For too long, the health system has been built from the top down, and look where that’s got us. It’s time for a bottom-up approach, says Glenn Colquhoun.
We can do better. That’s what I keep thinking. Patients at least make sense. They come in so many shades of beauty. Sad. Funny. Hoping. Brave. And sore. I have learnt that loving them is the only sanity in all the scurry of medicine. There is a sense in our tangling together. We are useful to each other there. So much medicine can be found in our gaps. Unless you need your appendix out. And usually you don’t.
So often what doesn’t make sense are systems. Human systems. The way they create pathways in thin air for people to move through like sheep on the way to drenching. I get that we have them. At their best they can be remarkable. They can make us better. At worst they have no brain. No heart. No flexibility. Then they can make us sick – as surely as bugs.
Our health system – the way we collectively try to prevent people getting sick and help them when they are – should be a national treasure. But it’s hard not to think it’s broken at the moment. Aspects work well, of course. But so much of it seems to be held together by sticking plasters placed on sticking plasters placed on sticking plasters.
I wonder if the people leading it remember what it is to be sick. Politicians use it for votes. People get growled at. They can’t get the help they need. They wait. We train doctors for the rest of the world and import them to keep it afloat. We defer to organisations with power and money. It has never met the needs of Māori and seems fundamentally tipped against them – the past is not past. We still seem to be in the middle of it.
I wonder what it takes for doctors to speak up about this. We are part of the system after all. And there are always our patients to hide in. My friend Art Nahill is a doctor. This month, he and I are driving a vanbulance from Kaitāia to Wellington to shake our fists at anyone who has ever had anything to do with creating our health system. It deserves to be so much better.
More importantly, we are doing it to listen to all of you out there. We are tired of a health system that is built from the top down. And wonder what it might look like if it was built from the bottom up. So if you ache. Or hurt. Or long. If you love and hurt and wonder and come up short – then come and tell us how to make something that grows out of us. At least come and say we’re not fools for trying.
Stop listening to managers and people who work for ministries and governments and parties. They have had their crack at it. They have created a kind of madness. An illusion of a health system. And they have told us there is something wrong with us when it doesn’t work.
Take a look at our website below. Follow us on Instagram @ hikoiforhealth. If we’re holding a meeting anywhere near you then come and have your say. Stand beside us and shake your fist. Think outside the square and dream. We’ll end up on the grounds of Parliament and present what people have told us. We’re planning to commission a book with a plan for a new health system in it. With essays from a range of contributors from across the country. Let’s plan a health system the way we think it would work, then vote for the politicians who support it.
If you are a manager or a politician, then bring your doubt and frailty. There is always a way back if you are humble and listen. Tāne had his head in the earth when he pushed Ranginui off Papatūānuku. All good thinking is in the soil. It can be trusted to grow what it needs. Please help us to make something wise in all our joining together.
Dr Glenn Colquhoun is a poet and GP in Horowhenua. The hīkoi for health website is healthreformnz.org.
