Crashing New Zealand's health system is not the way to prosperity, Prime Minister
Support our doctors, nurses and hospitals before we go down the way of Britain's NHS
Another day, and yet another piece of bad news for New Zealand’s health system.
Reports have come out that General Practitioners (GP) may have to close doors, or increase patient fees to survive. The so-called ‘capitation’ funding review, which supports GP practices to survive, is under way, and primary care practitioners are concerned.
First, let's do a quick recap to examine our health system landscape since Prime Minister Luxon, Health Minister Shane Reti and Finance Minister Nicola Willis have taken over their porfolios.
In May 2024, MP for Whangarei, Shane Reti, was selling his Government's health credentials:
“Our Government has set ambitious targets for the health sector...(Our) budget prioritises frontline health services & workers.”
But just a month earlier, in April, a series of information leaks had already forced Health NZ to confirm it was directing all public hospitals save a total of $105 million by July 2024. For example, Auckland was asked to cut $15.5m from its hospitals, Northland $4.5m, Canterbury & South Canterbury $14.5m, Nelson $3m, Bay of Plenty ~$7m etc.
The directive confirmed “the Government is asking the public sector to make efficiencies to manage significant cost pressures.”
Could this have anything to do with the $12-14bn of tax cuts the National Government was going to gift us all in May? The one that Nicola Willis made on the back of public service cuts and lowering beneficiary incomes. The one she then borrowed an additional $12bn for, pushing us into a government debt ratio of ~45% and with a larger budget deficit than any of Grant Robertson's budgets, bar Covid? The question is rhetorical.
Furthermore, Reti had, as soon as he got into office and through to the budget:
Put on indefinite hold the Whangarei hospital re-build despite the previous government's committed funds of $800m to it.
Put into limbo Nelson’s hospital plans, after plans had already been procured and agreed to for optimal patient care and capacity.
Deferred Dunedin hospital investment without a clear timeline, putting into doubt previous National Party promises
Did not fund any of the mental health doctors they promised
Funded half of the promised new medical registrars, and tried to blame that decision on the Universities!
Broke their promise of funding cancer drugs in the May budget, then spectacularly u-turning after public backlash.
Cut funding for the Health and Disability Commissioner (HDC) who is already dealing with a 3 year backlog of complaints
Cut $381 million in planned digital health investment, after Labour had committed the funds, leaving the health system in a disarray of paper records, and paper trails
And as Ministers Reti and Willis plugged their budget as being good for healthcare, doctors and medical professionals simultaneously warned -
“Budget 2024 leaves health system struggling.. It leaves our health system treading water, our workforce over-stretched and patients left waiting longer and longer. New Zealand deserves a commitment from Prime Minister Christopher Luxon, and his coalition partners Winston Peters and David Seymour, that they will grow our public health workforce and provide the investment to train, recruit and retain the staff needed."
About hospitals again -
It's been confirmed again this week that frontline hospital roles are going unfilled, amidst Health NZ's budget cuts.
Don't forget that this austerity doesn't apply to landlords ($3bn over 4 years), pothole contractors ($4bn over 3 years), and road build spend ($70bn over 10 years).
Make no mistake - this is about priorities, not forced austerity.
Last month, Health NZ denied a hiring freeze despite suddenly freezing new graduate nurse intakes. At a time of critical nursing shortages, it was a bizarre move to not support our home grown graduates and leave them in the lurch like this.
Health NZ flatly denied it, playing word semantics, as other reports filed in.
Health NZ had also already ordered an immediate hiring freeze on all non-frontline roles - as if that imaginary line between front-line and non-frontline means anything in practice.
This week, Whangarei hospital nurses stepped out to warn that conditions for patients and staff in Northland hospitals were deteriorating rapidly. "Eventually somebody will die."
They feared Government cutbacks on staffing was affecting patient care and risked lives -
"Possibly 20 patients a day might not be getting the care they're supposed to have … Putting a freeze on recruitment is not the way to get good healthcare..I think we're all feeling that eventually somebody will die as a result of these measures."
Hospitals are not the only frontline staff feeling the heat.
Back to primary care -
We are in a GP crisis. It’s not new. Weeks long waits to see one are common, if access is available at all. General Practitioners Aotearoa's Dr Burrell has said New Zealand’s GP-to-patient ratios is “embarrassing”. Only 25% of practising doctors now work in primary care, a stark fall from years before.
The GP body wrote to Health Minister Dr Shane Reti 5 months ago to discuss how to address this crisis.
Two months after that, Shane Reti showed us how that went. On a segment on Q&A with Jack Tame, he said he didn't include GP targets into his Government's 'ambitious' public service targets, because that was "too hard."
Once again, this Government demonstrates a keen lack of seriousness and responsibility, instead giving themselves homework that's more suitable for crayons than serious governance.
I could go on, but let's start to wrap it up.
In Lower Hutt, National Minister Chris Bishop's electorate, one practice had one GP for over 9000 patients. Today, after a lot of publicity and pressure, they hired a new GP.
The health system is in crisis, and it will need bold leadership to correct. The previous Government had started a number of those measures, and it is up to the current one to not only advance them, but also improve on it. Not roll them back and make it worse, or redirect investment to tax cuts and roads.
Before the election, ACT promised "care and dignity" to primary care practitioners. 13% funding per patient was what they said they would offer to GP practices if they won.
Fast forward to over a year later.
New Zealand's GP practices have just been offered 4% in patient funding support from the Government - that's less than inflation, and well below their cost pressures. The profession said this could hurt an already struggling sector and force some practices to close. But they are also being told they can increase patient fees by nearly 8 per cent to compensate.
That means, this Coalition Government wants sick New Zealanders to stump up the extra, with 1% still missing. At a time when cost of living, and the reinstatement of prescription fees is already hurting many.
The consultation process is now underway and as always, we hope the Government will capitulate to common sense.
Still how much of all the gifted tax cuts will be eaten up by ongoing fees caused directly by this same Government?
Is it any surprise that two more Health NZ Board members have suddenly and 'surprisingly' quit before their term has ended? That leaves only 2 members left after others opted to opt-out as well.
Make no mistakes, our health system is in crisis. The decisions of the present count more than any number of road cones.
These are not only significant health infrastructure deficits being incurred, they are health system deficits of skill, morale, capacity, and leadership too.
I pass Dunedin’s new hospital buildings most days. The first build for outpatients is being worked on. The other has piles in the ground but not much else happening. The old hospital is falling apart, staff are leaving, vacancies not being filled. One example is in outpatients where the various teams rely on booking clerks to maintain the rotas, make appointments and talk to patients. If one person goes on maternity leave and there is not cover, waiting lists climb, clinics go unused and all Health say is there is a hold on recruitment.
The reality is getting worse. Reti speaks with a forked tongue and he is a Doctor for heavens sake!
More broken promises more lies. This government is determined to increase the gap between the rich and the poor. They are also willing to destroy everything and make sure quality of life is only for them and their mates.