Keep on Keeping on

Building 101 in Taipei city was once the tallest building in the world. It has been forced into second place by the recently completed Burj Khalifa building in Dubai.

The President of ISQua and I were delighted to be the guests of Dr Chiu-liu Lin, the Deputy EO of the Taiwan Joint Commission on Hospital Accreditation and Dr Wui-Chiang Lee, President of the Asian Society for Quality in Health Care at a dinner for speakers at the recent Asian countries accreditation meeting on the 85^th floor of this building. Our delight was somewhat tempered however by typhoon Soulik which was rolling towards us and we were of course perfectly positioned to watch, with growing trepidation, its advance.

‘Typhoon Soulik battered Taiwan with torrential rain and powerful winds on Saturday that left two people dead and at least 100 injured.’ (Press report)

With a little speeding up of the courses we made our escape to the waiting bus and back to our hotel before the full force of Soulik hit in the early hours of the next morning.

I have worked on various projects in Asia for over 20 years but every time I return I am amazed and impressed by the work I see going on and in particular by the range and diversity of healthcare quality. In 1990, when CEO of the Royal Australasian College of Surgeons I visited a surgeon working in a hospital in Pokhara, Nepal where waste from the operating room was washed into an open drain running alongside the wall of the room. Elsewhere I have seen the crispest and cleanest of bed linen in the wards but open windows with pigeons on the sills of the operating room and open drums of alcohol for scrubbing up before theatre. Yet Hong Kong, Malaysia, Singapore, and other Asian countries are an exemplar of what one might strive to achieve in healthcare quality.

Asia is not unique in this regard. And not only are the extremes inter country – they are also intra country. One sees the best and the worst of healthcare quality in Europe and the best and the worst in the United States; and it is the same the world over.

I have written before in this BLOG about the inequities in healthcare quality suffered by minority groups and this remains a problem and a concern. In some parts of the world however we see the reverse of this with a privileged few enjoying high quality healthcare while the majority try to get by.

I editorialised once in another magazine under the heading ‘Never Enough’ and I have spoken in this BLOG about our ‘…almost insatiable demand for healthcare services’. But while we all seek out healthcare services as and when we need them, some of us must wait longer for our consultation or procedure and, when the system is finally ready to take us, some of us will have to settle for whatever we can access and whatever we can afford rather than what we would prefer.

Have universal healthcare insurance schemes such as ‘Medicare’ in Australia, the NHS in the UK, schemes in Japan, New Zealand and a group of Nordic countries for example made a difference? Yes, in my view, but they have not produced anything like the health utopia their protagonists may have promised and they have not penetrated society to the extent that the especially needy and vulnerable such as the minorities to whom I so often refer have particularly benefitted. In a 2010 WHO report it was commented that:

 ‘Universal health care is not a one-size-fits-all concept; nor does it imply coverage for all people for everything. Universal health care can be determined by three critical dimensions: who is covered, what services are covered, and how much of the cost is covered.^[1]

Along with education, free speech and a number of other fundamental rights, timely access to safe quality healthcare should be unqualified.

So many of us, ISQua included, will ‘keep on keeping on’ in this quest.

And having survived Soulik to be able to write this BLOG today I look forward to my visit to Dubai where I expect to experience a sand storm on the 101^st floor of Burj Khalifa and be inspired to write my next BLOG.

Peter Carter

Chief Executive Officer

August 01 2013

^1.                  ^ ^a b World Health Organization (November 22, 2010). "The world health report: health systems financing: the path to universal coverage". Geneva: World Health Organization. ISBN 978-92-4-156402-1.