Chris Crawford, PSM
Chris Crawford, PSM

After 15 years running the region’s health service - under various names, and varying footprints - Northern NSW Local Health District Chief Executive, Chris Crawford, will step down at the end of 2015. Over a suitably healthy lunch (Japanese) with GP Speak editor Robin Osborne, he reflected on his time in this highly challenging role.

To be clear from the start, Chris Crawford is not going anywhere, except in early January 2016 when he takes his younger son on a trip through the mostly southern states of the USA. He did a similar trip with his elder son, focusing on the eastern states.

For permanent living, however, Chris loves the Northern Rivers, “A place where many people come to retire, but we [his wife Catherine Cusack is a Liberal Party Member of the NSW Upper House] came here while we were working, and we still are, and we’re still here.”

But the US looms large in their lives, with Chris and Catherine spending time experiencing what many outsiders regard as the unfathomable US presidential election process. During his January trip, the first of the primaries will be taking place - in the southern states.

Chris loves Canada, too, again its politics, and is currently reading Full Circle - Death and Resurrection in Canadian Conservative Politics.

That’s not to say he only reads about conservatives - he’s looking forward to knowing more about Canada’s new PM, Justin Trudeau - nor just political histories. He is currently embroiled in the fourth book in the Millennium series, The Girl in the Spider’s Web, the one not penned by Stieg Larsson.

It is reassuring to hear that he has relaxation time, because Chris Crawford PSM (the Public Service Medal, awarded for outstanding government service) is legendary for long working hours and dedication to his job.

He has been employed in the public health sector for 28 years, some six of them as head of St George Hospital and community health, and many people find it hard to imagining his letting go.

Life after the NNSWLHD won’t be dull, he assures us, saying he will leave with fond memories and the satisfaction of a job he feels was well done.

Asked about highlights, he nominates the extensive redevelopment of Lismore Base Hospital, still under way, moving rehab to Ballina Hospital, changing Campbell Hospital, Coraki to a HealthOne model, and the current building of a new Byron Central Hospital, worth $88M.

I believe we have taken the region’s health system closer to a metro model, with significant enhancements to technology - MRI, CTs, cardiac cath labs - many more specialists, both medical and nursing, and superb facilities in areas such as mental health.

The population growth up here has created the demand and the expectation for such services, and a great many of these challenges have been met.”

Disappointments have been few, he said, although he wishes that the new Byron hospital could have been developed quicker. He recalls that in his first month here, 15 years ago, he met with community reps from the north and south of the Shire, to discuss a new facility but it has taken this long to get it built.

As usual, there were some financial constraints, but the delay was largely because the community couldn’t agree on the location, and discord of this kind causes concerns for government.”

He feels that where the system - and not just in northern NSW - may be failing the community is in the area of health literacy.

We need to better explain the need to take good care of themselves, and how to do so, both in terms of lifestyle behaviours and in seeking care early when problems arise.

It’s vital to communicate the benefits of healthy living and timely diagnosis and treatment, and to do so in an audience appropriate way.

Generally speaking, the middle classes are managing well, but there are significant special category groups who are not, for example drug users, which is a high percentage up here, mental health clients, and many Indigenous people.

GPs are ideally placed to assist with this, and to join the public health sector in the integrated care journey.”

What might come next?

Not surprisingly, politics rears its head again, and government. Chris is eyeing a PhD on the intersection between the two, and is working on the best angle. He also intends to set up an online blog. For those seeking an insider view on how western governance work, it should make for fascinating reading.