Feature
The Power List: Health and Medicine
The best, brightest and boldest in health and medicine.
No 1 Ron Paterson, Health and Disability Commissioner (New)
Eight years after being appointed, lawyer and medico-ethics expert Ron Paterson gets the nod as the health sector’s most influential person. A former male-voice choir member, he is acclaimed for his measured, thoughtful and practical approach – even when dealing with contentious issues like systems breakdowns between hospitals or investigating the death of babies in maternity units. This year, he has made forceful recommendations on problems in many hospitals – witness the damning reports on former Wanganui Hospital gynaecologist Roman Hasil – and on the cases of two patients at the private Wakefield Hospital, who died as a result of poor follow-up care. This work has led to new quality management programmes overseen by the Ministry of Health. He has also suggested the medical profession introduce its own rating system – similar to those “rate your real estate agent” sites – before a third party starts one. Such suggestions are likely to succeed because, unlike his predecessor, Robyn Stent, Paterson has carefully managed to avoid stirring up more divisiveness in the health sector.
No 2 Stephen McKernan, Director-General of Health (New)
Stephen McKernan earns twice as much as Paterson and has a Vote Health spending budget of more than $9.6 billion. Appointed two years ago, after roles as CEO of Counties Manukau District Health Board and its Hutt Valley counterpart, McKernan has undertaken a massive restructuring of the Ministry of Health – although some fear his efforts are leading to more unwanted bureaucracy in the health system. He was also a key damage controller this year, commissioning a report into alleged conflicts of interest between the Hawke’s Bay District Health Board and board member Peter Hausmann, an appointee of former Health Minister Annette King. The report found Hausmann, the board and its chairman did not manage the conflicts well – but it minimised potentially massive political embarrassment for the Labour-led Government. Insiders say McKernan probably undersells himself, but because he is so highly regarded, he is allowed to work a couple of days a week in Auckland.
No 3 Len Cook, Medical Training Board chairman (New)
A former Government statistician in New Zealand and the UK, Cook was appointed inaugural chairman of the Medical Training Board in 2007, where he advises on health workforce planning. Indications are that he intends implementing concrete changes, rather than simply issuing recommendations that are left to lie fallow. The board’s first report, out in October, recommended doing more to retain doctors working in New Zealand, and boosting medical school training places to 465 a year in the next four years. Cook was also appointed to chair the senior medical officers commission in October, charged with examining sustainable terms and conditions for dentists and senior doctors employed at DHBs. The numbers man has becoming the fix-it man for our health workforce problems.
No 4 Pat Snedden, Quality Improvement Committee chairman (New)
Brother to Rugby World Cup 2011 boss Martin, Pat Snedden is highly regarded in the health arena, where he is also chairman of the Auckland DHB. He heads the Quality Improvement Committee, established by former Health Minister Pete Hodgson in 2007. In February, the committee released its first report into hospitals’ worst mistakes, showing there were 182 serious errors in the 2006-07 financial year. Snedden says better reporting of such mistakes is the first step in measuring and improving systems. The committee also advocates barcoding for drugs and hospital patients to avoid medication mix-ups. Snedden’s involvement with Maori – he is economic adviser to the Ngati Whatua o Orakei Maori Trust Board – and other sectors (as chairman of Housing NZ and deputy chairman of ASB Community Trusts and business adviser to Health Care Aotearoa) has made him a formidable adviser on Treaty, health and economic matters.
No 5= Deborah Powell, Resident Doctors’ Association General secretary (New)
Ian Powell and Deborah Powell will hate sharing a position on this list – they are not related and, although both are unionists, have very different approaches to industrial bargaining. Deborah Powell is a skilled advocate for junior doctors, but she also fights battles on behalf of lab workers, physios, medical radiation technologists and radiation therapists as director of her firm Contract Negotiation Services, from which she reportedly earns more than $1 million a year. A divisive personality but an effective communicator, Powell was responsible for organising junior doctors’ strikes in May, resulting in the cancellation of thousands of patients’ clinics and operations. The dispute was settled in October. She was criticised by then Health Minister David Cunliffe as representing 7% of the health workforce whose members were responsible for 90% of the sector’s strikes. The panel hotly debated Powell’s inclusion on the Power List, but her influence – albeit often seen as negative – is without question.
No 5= Ian Powell, Association of Salaried Medical Specialists Executive director (New)
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