Dr Robyn Whittaker | Clinical Director of Innovation
The Commonwealth Fund was established in 1918 in the U.S. (one of the first private foundations started by a woman philanthropist, Anna M. Harkness) to ‘enhance the common good’. Its mission today is to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable. The Fund’s international program in health policy includes the Harkness Fellowships. In the first years, the fellowships’ goals were broadly advancing international understanding and included graduates from any field from the United Kingdom and other English speaking countries including New Zealand. Early New Zealand alumni include Sir Richard Faull and Sir Hugh Fletcher.
In 1997 the fellowships were re-designed to focus on Health Care Policy and Practice as part of The Commonwealth Fund’s new International Program in Health Policy and Practice Innovation. Fellows now come from nine countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, and the United Kingdom. Fellowships are intended for ‘talented mid-career professionals’ in order to build leadership capacity and international networks for on-going exchange and collaboration.
A New Zealand fellow is selected every December to spend 10-12 months based in the U.S. In 2003-03, Dale Bramley spent his fellowship at Mt Sinai-NYU Medical Centre investigating indigenous disparities in health status. In 2009-10, Penny Andrew was at the RAND Corporation looking at using patient experience survey data for quality improvement. In 2010-11 I was based in the Dept of Health & Human Services writing about the state of mHealth in the U.S. and in New Zealand. All three of us will say that the fellowship was a wonderful opportunity that broadened our horizons, taught us about the U.S. health system, and left us with a fantastic network of friends and colleagues across the world.
The Fund helps to place the fellows with a mentor to work on a project of interest to the U.S. and their home country. Fellows are spread all over the country but are brought together regularly as a group to learn about the U.S. healthcare system from some of the top people in their fields and to discuss the issues faced by all of our health systems. There were a total of 16 fellows in my year, and we recently had the chance to continue our longstanding friendship at a 20 year reunion of all the healthcare policy and practice fellows.
The three day meeting in Surrey, England, involved panel sessions on topics of interest, given by past fellows, as well as some inspirational speakers such as the CEO of the UK’s NHS, Simon Stevens. The UK has been going through interesting times with austerity measures, the integration of health with social care services, and severe pressures on primary care due to shortages of GPs. Simon Stevens also talked about the current immigration debate in light of the reliance of the NHS on immigrant staff, and the new paradoxical push for both place-based care and digital platforms. We will follow up with some examples of how different places in the UK are trying to address both the GP shortage and the integration of social care in another blog.
The three of us had a great time catching up with old friends and hearing about some of the great work going on across the nine countries. It also reinvigorated the New Zealand Harkness contingent to establish an alumni quarterly meeting and support new fellows. I would thoroughly recommend the Harkness Fellowship to anyone considering it. Please come and talk to any of us about it – we are more than happy to support proposals and tell you about our experiences. The next application round is due in September 2018.