Privatisation Kills So Why is Reti, Luxon and Lester Levy Speeding Towards It Like A Rocket Ship?

In 2022, Lancet Medical Journal issued the findings of a long term longitudinal study on the effects of increased outsourcing of health to the private sector i.e. privatisation.

Examining the outcomes from between 2013-2020, it conclusively found:

The privatisation of the NHS in England, through the outsourcing of services to for-profit companies, consistently increased in 2013–20. Private sector outsourcing corresponded with significantly increased rates of treatable mortality.

The correlation was conclusive.

The study noted:

This finding was robust to matching on background characteristics, adjusting for possible confounding factors, and measurement error in our dataset.

Changes to for-profit outsourcing since 2014 were associated with an additional 557 (95% CI 153–961) treatable deaths across the 173 CCGs

And in 2024, Oxford University published another study, examining the impacts of privatisation on public health.

High rates of privatisation and outsourcing almost always corresponded with worse health outcomes in the studies included in this Review… higher avoidable mortality rates than before outsourcing took place…

No studies found that increased privatisation corresponded with better health outcomes for patients….

Overall, our Review provides evidence challenging the justifications for health-care privatisation.

The conclusions based on empirical evidence and longitudinal analysis are definitive:

Healthcare privatisation kills, quality of patient care falls, private companies are interested in profit above all, and do make more money from privatisation, and preventative care is almost non-existent.

The NHS (UK’s health system, once a crown jewel, now a deteriorating and expensive liability) warned against the UK Tory government“embedding a longer-term trend of outsourcing NHS contracts and funding to ISPs (independent sector providers) in England, rather than sustainably increase NHS capacity.”

We have consistently opposed the outsourcing of NHS contracts to the independent sector, on the basis that it threatens the clinical and financial viability and sustainability of the NHS.

i.e. Privatisation also inevitably builds capacity, quality and investment into the private sector - which aims to not only deliver health services, but make profits at every point of the cycle - while diminishing the public health care system.

The UK is currently grappling with this issue - as it tries to balance how to reduce outsourcing while building its health system back up - and 10 million British languish on waiting lists and health costs to the country soar.

Yet as I have been writing about fairly consistently this year, this appears to be the exact direction this government was heading towards.

I thought that last month’s video where Shane Reti and Luxon praised health privatisation [and in fact, privatisation of everything - including water] was telling enough.

Unfortunately, it didn’t make any headlines and a “Mountain Tui” Substack is insufficient proof.

We rely on our journalists in New Zealand to parse, define and analyse.

Former Health NZ Chair Rob Campbell went on Breakfast to explain how an army of investment bankers have been wanting to get their hands on our health care system for years.

He clearly opined that the government was manufacturing a health crisis in order to privatise it.

This is all backed up by the evidence:

Reti lied about the alleged bloat in Health NZ and Luxon lied about the “unexpected deficit” that they used as pretext to start breaking down our health system at its knees: from our epidemic teams, to breaking critical health investments & infrastructure, to refusing local nurse graduates, to rejecting critical doctor hires to ignoring staffing in hospitals and telling GPs to raise fees on sick Kiwis.

This week, nurses strike, but who is listening to them?

Finally, yesterday, Shane Reti, questioned at an Association of Salaried Medical Specialists conference, admitted privatisation was not his “overt policy”

i.e. It is his covert policy - under cover, by stealth, trying to mask it.

He subsequently went on to say he was privatising healthcare:

"So you will see us increasing the relationship and outsourcing to the private operators - that is not at all a step toward privatisation at all, that is not my agenda.

"My agenda is to lift the capacity of the public system so it's there when we need it."

In other words - Reti is muddying the waters with double speak - hoping Kiwis’ ignorance of what privatisation is, means they won’t notice.

Increasing outsourcing is precisely privatisation [the video above notes Reti claims ~10% of procedures are now covered by private services]

The rest of the play is clear - Luxon will claim over the next years his health system KPIs look good (elective wait times, ED admissions/transfers).

But KPIs can be gamed, especially ones as static and evident as Luxon’s (There is a reason people should not be allowed to set their own performance measures)

A cancer specialist in Northland explained it explicitly, risking his position to do so:

"We have to see a patient with small cell lung cancer as soon as possible or they will die, we need to see a young patient with breast cancer early to deliver new adjuvant chemotherapy because otherwise the cancer will become stage four.

"We do these acrobatics in our own time, we basically burn the midnight oil and do extras, but we do these things to our peril because basically it appears on the KPIs - the blunt tool that they use - that we're actually doing quite well.”

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.”

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."

Lester Levy, a Director of private health companies, is not listening.

He is in “la-la land”, says it’s “not his job” to fix having no doctors at a hospital, and has explicitly stated more than once his real job is to help with Luxon’s KPIs.

As an advocate for running health as a business, Levy will of course move to privatise.

Anecdotal feedback on Lester includes - “top-down, controlling and destructive”, “ego the size of Uluru”, “Lester the investor.” etc

This government will hope the move will make the government’s finances look better, as Willis struggles to follow through on her budget promises. Borrowing $12b for $15bn of tax cuts was foolish, but a marketing PM and an incompetent Finance Minister will do that to you.

Luxon will hope that, by the time the next election comes around, his government will be able to parade health success stories, and “good numbers” to show Kiwis how much they’ve done for our healthcare.

And next year, Nicola Willis will likely tell Kiwis they are investing “record” amounts into health.

I presume they will not mention the $2b cuts, and negative per capita health funding, they have gifted New Zealand, nor how we have lost top doctors, healthcare professionals, and may return to paper and pen with incomplete patient records, how desperate patients can’t make waiting lists, and doctors are making beds and cleaning sinks while patients have died in more than one related incident by now.

For good measure, ACT are bringing in a law to prevent anyone earning over $180,000 to file for unfair dismissal - chilling the ability for professionals and leaders to speak out - everywhere.

When I first saw that headline yesterday, my first thought was Dr Gary Payinda - who recently wrote a good post to share with medical professionals around the country regarding what they can and cannot do when speaking up about public health.

This government is only one year in and the first year was only to lay the groundwork, the runway, so to speak.

The best is yet to come.

But most worryingly, they are changing our culture and every part of our laws to centralise power, and silence critics and opponents.

It is truly an insidious playbook.

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