health services at the crossroad
DESCRIPTION
A very personal view about health systems and services,TRANSCRIPT
The Planning and Management of Health Services
Working on the interface
José Francisco García GutiérrezOPS/PAHOHSS/HR
Nassau, 24 November 2011
My apologies ….but we do need to get to know each other
NameWork
ExpectationsHobbies
To understand my discourse
Rememberinga friend anda good man
Tony Judt
Tony Judt remembered
From MACRO to MESO and MICRO
…and certain digressions
Evidenciators, Calidators, Implementators,
Proceseitors, Genderators & Determinators
What´s next?
Small
digressions
A new syndrome:
Power Point Toxicity
Funny but banal !
From MACRO to MESO and MICRO
…and certain digressions
Moving into the mud!
ManagersHealth professionals
Patients
Citizens
Moving into the mud!
ManagementGood clinical practicePatients Patnerships
Citizens Engagement
HEALTH MANAGERS
The dark side of the force?
Manager´s Triangle
Budget control Priority goals Social peace
Are you willing to add anything else?
Citizen´s Triangle
Accesibility (24/7) High quality care Unlimited care Low cost (or free!)
The low moral among the professionals
FROM
2
Julian Tudor Hart
“My medical education began three times. What I learnt at medical school was no use in the hospital. What I learnt in the hospital was no use in general practice”
MEDICINE 2.0
Jay Parkinson at work!
Changing practice
Cambio de prácticas clínicas
Are you wearing a wrist watch ?
… why ???
From Baby-Boomers to Generation 2020
The Side B
If reform is the answer…
What was the question?
Is HEALTH a consumer good?
…and health care?
IF YOU ARE THE PATIENT,
What type of care do you want to receive?
The other framework
The other framework
ModelPaterna-listic Informative Shared
Ro le
No informed
Partially informed
Well informed
Active
Undecisive
Pasive
Information
That Old Dilemma
From desire to realityo
From reality to desire
Pictures of the future of health care
Dangers of predicting the future
Sam Goldwyn Mayer
“ I never make predictions, especially about the future.”
Why bother with the future?
"If you think that you can run an organisation in the next 10 years as you've run it in the past 10 years you're out of your mind."
CEO, Coca Cola
Why bother with the future?
“The future belongs to the unreasonable ones, the ones who look forward not backward, who are certain only of uncertainty, and who have the ability and the confidence to think completely differently.”
Charles Handy (quoting Bernard Shaw)
Why bother with the future?
The point is not to predict the future but to prepare for it and to shape it (more or less)
Myself (sorry!)
The future of health care systems
STREET VISIONS
Fee for service for the rich
Marks and Spencer style managed care for the middle classes
Safety net service for the poor
“McDonalization” of medicine
“Two roads diverged in
a yellow wood.
And sorry I could not
travel both” Robert Frost
Where do we want to go?
Official Frameworks Patient centered Evidence based Supported by systems
Safe & On time Effective & Efficient & Equitative
Six Lines 4a New Code
Safe and reliable care Service redesign and transformation
Leadership and business management
Clinical improvement and innovation
Patient partnerships Learning, education and culture
Final thought
If you aren’t confused you don’t know what’s going on
Jack Welch, former CEO General Electric
THANKS
4YUR
ATTENTION