A year ago, Prof Helena Liira packed her bags from her home in Kirkkonummi, Finland, to begin a new chapter of her career as Head of the School of Primary Aboriginal and Rural Health Care (SPARHC) at the University of WA.
Apart from the obvious weather contrasts between a country that experienced a record low of -35C and a country where the mercury has been known to soar into the mid-40s, Helena also can tick off some interesting differences in the way doctors, particularly GPs, go about their daily tasks in their respective home ports.
If the local landscape seems fragmented with two systems often working against each other, try the nationalised Finnish model of three funding systems where decentralised multidisciplinary health centres, funded by municipal governments, and occupational general practice are the heavy lifters.
“Public health outcomes are very good in Finland, but over the past decade, finances have become problematic and health centres are suffering with a number of doctors leaving for the private sector. There is universal care but the queues to see a GP are very long,” she said.
“The first thing that really struck me about the Australian system was how strong the role of GPs was here. They are far more independent and as business owners they are masters of their own work.”
Ability to adapt to change
The second was just how flexible and resilient GPs were to system change. One might add they have had plenty of practice!
“The Australian system was at first complicated for me to comprehend. It can be difficult to discover what’s going on and there are often changes. Medicare Locals were here for only three years and now they are replaced with Primary Health Networks but while there might be policy change, people take those changes so easily and service is not really disrupted.”
“In my country nobody has been able to change a thing! Everybody knows the system doesn’t work but nothing changes. So I admire this attitude here which embraces change. People here are innovators and think outside the box, you can see that courage in medical research and in practice. The mindset is focused on being able to do things.”
As head of SPARHC, Helena has five centres of study to coordinate – the Rural Clinical School, General Practice, Centre for Aboriginal Medical and Dental Health, Emergency Medicine and the WA Centre for Rural Health and it’s to the strategic coordinating role that she has devoted her first 12 months.
She is excited to be at the forefront of curriculum development and connecting the five centres of study under her remit.
Connections are the future
Collaboration is a word Helena Liira uses a lot. As she talks, she moves to the white board where there is a spider’s web of interconnecting lines between the schools.
The strategy has been written and already there is action.
“It’s exciting putting it all together and goal setting. I’m happy with the process. It has been challenging, but it is working so far but it’s a good time for all this to happen.”
UWA is undergoing a rebranding which has put the student experience in focus in an era of tightening funds. The medical school is no exception.
It’s well aware of the challenges ahead with funding an ever-present question mark as well as the prospect of competition from the newly announced Curtin Medical School which is expected to take its first students in 2017.
“I am also impressed with WA Health Translation Network, which Prof John Challis is now leading after it was established by cardiologist Dr Peter Thompson.
Here is a consortium of all universities with the aim of making stronger cases for research funding. It’s a very good sign that all West Australian universities are collaborating to form a united front in the very difficult area of funding.”
Speaking with one voice
“I would like there to be a united voice for primary health care research, so there is room for partnerships as well as competition. Of course there will be competition but UWA is strong and we are well prepared for the future.Next year we will begin with a new sense of who we are, what are our most important goals and what we can do best together.”
While this attitude might mark her as “not from around here” she has a wonderfully liberated perspective which comes from seeing something for the first time. Systems, courses, research, students and teachers need to complement each other – it is a lesson for the entire health system.
Her primary responsibilities are to help produce young doctors capable of meeting the challenges of the future, while giving students a satisfying experience in the process. In this new university environment, the student wields an unprecedented degree of influence.
However, Helena is impressed with the quality and resourcefulness of the students she has come across and has no doubt they will take those qualities into the workplace.
She has endeavoured to discover what kinds of workplaces they will be, which has meant meetings with community and professional groups and representatives from the WA Primary Health Alliance, and has clarity in areas that many who have been in the system for decades have failed to achieve.
“I’m a manager and a strategist and I’m also an outsider. I don’t have a political opinion I just see things as they are.
People like to talk to someone who is neutral.”