Levy's weasel-words have such a Trumpish ring to them - reading between the lines one is filled with horror at the thought of this country on the brink of its own Project2025, with the "Black Riders" (excuse my Tolkienish metaphor!) already set loose and galloping about the countryside!
On the KPI, the numbers coming through the doors and the capacity of the system should be a better indicator of how it is working. Some weekends you might only have one ED specialist on when there should be 3, you are never going to hit numbers of 95% when you don’t have the right people in the right place at the right time.
Yes I agree 💯 it appears to be a made up number and as such perhaps not the best target 🎯 to be focusing our resources on? If you really wanted to hit it you would be stopping outpatient clinics and getting your wards moving so there is somewhere for those sick people to go once they get seen in ED. Oh that’s right hospitals get extra funding for outpatient clinics! All comes back to the $$
I've said this before. There is no wait time if you go private. Leopards don't change their spots. This guy is a user-pays politico. He's bundling up the health system for sale to AIG (with our$40b ACC) the US health insurance company and Reti and Luxon are compliant. Levy tells us about his family health needs but don't they all have private health care.?? He quotes political polemists Lange Churchill with admiration. Inspirational leaders and he so aspires...
As someone who has spent time in retail THIS IS BASIC! More staff at peak times resulted in more profit to the company because people were both able to obtain advice, and be processed through the checkout without storming out and going elsewhere. Of course it is much more vital people get timely health care than advice on which dress suits them, or which plant will grow well in the shade/sun/wet/dry, but the principle is the same - appropriate qualified staffing levels = best outcomes for all. (and unlike retail, the ED is a virtual monopoly so storming out and going ... where?)
Unfortunately part of the razor gang cutting are some (read most) of the analysts that have the access and the skills to extract the data required to make sense of of what is happening in the hospital systems. Every DHB used to have a team of them? Now I think there is one team for the whole country. So nuanced datasets might be a struggle to get internally let alone for Joe Public!
OMG, if I hear one more media story using the phrase "budget blowout", I'm not sure I will stop screaming. It's only a blowout if you spend way more than you expected, and if your basic premise was wrong, or in the case of this government, arbitrary to help sell their narrative, then it only illustrates your incompetence. I read somewhere, disability costs "had doubled since 2005". Ffs. So what! The purpose of that statement is to hook "doubled" into the outrage as opposed to thinking, "jaysus, how badly were we supporting them before?"
We are naive if we think reasoned debate is going to change any outcomes. The blueprint is in and they are going hell-for-leather to implement it. I knew it was going to be bad, but I'm astonished at their audacity.
I laughed when I read your sentence, but only because you hit the nail on the head so quickly, Lynette. It's really crazy and sad. And a lot of it in my opinion is pure emotional manipulation - without context, all their numbers and stories become meaningless, and mostly, outright misleading.
But I believe that trend started pre-election and their ethos and tactics have been quite dirty for that long, at least.
Oh yes, it has always been their 'way', but people seem to suffer from selective amnesia and somehow, I dunno, thought they should be given a 'go'??!! It's the unbridled power and speed of disestablishment and arson that is really disturbing - like some kind of weird riot without the smoke bombs. Intimidation is everything and I feel like I am peering through the curtains at the mob. At some point I'm going to have to get out on the street or at least join the resistance
I hear you, Lynette. It does feel like action will soon be needed, but how do we get a cohesive opposition is my question. Even the Greens, under Chloe, were at one point attacking Labour, and I thought it was a waste of air space for where we are at. As to the government - nearly everything they have done was signalled pre-election. But as you said before, they are much more brazen than maybe you or I would expect.
🙋🏾♀️Absolutely the RIGHT question with disability costs - most people understood this area was under-resourced on many levels so if costs have DOUBLED and they are STILL under-resourced by all trustworthy measures (i.e. not the current govt!) they should be getting more not less. And let's recognise that as a healthy independent citizen with no extra support needs, MY costs have gone up A LOT since 2005 🤷🏾♀️
Hmmm… last time National was in power they had similar goals - 6 hour ED times and 6 month elective waiting lists.
So what happened was hospitals created new wards that were effectively just glorified ED beds but they qualified as “transfers” for the targets. With regard to the waiting list time, they simply sent letters to the people whose elective surgeries weren’t seen as significantly necessary as others on the list to make the six month cut off and those poor people were basic told to come back later (when they were worse and met the more stringent criteria to get surgery within six months).
So patient outcomes won’t actually improve here, it’s just a flashy paint job on a rotting building. They could just fix the building instead, but there is no glory in that for this government as it doesn’t lead them closer to privatisation of the health system.
The more things change, the more they stay the same.
Yes, Melissa, the ED target in particular is easily manipulate-able, and it sounds from what you said, they are just playing an old record. And what you say happened would add more burden onto the health system, ultimately as well as the poor patients and their families..
Ironically if one looks at most of what Luxon has been doing and saying - including boot camps, KPIs etc, he's been copying and pasting most things from the past and in thoroughly uninspiring, uncreative, and regressive ways.
It's really disappointing and I think he should probably stay true to his Christian values and try not to exercise that low self esteem - and need to be seen to achieve - on the country.
I worked in health at the time but there was some contemporaneous news coverage so hopefully something out there to corroborate my memory if I can muster the energy to search for it. I definitely remember media coverage on the elective surgery waiting lists. I’m not so sure about media coverage of the ED transfer wards as the people had been triaged before being “transferred” to what was essentially another ED for people deemed to be ill (sometimes quite ill) but not at risk of imminent death. I found it disingenuous at the time, as it was clearly created as a way to meet the ED targets. But technically it was a “ward” so make of it what you will.
Even without a google, which is my specialty :-) I would say it definitely happened. I recall on Q&A with Jack Tame, Shane Reti was asked about gaming the system, and Reti droned on about how under him he would manage it.
Also, just looking at their big medical KPIs, it's obvious to me that it really is about gaming the system from the government.
Just as one example - not one housing build KPI - but a KPI for how many vulnerable and poor people they can throw out of emergency houses.
Thank you. There was a pīwakawaka in my neighbourhood who tried to get in my house through the same window in my living room every summer. Once he succeeded, and I had to shuffle him out, he never tried it again! Nevertheless, he still danced in front of my big living room window every year until a couple of years ago when he just didn’t appear one spring. I still miss that bird, but his memory brings me joy. ❤️🩹
I too remember this - I like the analogy of "a flashy paint job on a rotting building" - particularly because they are literally stopping work on fixing/replacing substandard buildings.
Lastly mental health they are talking about getting people with lived experience as mental health assistants to work in EDs , I saw this in some of the select committee discussions, not sure what the mental health profession thinks of this ? I know in South Australia they are building separate mental health facilities so that these people have a safe space instead of in general ED. Is this something for nz to consider?
The real question Dave is how bright ideas and genuine research backed policies come into effect. I'm not feeling a great degree of confidence with the decisions that I've seen from the Luxon led government to date.
Treasury will be releasing the document pack for last budget at the end of August, this should be revealing as to what was asked for and how they have justified the position. Some of the prep for next budget is out as well, reading the auditor general report for vote health they are looking at hospital health workforce numbers and asking if total number has increased why hasn’t productivity? Of course the answer to this is complex and has many factors. One is current collective contracts for doctors that essentially means that they work “less” number of hours than previously ie they have rosters that are more realistic , so you need more FTE to cover the same service. Etc etc.
Given Levy has established his credentials IN THE HEALTH SECTOR with multiple failures, it is sadly obvious he was deliberately manoeuvred into having this role - in other words his appalling lack of understanding of how things actually work and empathy for actual people/patients, is seen as "a feature not a bug" as we say these days.
Yes, I felt concerned too - hence my post. It’s hard to explain isn’t it? But I summarise it as mumbo jumo but scary it in its outlook and potential execution.
LEVY is a disaster that's already happened but apparently the Govt wants more of the same destruction. He is an arrogant, entitled 🙄 self centered piece of work who will cause untold damage to a health system already under pressure.
I feel for Margie Apa, the CE.
I've heard that Shane Reti was given a clear message - front the health direction the Nats want to head in or get on ya bike. If that's the case and for the sake of his own integrity, I'd like to see him walk the talk and prove he cares before it's too late.
I wonder why Apa is staying - it's clear to me they will roll her if they can and/or set her up.
Re: Reti, I've seen a few interviews and he strikes me as a timid, fearful politician who is willing to say anything to protect himself and his party. For example, he would not answer if nicotine was as harmful as caffeine, instead adding all sorts of variables into the mix to avoid answering it directly.
Re: Levy, the Newsroom article quoted above made it pretty clear that he is Luxon's sort of guy.
Tbh I understand Dr Reti is a lovely person and decent human being. However, both he and Tama are selling the un-sellable. There will be a stage when they'll have to make a call because right now their reputation is close to if not below zero within Māoridom.
Re Margie Apa, I'm pretty sure she knew what was coming on election night. But she still has a job to do and she will continue to do it to the best of her ability until she's moved on - and probably replaced by a boys club member of the stale, pale, male brigade.
Arohamai this whole bloody scenario pisses me off. For the first time in my life I'm feeling this is NOT my country right now.
I remember a reader once wrote on here that most people are friendly.
And I reflected on your point too.
But I wonder how someone can be decent and lovely, yet show ethics of that nature? i.e. I think all people can be friendly or nice on the surface, but actions speak louder than words.
There's a lot of negative news, but the most ironic part is that so many believe it isn't so.
Gotta love his immediate points of reference to Health NZ in terms of organisational complexity is a bank or an energy company. Because those do have the same motivation and purpose. Unbelievable
Levy's weasel-words have such a Trumpish ring to them - reading between the lines one is filled with horror at the thought of this country on the brink of its own Project2025, with the "Black Riders" (excuse my Tolkienish metaphor!) already set loose and galloping about the countryside!
Yep, agreed Peter, and with sadness too.
On the KPI, the numbers coming through the doors and the capacity of the system should be a better indicator of how it is working. Some weekends you might only have one ED specialist on when there should be 3, you are never going to hit numbers of 95% when you don’t have the right people in the right place at the right time.
100% There are far smarter minds than I but the wait time one just felt one dimensional and un-intelligent to me. Once again, great point!
Yes I agree 💯 it appears to be a made up number and as such perhaps not the best target 🎯 to be focusing our resources on? If you really wanted to hit it you would be stopping outpatient clinics and getting your wards moving so there is somewhere for those sick people to go once they get seen in ED. Oh that’s right hospitals get extra funding for outpatient clinics! All comes back to the $$
When will the adults be in charge? :-)
I've said this before. There is no wait time if you go private. Leopards don't change their spots. This guy is a user-pays politico. He's bundling up the health system for sale to AIG (with our$40b ACC) the US health insurance company and Reti and Luxon are compliant. Levy tells us about his family health needs but don't they all have private health care.?? He quotes political polemists Lange Churchill with admiration. Inspirational leaders and he so aspires...
Yes, you're right.
As someone who has spent time in retail THIS IS BASIC! More staff at peak times resulted in more profit to the company because people were both able to obtain advice, and be processed through the checkout without storming out and going elsewhere. Of course it is much more vital people get timely health care than advice on which dress suits them, or which plant will grow well in the shade/sun/wet/dry, but the principle is the same - appropriate qualified staffing levels = best outcomes for all. (and unlike retail, the ED is a virtual monopoly so storming out and going ... where?)
You just prove common sense is the key to a lot of things.
Unfortunately part of the razor gang cutting are some (read most) of the analysts that have the access and the skills to extract the data required to make sense of of what is happening in the hospital systems. Every DHB used to have a team of them? Now I think there is one team for the whole country. So nuanced datasets might be a struggle to get internally let alone for Joe Public!
Tracks.
OMG, if I hear one more media story using the phrase "budget blowout", I'm not sure I will stop screaming. It's only a blowout if you spend way more than you expected, and if your basic premise was wrong, or in the case of this government, arbitrary to help sell their narrative, then it only illustrates your incompetence. I read somewhere, disability costs "had doubled since 2005". Ffs. So what! The purpose of that statement is to hook "doubled" into the outrage as opposed to thinking, "jaysus, how badly were we supporting them before?"
We are naive if we think reasoned debate is going to change any outcomes. The blueprint is in and they are going hell-for-leather to implement it. I knew it was going to be bad, but I'm astonished at their audacity.
I laughed when I read your sentence, but only because you hit the nail on the head so quickly, Lynette. It's really crazy and sad. And a lot of it in my opinion is pure emotional manipulation - without context, all their numbers and stories become meaningless, and mostly, outright misleading.
But I believe that trend started pre-election and their ethos and tactics have been quite dirty for that long, at least.
Oh yes, it has always been their 'way', but people seem to suffer from selective amnesia and somehow, I dunno, thought they should be given a 'go'??!! It's the unbridled power and speed of disestablishment and arson that is really disturbing - like some kind of weird riot without the smoke bombs. Intimidation is everything and I feel like I am peering through the curtains at the mob. At some point I'm going to have to get out on the street or at least join the resistance
I hear you, Lynette. It does feel like action will soon be needed, but how do we get a cohesive opposition is my question. Even the Greens, under Chloe, were at one point attacking Labour, and I thought it was a waste of air space for where we are at. As to the government - nearly everything they have done was signalled pre-election. But as you said before, they are much more brazen than maybe you or I would expect.
🙋🏾♀️Absolutely the RIGHT question with disability costs - most people understood this area was under-resourced on many levels so if costs have DOUBLED and they are STILL under-resourced by all trustworthy measures (i.e. not the current govt!) they should be getting more not less. And let's recognise that as a healthy independent citizen with no extra support needs, MY costs have gone up A LOT since 2005 🤷🏾♀️
Hmmm… last time National was in power they had similar goals - 6 hour ED times and 6 month elective waiting lists.
So what happened was hospitals created new wards that were effectively just glorified ED beds but they qualified as “transfers” for the targets. With regard to the waiting list time, they simply sent letters to the people whose elective surgeries weren’t seen as significantly necessary as others on the list to make the six month cut off and those poor people were basic told to come back later (when they were worse and met the more stringent criteria to get surgery within six months).
So patient outcomes won’t actually improve here, it’s just a flashy paint job on a rotting building. They could just fix the building instead, but there is no glory in that for this government as it doesn’t lead them closer to privatisation of the health system.
The more things change, the more they stay the same.
Yes, Melissa, the ED target in particular is easily manipulate-able, and it sounds from what you said, they are just playing an old record. And what you say happened would add more burden onto the health system, ultimately as well as the poor patients and their families..
Ironically if one looks at most of what Luxon has been doing and saying - including boot camps, KPIs etc, he's been copying and pasting most things from the past and in thoroughly uninspiring, uncreative, and regressive ways.
It's really disappointing and I think he should probably stay true to his Christian values and try not to exercise that low self esteem - and need to be seen to achieve - on the country.
I worked in health at the time but there was some contemporaneous news coverage so hopefully something out there to corroborate my memory if I can muster the energy to search for it. I definitely remember media coverage on the elective surgery waiting lists. I’m not so sure about media coverage of the ED transfer wards as the people had been triaged before being “transferred” to what was essentially another ED for people deemed to be ill (sometimes quite ill) but not at risk of imminent death. I found it disingenuous at the time, as it was clearly created as a way to meet the ED targets. But technically it was a “ward” so make of it what you will.
Even without a google, which is my specialty :-) I would say it definitely happened. I recall on Q&A with Jack Tame, Shane Reti was asked about gaming the system, and Reti droned on about how under him he would manage it.
Also, just looking at their big medical KPIs, it's obvious to me that it really is about gaming the system from the government.
Just as one example - not one housing build KPI - but a KPI for how many vulnerable and poor people they can throw out of emergency houses.
I hope you are well, and love your new icon, Mel!
Thank you. There was a pīwakawaka in my neighbourhood who tried to get in my house through the same window in my living room every summer. Once he succeeded, and I had to shuffle him out, he never tried it again! Nevertheless, he still danced in front of my big living room window every year until a couple of years ago when he just didn’t appear one spring. I still miss that bird, but his memory brings me joy. ❤️🩹
❤️ That's beautiful, Mel. I bet he misses you too.
I too remember this - I like the analogy of "a flashy paint job on a rotting building" - particularly because they are literally stopping work on fixing/replacing substandard buildings.
*phew* Thanks Cindy. Glad to know others remember it, too!
Lastly mental health they are talking about getting people with lived experience as mental health assistants to work in EDs , I saw this in some of the select committee discussions, not sure what the mental health profession thinks of this ? I know in South Australia they are building separate mental health facilities so that these people have a safe space instead of in general ED. Is this something for nz to consider?
The real question Dave is how bright ideas and genuine research backed policies come into effect. I'm not feeling a great degree of confidence with the decisions that I've seen from the Luxon led government to date.
https://www.neaminational.org.au/news-and-stories/neami-launches-urgent-mental-health-care-centre-in-adelaide-cbd/
If the Australians can do it?
Treasury will be releasing the document pack for last budget at the end of August, this should be revealing as to what was asked for and how they have justified the position. Some of the prep for next budget is out as well, reading the auditor general report for vote health they are looking at hospital health workforce numbers and asking if total number has increased why hasn’t productivity? Of course the answer to this is complex and has many factors. One is current collective contracts for doctors that essentially means that they work “less” number of hours than previously ie they have rosters that are more realistic , so you need more FTE to cover the same service. Etc etc.
Noted and thanks for the excellent info as always, Dave.
Given Levy has established his credentials IN THE HEALTH SECTOR with multiple failures, it is sadly obvious he was deliberately manoeuvred into having this role - in other words his appalling lack of understanding of how things actually work and empathy for actual people/patients, is seen as "a feature not a bug" as we say these days.
In his speech, Cindy, he talks about “compassion” but when he gets to that part, I sensed he faltered and had to look at his notes.
Wow, when you can quote Milton Freidman and he sounds at least a little sympathetic, you know the world is in a perilous state.
Yes. I hope they get voted out pretty soon. Just read one of the hospitals went into Code Black.
Hope you're well James, and your partner. 🙏
They are very much on the mend now.... just gotta get rehab happening after all this time with their world being a hospital bed.
🙏
Does Levy-Reti sound a bit like lavatory? Where genuine public health care is going? Or is levy-ready-go his real job?
I am more concerned than ever after listening to this. How have we let this happen?
Yes, I felt concerned too - hence my post. It’s hard to explain isn’t it? But I summarise it as mumbo jumo but scary it in its outlook and potential execution.
LEVY is a disaster that's already happened but apparently the Govt wants more of the same destruction. He is an arrogant, entitled 🙄 self centered piece of work who will cause untold damage to a health system already under pressure.
I feel for Margie Apa, the CE.
I've heard that Shane Reti was given a clear message - front the health direction the Nats want to head in or get on ya bike. If that's the case and for the sake of his own integrity, I'd like to see him walk the talk and prove he cares before it's too late.
I wonder why Apa is staying - it's clear to me they will roll her if they can and/or set her up.
Re: Reti, I've seen a few interviews and he strikes me as a timid, fearful politician who is willing to say anything to protect himself and his party. For example, he would not answer if nicotine was as harmful as caffeine, instead adding all sorts of variables into the mix to avoid answering it directly.
Re: Levy, the Newsroom article quoted above made it pretty clear that he is Luxon's sort of guy.
Tbh I understand Dr Reti is a lovely person and decent human being. However, both he and Tama are selling the un-sellable. There will be a stage when they'll have to make a call because right now their reputation is close to if not below zero within Māoridom.
Re Margie Apa, I'm pretty sure she knew what was coming on election night. But she still has a job to do and she will continue to do it to the best of her ability until she's moved on - and probably replaced by a boys club member of the stale, pale, male brigade.
Arohamai this whole bloody scenario pisses me off. For the first time in my life I'm feeling this is NOT my country right now.
I remember a reader once wrote on here that most people are friendly.
And I reflected on your point too.
But I wonder how someone can be decent and lovely, yet show ethics of that nature? i.e. I think all people can be friendly or nice on the surface, but actions speak louder than words.
There's a lot of negative news, but the most ironic part is that so many believe it isn't so.
Gotta love his immediate points of reference to Health NZ in terms of organisational complexity is a bank or an energy company. Because those do have the same motivation and purpose. Unbelievable
Yes. A lot of it feels unbelievable and yet this is precisely how it now seems to roll