The Good, The Bad and the Ugly

By Jim McVeagh 08/12/2009


There is good and bad in the news that Pharmac is to morph into a single purchasing point for all medicine and health technology.

The Good

Technology purchases will be co-ordinated across the country, meaning that a doctor can move from one hospital to another without having to learn how all the gadgets that have become so essential to medical practice work.  I can’t tell you how many hours I have wasted having to ensure that I know my way around the different menu systems of the monitors, defibrillators and point of care analysers in each and every emergency department. And I mean each and every: each hospital within a DHB seems to purchase entirely different equipment. In one hospital I worked in, the monitors in theatre, ICU, recovery, the wards and the ED were all different. Babel would have been a cakewalk.

The Bad

Expect masses of bureaucracy and delays for purchasing essential equipment. Expect many dumb purchases. The reason why the hospital mentioned above has so many different monitors is because each area has different requirements. Sure, that particular hospital went a bit crazy – some standardisation is possible – but there is also too much standardisation, leading to monitors that are insufficient for the job or ridiculously overspec’ed for other places of lower acuity.

The Ugly

When tenders for CT scanners go from one scanner to twenty and tenders for ventilator go from three to three hundred, you can expect some unsavory competition occurring. I like competition in general, but very big single purchases, that are make or break for companies, can get very ugly indeed.

But not as ugly as doctors when they can’t have the latest toy …

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