Independent Practitioners Associations Council of New Zealand

Master of Ceremonies, Doug Baird, Ladies and Gentlemen, I greet you in the languages of the realm of New Zealand.  Maori, Raratongan Niuean & Tokelauan.

"Kia Ora, Kia Orana, Fakalofa Lahi Atu, Taloha Ni"

In particular may I recognise and greet you, Honourable Minister of Health, Pete Hodgson; you, Stephen McKernan, Chief Executive and Director General of the Ministry of Health; you Doug Baird, in your capacity as Chair of IPAC; Dr Tom Marshall, Chairman of ProCare Health Limited; and you the distinguished speakers who are to follow:- Richard Smith, Sir Donald Irvine, Judith Smith and Philip Davies.  I greet you, delegates; ladies and gentlemen.

Thank you for the invitation to me to me today to open the Independent Practitioners Associations Council of New Zealand Annual Conference.

In every New Zealand setting, whoever speaks ought first to establish a place to stand before the audience.  In that regard, I come from a medical family, where names such as Sir Charles, Sir Carrick, Sir Edward and Sir Douglas (all who, it may be noted, were independent practitioners) were always spoken with some reverence.

Secondly as a working lawyer, Judge and Ombudsman in previous occupations, there has been a closeness with many contemporary medico-legal issues.  For just one example I spent 16 months until April of this year (2006) chairing at the Government' s request the Confidential Forum for Former In Patients of Psychiatric Hospitals - which is a legal first for New Zealand seeking to add a 'truth and reconciliation' element into dealing with issues that some former patients may wish to raise affecting their time in a hospital.

Thirdly I have been a patient - and aside from being an advertisement for the wise gp doctoring over many years of your ProCare Chairman, Tom Marshall, I have also had some more dramatic times as a heart surgery patient and as someone after a road accident and an odontoid fracture of C2 who spent three months in the "derrick round the head" environment of halo traction equipment.

Out of these three influences - family, professional and patient, I have gained some little insight into the world which is your daily domain, sufficient to show me that you each have to work extraordinarily hard in your own field to improve the health and well-being of New Zealanders.

The health sector is a significant contributor to most societies and its practitioners are respected because of the values which society perceives you to have, such as altruism and such as having an approach which is evidence based.

An abiding impression I carry as a layperson observer relates to the necessity for your profession to communicate clearly - with patients but also with the public and the media.

Effective communication is not always easy, particularly in New Zealand's dynamic and diverse environment.  When comparisons are made with some countries in the Northern hemisphere and our country is seen to be holding a somewhat lesser place than at some times, it is sometimes overlooked how much more diverse our society has become in the last 25 years and that we do not have the same homogeneity as in Scandinavian countries for example.

It is good to see this meeting including contributions from a number of quarters in the medical landscape.

Doctors make individual decisions for individuals and as individuals having a duty of care.  Managers and politicians are concerned with the general consequences of individual decisions.  The groups (doctors on the one side and managers and politicians on the other) are viewing the same problem from different ends of the telescope.  Things such as, generosity, teamwork, and leadership are needed to deal with this and Conferences such as yours today are part of the tapestry that will achieve that.  Sir Cyril Chantler's Harveian Oration in 2002 which I acknowledge for this thought provides a fine exposition of what Maori New Zealanders call the wero or challenge in this area.  Communication is a vital requirement for that too.

You work in all parts of New Zealand society and this requires great flexibility and an inherent understanding of people. There can be no blanket, "one-size-fits-all" answer to effective communication.

Since 1998, I am advised that New Zealand has been part of an international survey conducted by the US based Commonwealth Fund. This placed New Zealand above any other nation surveyed for ease of access to a GP and for stability of the GP relationship, as well as for the quality of communication and ease of access to medical records.  This suggests we are making good progress in the field of communication. You, our health providers, are well aware of the need to communicate and you do it well.

May I add congratulations you all for the work you do, each day, for all New Zealanders such as helps ensure we have a productive and healthy future.  The way ahead includes a number of challenges - dealing with equitable access to health care, with recruitment of providers for the future, with empowerment of patients, with cross-cultural awareness and training - and may I suggest we have the capacity in this country to do it.

I wish you the best for this conference. I now have great pleasure in handing over to Hon Pete Hodgson, Minister of Health but just before I do so, I will fulfil my duty by declaring this, the Third Annual Conference of the Independent Practitioners Associations Council of New Zealand open.

Tena koutou, tena koutou, tena koutou katoa