My Account
Warkworth resident Ailsa Claire used to help run the National Health Service in the UK. She now runs an organisation with a budget of a mere $2 billion. She talks to Karyn Scherer about what brought her home.
I was born in Dunedin and lived there till I was about 13, when we moved to Rangiora. Dad worked in a shop and my mother was a dressmaker. I was bought up in the generation where tertiary education for girls was thought to be a waste of time. I’m dyslexic and up until nearly high school, they basically thought I was not very clever. I had a teacher who worked out my problem, and at high school I worked like stink. I then self-financed my way through university, by working full-time as well.
I’m not quite sure where it came from but I made a decision to be a social worker when I was at school. I got a job with Child Services during the holidays — it’s ridiculous when you think about it now, how old I was — and I continued working when I was at uni. It was easier then because you could do lectures in the evenings and things like that. I was a social worker at Templeton Hospital, which housed children with learning difficulties, and my job was to talk to the parents of newly diagnosed children about placing their child in hospital. A lot of families didn’t want that, but there weren’t many alternatives. It was pretty horrible. I was also involved in the women’s movement and I got pretty stressed, so I decided to go to the UK, because that’s where my grandparents were from, for time out. I went to do a master’s degree, but I ran out of money, got a job, and ended up staying.
I was working for Social Services, and there were large numbers of institutions like Templeton and they were starting to close them. I was asked to come into the health service to close three large hospitals for people with learning disabilities. That was one of the best things I ever did, because people were living in quite appalling circumstances and we got the majority into residential homes in the community and into different lives. I just had a real passion for supporting people who were powerless gain some control over their lives. It’s something I still feel very, very strongly about. In health systems we disempower people, so I have a real passion for how we support individuals to get the outcomes they want, not the outcomes we think should be available. I don’t really know where it comes from, other than I did grow up frustrated by not being able to do what I wanted to do.
After I had my three children, I worked in Barnsley in South Yorkshire, which is an area of high deprivation. I was asked to go there for six months and ended up staying 12 years. Three or four years ago I got an OBE for services to healthcare in Barnsley, and I got to shake hands with the Queen. I ended up on national committees and the last job I had in UK was with the NHS Commissioning Board, which is the organisation that ran the NHS. I was acting national director. But I felt it was just too far removed from people, and I was dealing a lot with politicians and stuff like that. My son James decided to do a gap year in NZ and we decided if the right job came up we’d move back — and the right job did come up.
My image of the NHS is grey. It’s full of people who really want to do the right thing but it was a real grind for many years. We had 10 years of real financial austerity, but even before the big crunch they were taking money out, and every time there was a change of government there was a reorganisation. But the UK was good to me. I arrived with hardly a penny to my name and ended up a national director.
We moved here in September 2012. I didn’t know anybody in Auckland and we wanted to live somewhere with the feeling of a community. We found Warkworth on the second day. It just had a really nice feel about it. My daughter Kate is still at school so we went into Mahurangi College and really liked it. We then looked at 32 houses in a week. The house we had in the UK was built in 1640, so it wasn’t easy finding a replacement, but Warkworth is definitely the place I want to be and I can’t imagine living anywhere else. I leave for work at 4.45am. I go to the gym and I’m at work at 7am. I work a lot during the week but I’ve always been very protective of my weekends, which is family time.
Auckland DHB has an international reputation. When I was talking to people in the UK, they knew about Auckland Hospital whereas they couldn’t have named an Australian hospital. It clearly has some stonkingly good specialist services, particularly children’s services and things like that. But the sorts of services I would have expected in the community just don’t exist and that’s why I was recruited. There’s not a lot that supports an individual to control their own healthcare, and there’s also not a lot of accountability to the public.
NZ has very, very high placements for older people in residential care, and very little alternative care. People could have a different life. We need homecare services, and rapid response services so if you start to fail in the community you get assessed in your own home, and rehab in your own home, or rehab in a residential unit near your own home. We tend to provide rehab in hospital and you lose all that community contact. There’s a lot of evidence that when you’re elderly, the longer you stay in hospital the more likely you are to end up in residential care.
Auckland is perceived to be a wealthy place, but in the past 10 years there’s been no significant difference in the gap in life expectancy between Europeans, and Maori and Pacific Islanders. Everyone is living longer, but the gap has remained the same. Right now something like 17% of Auckland’s population do not speak English at all. I can’t see how we’re changing our services to accommodate that. But I feel quite optimistic because Auckland DHB is absolutely stuffed full of people with incredible skill and ability.
We’re doing a lot of things together with Waitemata DHB but there are no plans to merge. I think if organisations get too big they get very disconnected from their communities. The provider organsations got very big in the UK, because politicians believed in economies of scale and things like that, but I think the bigger you get the further away you get from the people you serve.
