Oh so they’re literally just killing fat people. If your BMI is higher than 35, you are,
according to this government, too fat to live.
(But also Bariatric waitlists are so far over capacity you’ll never get on them even if they didn’t start at >40, pharmac won’t fund your weight loss drugs because of price, and we also won’t ban fast food advertising because fuck you, die. This is really your own fault, you know.).
Never mind the fact that BMI is a non-accurate measurement and bias in medicine has been evidenced to be understating the fact that people with a higher BMI recover BETTER during hospitalisations. (Which is called a paradox by medicine because being fat means that NOTHING about you should be healthier or better than being skinny!) But you won’t hear about that because it’s all about the increased risk.
They literally couldn’t do this to old people. Winston Peters is in Parliament protecting them and also we have age discrimination laws that make this a grey area under BORA (if you’re already meeting legislated age thresholds, that is). But fortunately for Health NZ being fat is not a protected human right.
Absolutely on BMI - some of our fittest athletes representing NZ have body types that require them to have BMIs higher than 35 - can you imagine them saying, "Sorry Dame Valerie Adams", but you can't have life-saving surgery but thanks for all those medal you won for us, or any Prop from the All Blacks team, and probably all our weightlifters because muscle is heavier than fat, and loads of others I cannot think of - fortunately, Gerry Brownlee will have private health insurance, probably paid for by the taxpayer, so he is "sorted"
I also think that the Minister should front up on this, rather than the officials - this is a direct result of their cost cutting - we saw it in the UK where the target was that everyone could see a GP within something like 72 hours, so GP surgeries stopped allowing anyone to book an appointment more than 3 days in advance, so everyone they saw was seen withing 72 hours of booking - never mind all the people that could not get an appointment, as the target was 100% met
Targets should be "bigger" and measure the overall health of the nation (Impacts) rather than time spent in the EDs or waiting to see specialists or GPs (Inputs) - anyone who has ever done any intervention logic or monitoring and evaluation knows that if the inputs don't improve the impacts, then you are measuring the wrong inputs
I couldn't agree more - I wish more of us knew what to expect, and what we can ask for.
In lieu of that, they seem to do what they want.
Your comments remind me of a Northland oncologist I read about last year. His comments touched me and I remember his care.
He spoke about the shortcoming in this government's KPIs - I copy them below, Martin:
"THEY SEE NUMBERS. WE SEE FACES"
The problem with KPIs - including the Government's new target of faster cancer treatment times - was they just gave "a snapshot in time in a really complex process", Dr Ang said.
They did not capture waiting for scans, reporting on scans, treatments after surgery to wipe out rogue cancer cells lurking somewhere in the body, patient follow-ups, managing treatment side-effects and other symptoms, and all the other parts of the treatment "journey".
"If we do very well at faster cancer treatment and fail on all the rest of the cancer journey, we are basically failing our patients. And this is my concern - the fixation with the KPIs and big announcements on faster cancer treatments is it doesn't provide the whole picture."
Dr Ang expected to be disciplined by upper management for speaking publicly, but said his contract with his patients came first.
"I love my job as a medical oncologist, I care for my patients ... if my patient dies, a little part of me dies.
"The difference between us and the upper echelons of management is that we see faces.
"When I close my eyes, when I try to sleep, I think about the patients who the delays in appointments for treatment [or] for scans have harmed. I think about that and I feel the hurt or the pain they feel.
"I don't think our managers see those faces. They see numbers - but we see people.
"We don't expect them to carry the burden we carry as clinicians. But we just want them to acknowledge us and hear us and support us, rather than trying to obstruct what we're trying to achieve for patients."
It’s fair to say we now have The Hunger Games Public Health System—may the odds (and BMI) be ever in your favour.
Who could have predicted that the new Health KPIs would be gamed? Fortunately, we’ve had practice calling out such tactics. Full credit to the five Porirua GPs for shining a light on this.
Meanwhile, Health NZ leadership is spinning furiously and avoiding scrutiny—at least, those who are still in their roles.
Brace for more spin from the Minister, Commissioner, and Health NZ leadership in 3, 2, 1… It’s a disgraceful show of disrespect to the thousands of dedicated Health NZ employees who turn up every day to serve their communities.
We must keep holding the Coalition of Cruelty and their ‘mates’ to account.
Precisely . And as I’ve mentioned before they’ve also stopped surveillance colonoscopies. And asked high risk pregnant mothers to travel 3 to 4 hours.
This feels like putting lives at risk once again.
Too many still believe the lie that this government is trying to “fix” the errors of Labour. Or it’s about bureaucracy.
So many doctors have spoken up and sounded warnings.
At one level it’s incredible how all those warnings are either not being heard, or people are so influenced by doubt, that they believe the Govt is trying to fix anything here.
(Well they are trying to put a fix in to privatize health)
On the other hand, quick, short sound bites on media channels seems to be their key to deception.
And if there’s bad news they lie low until it’s forgotten.
This from yesterday's RNZ article asking if we should have a private health care system:
"Health NZ deputy chief executive Robyn Shearer said public-private partnerships were a "pragmatic" way to meet the government's wait time targets.
"At the moment the public system isn't able to meet the need, so this is a great solution for us."
This seems to me to be saying let's use public money to pay for private heath care (including a margin for profit) instead of using that money to improve the public health system. Just genius management.
I was an elected member of Northland DHB and we were using private surgical hospitals and consultants to decrease the waiting list. It never made any sense as private surgeons and hospitals are always more expensive than the public sector. So rather than invest in a public health system we were supporting private business purely because of the need to make our waiting list figures look better. The end result of any outsourcing to private interests is a degrading of the public sector and a push for sub-specialist surgeons from public to private.
Yes this is their intention - and the large majority of Kiwis are not aware at all.
Unfortunately NZME (NZ Herald) is an ally of this governmetn and Stuff's owner is part of a right wing lobby group.
There is no "Newstalk ZB" - Newstalk allowed Casey Corruption Costello to go on to say her critics were being "unfair" while she ran from other outlets.
It is straight from the playbook of disaster capitalism - decrease public spending, manufacture a crisis and subsequently invest in private business interests (normally multinationals) as a solution. Shock Doctrine by Naomi Klein is an eye opening read and gives a suggestion of what is awaiting us.
Not to mention that the private healthcae people cannot borrow money to build stuff as cheaply as government can, so it is not only the profits we end up paying, but also the extra interest on the capital borrowed. PPP might be a reasonable halfway house but until we can see a really brilliant example of one working here in NZ, then why would we bet all our money on PPP being the solution? We can do a real life experiment - build some piece of infrastructure using government debt and a very similar one using PPP, then let the mathematicians, scientists, statisticians, economists, etc tell us what was better for NZ - could be two roads, two hospitals, two anything really
I find it depressing that the COC continue to regress public services for their donors / investors with the assistance of media. This morning for instance this media was having a feeding frenzy over the Waipareira trust election investigation. Māori bashing is a lot more appetizing to them than the skullduggery the current government is up to.
A lot of the population are reluctant to admit they were played in the last election?? Will the majority remain so distracted that they allow democracy to be lost??
Yes, I agree - it's interesting what will get peoples' attention, and what won't.
I think a lot of it is about positioning. The media players know how to position things - and the right wing media in particular are great at sensationalising stories they want people to get angry about.
Again - I know I seem to be one of th few people who think it's a big deal - but the fact that a govt would cut ties with an at-cost provider to move them to private, expensive facilities is mindblowing to me - for what it reflects.
THAT article is only in ONE paper.
I have to say RNZ do a fantastic job of keeping on top of Health news for us - but I didn't even find it there
We do have to remember how popular soaps and reality TV are just to remind us what so many people seem to want these days - I like to go back and watch the Belgian classic "Man bites dog" every 5 years as the ultimate antidote to reality TV
As noted BMI has very poor correlation with health outcomes. Despite this BMI has been used for at least a decade in blocking access to particular surgeries. Orthopaedic surgery, in particular joint replacement surgery, has always been a discipline in which BMI has been used to block access. While there are limited studies showing increased complications from a high BMI with surgical outcomes (see https://www.sciencedirect.com/science/article/pii/S1063458414000089) a high BMI might result in a surgeon taking a longer time with surgery. Therefore a BMI cutoff is conveniently used by surgeons to avoid operating on patients that might take a little longer on the operating table. As a GP this is incredibly frustrating as my patients who have a BMI above some arbitrary cutoff suffer in pain, often unable to work and diminished quality of life. BMI should be banned for access to healthcare as there is limited evidence base.
Not sure if someone said this already, but why are we not hearing more in the media from healthworkers' unions, so that individuals dont have to speak oit and put their careers at risk?
The unions have been fighting pretty hard I think - but it’s primarily RNZ that cover them. They don’t get as much air time in Stuff and certainly less in NZ Herald. At least that’s my observation of it….
Lester Levy is learning from history. In the aftermath of the Vietnam War it was said that the US should have put a ring of steel around Saigon, declared victory and left. Change the criteria for entry onto a list, remove all those who don't meet them, declare victory. Simple really.
And the CEO of Fortehealth is, ... wait for it ..., none other than one Michael Woodhouse (more commonly referred to as"Woodlouse" in Dunedin), a former Natz MP!
Such an outrageous position. I'm now entering my 14 month on a waiting list for elective surgery to my knees. I have put on weight in this time because I can't walk for exercise!!!!!! A vicious circle. How do these people sleep at night?
Oh so they’re literally just killing fat people. If your BMI is higher than 35, you are,
according to this government, too fat to live.
(But also Bariatric waitlists are so far over capacity you’ll never get on them even if they didn’t start at >40, pharmac won’t fund your weight loss drugs because of price, and we also won’t ban fast food advertising because fuck you, die. This is really your own fault, you know.).
Never mind the fact that BMI is a non-accurate measurement and bias in medicine has been evidenced to be understating the fact that people with a higher BMI recover BETTER during hospitalisations. (Which is called a paradox by medicine because being fat means that NOTHING about you should be healthier or better than being skinny!) But you won’t hear about that because it’s all about the increased risk.
They literally couldn’t do this to old people. Winston Peters is in Parliament protecting them and also we have age discrimination laws that make this a grey area under BORA (if you’re already meeting legislated age thresholds, that is). But fortunately for Health NZ being fat is not a protected human right.
Maybe it should be.
Yes the article points out that BMI is not only an arbitrary index, it’s based on Western body types.
In addition, if someone needs knee surgery and are fat, that surgery could mean the difference between them getting up or not.
But all this is on brand - Chris Bishop has also been accused of gaming social and emergency housing waitlists
Media should be able to call deception out
Absolutely on BMI - some of our fittest athletes representing NZ have body types that require them to have BMIs higher than 35 - can you imagine them saying, "Sorry Dame Valerie Adams", but you can't have life-saving surgery but thanks for all those medal you won for us, or any Prop from the All Blacks team, and probably all our weightlifters because muscle is heavier than fat, and loads of others I cannot think of - fortunately, Gerry Brownlee will have private health insurance, probably paid for by the taxpayer, so he is "sorted"
Great point Martin !
Yep, it's all right to be anything if you're also wealthy 😭
I'm sure Brownlee has private health backup. Ditto Donald Trump.
The media just don't give a damn, far to busy chasing TPM, John Tamihere, and the Waipareira trust
I also think that the Minister should front up on this, rather than the officials - this is a direct result of their cost cutting - we saw it in the UK where the target was that everyone could see a GP within something like 72 hours, so GP surgeries stopped allowing anyone to book an appointment more than 3 days in advance, so everyone they saw was seen withing 72 hours of booking - never mind all the people that could not get an appointment, as the target was 100% met
Targets should be "bigger" and measure the overall health of the nation (Impacts) rather than time spent in the EDs or waiting to see specialists or GPs (Inputs) - anyone who has ever done any intervention logic or monitoring and evaluation knows that if the inputs don't improve the impacts, then you are measuring the wrong inputs
I couldn't agree more - I wish more of us knew what to expect, and what we can ask for.
In lieu of that, they seem to do what they want.
Your comments remind me of a Northland oncologist I read about last year. His comments touched me and I remember his care.
He spoke about the shortcoming in this government's KPIs - I copy them below, Martin:
"THEY SEE NUMBERS. WE SEE FACES"
The problem with KPIs - including the Government's new target of faster cancer treatment times - was they just gave "a snapshot in time in a really complex process", Dr Ang said.
They did not capture waiting for scans, reporting on scans, treatments after surgery to wipe out rogue cancer cells lurking somewhere in the body, patient follow-ups, managing treatment side-effects and other symptoms, and all the other parts of the treatment "journey".
"If we do very well at faster cancer treatment and fail on all the rest of the cancer journey, we are basically failing our patients. And this is my concern - the fixation with the KPIs and big announcements on faster cancer treatments is it doesn't provide the whole picture."
Dr Ang expected to be disciplined by upper management for speaking publicly, but said his contract with his patients came first.
"I love my job as a medical oncologist, I care for my patients ... if my patient dies, a little part of me dies.
"The difference between us and the upper echelons of management is that we see faces.
"When I close my eyes, when I try to sleep, I think about the patients who the delays in appointments for treatment [or] for scans have harmed. I think about that and I feel the hurt or the pain they feel.
"I don't think our managers see those faces. They see numbers - but we see people.
"We don't expect them to carry the burden we carry as clinicians. But we just want them to acknowledge us and hear us and support us, rather than trying to obstruct what we're trying to achieve for patients."
https://www.rnz.co.nz/news/national/523895/northland-cancer-specialist-speaks-out-on-shortages
Thanks for highlighting this Health NZ reporting.
It’s fair to say we now have The Hunger Games Public Health System—may the odds (and BMI) be ever in your favour.
Who could have predicted that the new Health KPIs would be gamed? Fortunately, we’ve had practice calling out such tactics. Full credit to the five Porirua GPs for shining a light on this.
Meanwhile, Health NZ leadership is spinning furiously and avoiding scrutiny—at least, those who are still in their roles.
Brace for more spin from the Minister, Commissioner, and Health NZ leadership in 3, 2, 1… It’s a disgraceful show of disrespect to the thousands of dedicated Health NZ employees who turn up every day to serve their communities.
We must keep holding the Coalition of Cruelty and their ‘mates’ to account.
Precisely . And as I’ve mentioned before they’ve also stopped surveillance colonoscopies. And asked high risk pregnant mothers to travel 3 to 4 hours.
This feels like putting lives at risk once again.
Too many still believe the lie that this government is trying to “fix” the errors of Labour. Or it’s about bureaucracy.
So many doctors have spoken up and sounded warnings.
At one level it’s incredible how all those warnings are either not being heard, or people are so influenced by doubt, that they believe the Govt is trying to fix anything here.
(Well they are trying to put a fix in to privatize health)
On the other hand, quick, short sound bites on media channels seems to be their key to deception.
And if there’s bad news they lie low until it’s forgotten.
This from yesterday's RNZ article asking if we should have a private health care system:
"Health NZ deputy chief executive Robyn Shearer said public-private partnerships were a "pragmatic" way to meet the government's wait time targets.
"At the moment the public system isn't able to meet the need, so this is a great solution for us."
This seems to me to be saying let's use public money to pay for private heath care (including a margin for profit) instead of using that money to improve the public health system. Just genius management.
And it's increasingly not able to meet needs because this govt guaranteed it to be the case :
- freezing hires,
- not replacing frontline professionals
- slashing up to $2bn from health
- underfunded health to a negative per capita rate in the 2024 budget.
It's the Noam Chomsky formula through and through - cut, destabilise, and claim private is the only answer.
They've done this.
This would theoretically all be fair but for how few people seem to really understand what is happening, how it's being done and what's at stake.
Wellington mums not getting toast can get the country in uproar - but this - is just absorbed now & is no longer a shock to most of us.
The reason why I harp on about the surgeries being moved to private is because it's a huge signal of their intent and disregard for taxpayer money.
i.e. It's a farce
What I'm learning is most people don't understand root cause analysis or linking cause to effect.
And without Mike Hoskings or Ryan Bridges yelling it at them, most of us won't care.
I was an elected member of Northland DHB and we were using private surgical hospitals and consultants to decrease the waiting list. It never made any sense as private surgeons and hospitals are always more expensive than the public sector. So rather than invest in a public health system we were supporting private business purely because of the need to make our waiting list figures look better. The end result of any outsourcing to private interests is a degrading of the public sector and a push for sub-specialist surgeons from public to private.
Yes this is their intention - and the large majority of Kiwis are not aware at all.
Unfortunately NZME (NZ Herald) is an ally of this governmetn and Stuff's owner is part of a right wing lobby group.
There is no "Newstalk ZB" - Newstalk allowed Casey Corruption Costello to go on to say her critics were being "unfair" while she ran from other outlets.
Let's keep speaking up - thank you Kyle!
It is straight from the playbook of disaster capitalism - decrease public spending, manufacture a crisis and subsequently invest in private business interests (normally multinationals) as a solution. Shock Doctrine by Naomi Klein is an eye opening read and gives a suggestion of what is awaiting us.
It is shocking - and so in our faces, they don't even care anymore.
Not to mention that the private healthcae people cannot borrow money to build stuff as cheaply as government can, so it is not only the profits we end up paying, but also the extra interest on the capital borrowed. PPP might be a reasonable halfway house but until we can see a really brilliant example of one working here in NZ, then why would we bet all our money on PPP being the solution? We can do a real life experiment - build some piece of infrastructure using government debt and a very similar one using PPP, then let the mathematicians, scientists, statisticians, economists, etc tell us what was better for NZ - could be two roads, two hospitals, two anything really
Great point Martin,about the interest costs.
Thanks MT another excellent article. Shared.
I find it depressing that the COC continue to regress public services for their donors / investors with the assistance of media. This morning for instance this media was having a feeding frenzy over the Waipareira trust election investigation. Māori bashing is a lot more appetizing to them than the skullduggery the current government is up to.
A lot of the population are reluctant to admit they were played in the last election?? Will the majority remain so distracted that they allow democracy to be lost??
It’s a very real possibility because of the incessant lies this government spins.
Amazing they are not called out by the media that this is explicit lying.
Hi Rob - About the media too.
Yes, I agree - it's interesting what will get peoples' attention, and what won't.
I think a lot of it is about positioning. The media players know how to position things - and the right wing media in particular are great at sensationalising stories they want people to get angry about.
Again - I know I seem to be one of th few people who think it's a big deal - but the fact that a govt would cut ties with an at-cost provider to move them to private, expensive facilities is mindblowing to me - for what it reflects.
THAT article is only in ONE paper.
I have to say RNZ do a fantastic job of keeping on top of Health news for us - but I didn't even find it there
We do have to remember how popular soaps and reality TV are just to remind us what so many people seem to want these days - I like to go back and watch the Belgian classic "Man bites dog" every 5 years as the ultimate antidote to reality TV
Yes indeed
As noted BMI has very poor correlation with health outcomes. Despite this BMI has been used for at least a decade in blocking access to particular surgeries. Orthopaedic surgery, in particular joint replacement surgery, has always been a discipline in which BMI has been used to block access. While there are limited studies showing increased complications from a high BMI with surgical outcomes (see https://www.sciencedirect.com/science/article/pii/S1063458414000089) a high BMI might result in a surgeon taking a longer time with surgery. Therefore a BMI cutoff is conveniently used by surgeons to avoid operating on patients that might take a little longer on the operating table. As a GP this is incredibly frustrating as my patients who have a BMI above some arbitrary cutoff suffer in pain, often unable to work and diminished quality of life. BMI should be banned for access to healthcare as there is limited evidence base.
Thank you Kyle for sharing your insights and knowledge with us. It's much appreciated 🙏
So darn depressing….
Not sure if someone said this already, but why are we not hearing more in the media from healthworkers' unions, so that individuals dont have to speak oit and put their careers at risk?
The unions have been fighting pretty hard I think - but it’s primarily RNZ that cover them. They don’t get as much air time in Stuff and certainly less in NZ Herald. At least that’s my observation of it….
Lester Levy is learning from history. In the aftermath of the Vietnam War it was said that the US should have put a ring of steel around Saigon, declared victory and left. Change the criteria for entry onto a list, remove all those who don't meet them, declare victory. Simple really.
😔
And the CEO of Fortehealth is, ... wait for it ..., none other than one Michael Woodhouse (more commonly referred to as"Woodlouse" in Dunedin), a former Natz MP!
Oh no.
Shame on them 🤬
Bloody hell. Really appreciate being informed on this but it is very scary. What are we coming to 😔
I predict over the next year they will try to mass outsource to get the wait lists down - they need things to look good for the 2026 election.
I predict that in the 2025 budget Nicola Willis will announce "record investment" to allow this outsourcing to take place.
Things are challenging around the world - take solace you are not alone, and things can and will improve over time. 🌳🌳
Read the fine print of hospital admission consent forms.
The pharmacy is well stocked with midazolam.
Such an outrageous position. I'm now entering my 14 month on a waiting list for elective surgery to my knees. I have put on weight in this time because I can't walk for exercise!!!!!! A vicious circle. How do these people sleep at night?