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Ian Powell
Otaihanga Second Opinion is a regular health systems blog in New Zealand.
Ian Powell is the editor of the health systems blog 'Otaihanga Second Opinion.' He is also a columnist for New Zealand Doctor, occasional columnist for the Sunday Star Times, and contributor to the Victoria University hosted Democracy Project. For over 30 years , until December 2019, he was the Executive Director of Salaried Medical Salaried Medical Specialists, the union representing senior doctors and dentists in New Zealand.
Ian Powell - Latest News [Page 1]
New Hospital Building Trumps ‘Yes Minister’ Hospital Without Patients
Friday, 19 April 2024, 7:05 am | Ian Powell
Ian Powell discusses how New Zealand’s vertically centralised health system led to a new hospital surgical building without staff and its similarity with the ‘Yes Minister’ comedy and the hospital with no patients. More >>
Reflecting On Maximilien Robespierre And Other Things
Sunday, 14 April 2024, 1:42 pm | Ian Powell
Politics in New Zealand would benefit from a healthy debate on the relationship between class and identity politics. I regard them as interconnected and supplementary rather than opposites. More >>
How To Immobilise A Health System’s Primary Statutory Adviser And Monitor
Thursday, 11 April 2024, 9:15 am | Ian Powell
Ian Powell discusses the immobilising implications of the Government’s severe public service staff cuts for the critical health system functions of the Ministry of Health. More >>
Time For Health Minister To Step Up On Workforce Crisis
Wednesday, 3 April 2024, 8:17 am | Ian Powell
Ian Powell discusses why and how new health minister Shane Reti needs to step up over resolving the health system’s workforce crisis. More >>
Function Versus Form: Public Service Cuts
Saturday, 30 March 2024, 7:00 pm | Ian Powell
Ian Powell discusses the public service staffing cuts being pushed by the new government in the context of the relationship between function and form along with process improvement. More >>
Capitation Should Not Be Decapitated
Sunday, 24 March 2024, 8:03 pm | Ian Powell
Ian Powell discusses the importance of not allowing the system of funding general practices (capitation) from being decapitated by eroding neglect. More >>
From Overcoming ‘Bonkers’ To A Political Pickle
Thursday, 21 March 2024, 7:32 pm | Ian Powell
Ian Powell discusses the political pickle that New Zealand finds itself between an increasingly unpopular new government and a deeply unpopular former government. More >>
Challenges Facing The Funding Of New Cancer Treatment Drugs
Monday, 18 March 2024, 7:02 pm | Ian Powell
Funding new cancer drugs – good but…. In last year’s election campaign the then in opposition National Party promised to allocate $280 million to fund new 13 cancer therapies (drugs) that had yet to be approved for funding by Aotearoa New ... More >>
Road Ambulance Service Cuts Highlight Vulnerability Of Ownership Model
Monday, 11 March 2024, 7:08 pm | Ian Powell
The vulnerability of Aotearoa New Zealand’s road ambulance service was highlighted by the announcement last month than the largest ambulance (Hato Hone St John) was looking to pull ambulances off the road because of rising fiscal deficits. It raised ... More >>
Child Palliative Care: A Sad But Avoidable Plight
Monday, 4 March 2024, 5:54 pm | Ian Powell
On 21 February the NZ Herald published a compelling article by its Wellington-based journalist Vita Molyneux on the state of child palliative care in Aotearoa New Zealand: Health system failing terminally ill children . The ... More >>
Missing The Health Target
Tuesday, 27 February 2024, 8:17 pm | Ian Powell
Wilhelm Tell (more commonly known as William Tell in the English speaking world) was a 14th century folk hero in Switzerland then ruled by the Austrian Hapsburgs. Tell is widely considered to be the symbolic father of the Swiss Confederacy. Among ... More >>
Formal Democracy, Popular Will And Military Coups
Monday, 26 February 2024, 5:48 pm | Ian Powell
In its 2023 Index of the countries of the world Transparency International rated Aotearoa New Zealand the third best nation on transparency. However, as credible as this was, there was a drop in its score. The fall was in how common it was for ... More >>
Muddled Analysis: Left, Right, And Wrong!
Monday, 5 February 2024, 7:02 pm | Ian Powell
Sometimes when I contemplate whether to blog on a political subject or not, I struggle with the question of relevance. The fact that the subject interests me is not a guarantee of wider relevance. On this occasion, aided and abetted by personal bias I’ve opted ... More >>
US Lessons For New Zealand’s Health System: Profiteering, Hospital Adverse Events And Patient Outcomes
Monday, 15 January 2024, 4:48 pm | Ian Powell
Although not guaranteed it is likely that the ugly head of ‘Public Private Partnerships’ (PPPs) will be raised again in Aotearoa New Zealand’s public hospitals following last year’s election of a new National-led coalition government. Profit maximisation ... More >>
Message To Health Minister: Get The Foundations Right Beginning With Being ‘Relational’
Thursday, 21 December 2023, 7:54 pm | Ian Powell
When the Labour led coalition government came into power in October 2017 it inherited a health system in crisis, primarily due to the interlocked pressures of rising acute demand and severe workforce shortages compounded by underfunding. Unfortunately that ... More >>
Wealth Accumulation – ‘Big Sugar’ And Little Barbados: A Lesson In Struggle And Consciousness
Sunday, 17 December 2023, 5:41 pm | Ian Powell
If New Zealanders undertook four basic public health measures they would not only live longer, they would significantly reduce the pressure on their badly politically driven overstretched health system. Three of these measures involve doing moderate ... More >>
When Smoke Gets In Your Eyes The Outcome Is Perversity
Tuesday, 12 December 2023, 8:47 pm | Ian Powell
In 1959 The Platters , an early rock-and-roll era group, released the song Smoke gets in your eyes (first sung in a 1933 Broadway show: ‘Smoke gets in your eyes’ . The song is a sweetly romantic metaphoric song about falling in love and then breaking-up. ... More >>
Tone-deaf Health System Leadership: Business Consultants And A Symbolic Specialist Resignation
Tuesday, 28 November 2023, 5:55 pm | Ian Powell
The catalyst for the heading of this blog was a text I recently received from a former district health board (DHB) chair on the response of Health New Zealand (Te Whatu Ora) to a paywalled article by journalist Isaac Davison in the NZ Herald (24 ... More >>
Why Labour Lost The 2023 Election So Badly
Thursday, 23 November 2023, 1:57 am | Ian Powell
On 1 August 2017 Jacinda Ardern was elected leader of the opposition Labour Party in extraordinary circumstances. Opinion polls were showing Labour heading towards a massive fourth consecutive electoral defeat in September. National meanwhile was ... More >>
No Pressure Dr Reti But Starting On The Right Foot Is Critical
Tuesday, 7 November 2023, 7:32 pm | Ian Powell
With the final election count now confirmed it is clear that Aotearoa New Zealand will soon be governed by a National-ACT-NZ First coalition. Further, not that there was any prior doubt, Dr Shane Reti (a general practitioner) will be the next minister ... More >>
