government is trying to do some things that are right for the health service, and those should be supported. If we spend all our time fighting against the Government and criticising what they do, without taking responsibility for solutions, then we won't make any progress."

Dr Youngson says it's easy to see more money as the solution to all problems, but it is more difficult to recognise that there are limitations on resources, that demand will always greatly exceed the resources available, or to take responsibility for using the limited resources wisely.

He believes doctors can no longer simply be concerned with the care of individual patients, regardless of the cost to other patients or the need to ration resources.

The people best able to make these decisions wisely are those with direct knowledge of the issues, the health professionals working together with managers, he adds.

That view was confirmed last year in a survey of CLANZ members on their views of the controversial booking system.

"Our members came out strongly in support of the fact that rationing is a reality, that we need to make these decisions wisely and that we need good information to do that," Dr Youngson says.

"The survey showed that the booking system is seen as a rational approach to the problems and is a step in the right direction, although there were some concerns about what were seen as flaws in the process, such as the scoring system.

"Essentially members felt we should support the system and work with the Government to improve the way it operates, rather than trying to tear it down or cheating the points system."

CLANZ is promoting networking and communications among its members, and providing peer support for clinical leaders. It is also investigating the training needs of health professionals who are moving into broader management and leadership roles.

Dr Youngson graduated from Cambridge University with a masters degree in engineering, and first came to New Zealand to work in oil exploration. He meet his wife, but returned to England to attend Bristol University Medical School.

He became a fellow of the Royal College of Anaesthetists in London in 1990, and returned to New Zealand in 1991.

He was founding medical officer on the Auckland childflight paediatrics air ambulance service, and was corporate medical adviser for Auckland Healthcare.

Dr Youngson will continue to practise anaesthesia as well as be involved with CLANZ.