Guest Editorial

Disasters have a habit of catching us unawares, despite the best of planning.  In the years leading up to 2000, much of the developed world was obsessed with the risks associated with the so-called Y2K bug.  Those that advocated strongly in favour of the massive investments in system upgrades to avoid the potential catastrophe subsequently insisted that the effort was well spent; the US government’s official report was subtitled “Crisis Averted”.^[i] A more sceptical view was expressed to me on 1 January 2000 by a senior executive at the hospital where I worked after we had had the entire IT support team on standby on the night of the millennium: “it was all a big con” he said.

Of course we now know that what we really should have been preparing for was the possibility that airliners would be turned into missiles by terrorists, but anyone seriously suggesting such a possibility in the first year of the new century would have been quietly assigned to the lunatic fringe.

Such is the environment in which the disaster planner has to work. Planning for an eventuality which may never occur requires a different mindset to other kinds of planning.  In this edition of the journal, we provide a practical analysis of the generic issues to be considered in business continuity planning, and some examples of how such planning might be applied in the highly topical area of pandemic influenza, from both the information systems perspective and the organisational readiness perspective.

Kerr notes that as the delivery of health care becomes more dependent on technology infrastructure, then so must the planning to preserve that infrastructure. The classic "four Rs" of disaster planning - risk reduction, readiness, response and recovery - are outlined. It is disquieting to learn that the extent to which these well-established principles are not being followed in health care to the extent that one might reasonably expect.

Delany provides some relief by describing the detailed emergency planning steps set out by the Ministry of Health and other agencies for response to a pandemic emergency. However, the morbidity and mortality projections for a pandemic make grim reading, as does the lack of sophistication in the public health surveillance systems when set against the relatively technology-enabled hospitals and primary care facilities. Delany cautions against grand plans that may take years to come to fruition, and instead advocates simple pragmatic steps that can be undertaken now. This journal has previously published papers that would support this view.

Cameron’s paper takes a light-hearted tone, and shows that there has been a heightening of awareness of the need for adequate planning in primary care. Through the recent national exercises relating to pandemic planning, there has been an increase in the understanding of what is important. Once again, we hear that a significant barrier is a general unwillingness to take the subject of disaster planning seriously, but Cameron concludes optimistically that progress is being made, although there is, as always in health care, much work to be done.

We might well be alarmed by the theme running through all of these papers that there is in general a low level of awareness of the need for proper contingency planning, and that the resources required to undertake this role properly are scarce. In a year that has seen an unusual run of weather-related disasters both in New Zealand and in many other parts of the World - not to mention man-made catastrophes - perhaps it is time for us to take more notice. Hospitals and other emergency treatment facilities are the first places we look to when disaster strikes: It would be ironic indeed if these facilities were to find themselves unable to cope with the needs of the stricken through lack of forward planning.

Reference
United States Senate. Y2K Aftermath - Crisis Averted. Final Report of Special Committee on the Year 2000 Technology Problem. Washington DC. 2000.