Profile – Dr Art Nahill, Hīkoi for Health

Doctors Art Nahill and Glenn Colquhoun originally bonded over a love of poetry. But more recently, they have joined forces to complete a 3120-kilometre Hīkoi for Health by van from Kaitaia to Wellington Parliament grounds, aimed at transforming NZ's ailing health system. Dr Nahill shares his journey with us.

Can you share some background about yourself and how the Hīkoi for Health came about?

I've been a doctor for about 30 years. I trained and worked for several years in the United States, where I was born, and then came to New Zealand in 2005 with my Kiwi wife and two boys. I’m a hospital GP, and over the 20 years or so that I've been working in the system, I've seen conditions deteriorate significantly.

Glenn Colquhoun and I know each other from the writing realm. And we've spoken a lot about our frustrations and anger at the decline in the healthcare system. He from a primary care perspective, me from a hospital perspective. We started off joking about how it would cool if we drove around the country collecting people's ideas for a better healthcare system. And letting them know first and foremost that the system can be changed, that it's a man-made system, one that's not been particularly intelligently designed. For the last couple of years, we've been daring each other to do it. Then the stars aligned, and we decided to pool our resources and go.

What changes have you noticed over your 20 years in the New Zealand health system? What are the things that really concern you?

Lots and lots of GPs have retired early or left New Zealand, or not been replaced, so I've seen a real deterioration in people's access to primary care.

Because of that, I've seen growing numbers of people turning up to emergency departments with things that probably could have been better dealt with in primary care, but people don't have much choice.

In the hospital system, when I first arrived and started working in Auckland-based hospitals, you would have time to think about patients and get to know them. You'd have time to get to know the junior doctors working with you. You'd have time to reflect on the cases you were seeing. You'd have time to teach.

Over 20 years, all of that has pretty much gone. It really felt to me like it was a bit of an assembly line where our job was to just push people through the system as quickly as possible.

What was the aim of the hīkoi, and how do you hope it might lead to change?

We were tired of hearing ourselves whinge and complain. There is a value in that and in expressing your anger. But if you don't do anything creative with it, it tends to turn into cynicism and apathy.

We wanted to do this hīkoi so people would know change is possible. And we wanted to hear from people about what they would most value in a new, better-designed health system.

The second phase of the hīkoi is going through the around 500 submissions we collected. We're hoping to create a think tank, including some of the people we met along the way, to sit down and come up with a sort of ‘blue-sky’ framework for a new health system and then publish it, making it available to the public.

We've said from the outset that this is a people's inquiry, that we’re apolitical. Politicians on both sides of the aisle have let us down over the past couple of decades. What we're really trying to do is to get the word out to the public that the healthcare system could be changed, and here is one example of how it might be done. Just to give people a bit of a jump start and some vocabulary to use when talking about health care reform, which they can then use ultimately when they vote.

I think we, as voters, need to flex our collective muscles and demand that people give us a healthcare plan that spans more than three years.

Who are most of the submissions from?

The majority are from the public, with a smattering from GPs, emergency doctors and junior doctors in training.

They've shaken out along certain themes. People want a much more robust public health system. They want better food to eat and cleaner air. They want better water and better access to all those social determinants of health, like good housing, good jobs, etc. People are tired of living in neighbourhoods where every second business is a fast-food place, a liquor outlet, or a vape shop.

And we've actually seen with our own eyes health providers in the community who are doing really innovative things. Not only providing traditional Western medicine, but also traditional Māori and Asian medicines, helping patients and clients with job training, housing, lots of wraparound services that really contribute to health.

Is there a piece of advice you would give those nearing or currently in retirement? Perhaps around navigating the health system.

I would say it's really important that people advocate for themselves or get help from people who can advocate for them, even if you're not naturally inclined.  Unfortunately, the health care system is in such a state that unless you make a lot of noise, things can easily slip through the cracks. Ask a lot of questions. 

If there was one piece of advice you could give your younger self around retirement and ageing, what would that be?

Don't do it. I mean, I don't like to think of retirement as this stage that you get to
and then, bang, something happens, and you retire. I look at it as I’ve stopped paid employment, but I'm still doing things that I think are valuable, things that have personal meaning to me. And I think that this is just another stage in life. I think the more we can stay connected, stay relevant and continue to do what we love to do, the better off we'll all be.