25 Comments
founding
Oct 3Liked by Mountain Tui

Love the Lancet review - it spells out the consequence of privatisation. It’s very clear:

It drives profit taking by the private sector;

It drives poorer health outcomes for patients; and

It delivers inequitable outcomes through selective intake of patients.

That last point is particularly critical.

Privatisation of health services represent a transactional exchange for profit taking by private businesses within the scope of the health services they are contracted to deliver on. They will do no more, no less than what they are contracted to deliver.

This ignores the complex interplay of needs and service delivery that is required to be integrated across health, social services, housing and all the other needs that the more vulnerable in our communities require.

Privatising health delivery removes this (key health services) from the mix of services and tools that can be integrated to deliver improved outcomes when we can improve inter-agency deliverables.

There is no incentive for this integration. Instead profit gets maximised by “selective intake of patients”.

Long story short: privatisation allows a focus only on the higher return easier delivery services.

The long term impact is lower overall outcomes, segregation of inequitable outcomes, and hidden deferred costs that other agencies then incur to compensate for the lowered health outcomes.

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Oct 3Liked by Mountain Tui

Agree 💯 percent. I admit I had misgivings about Campbell when he was chair but he's obviously used the insights he was privileged to get as the baseline to respond to the Govt's sprint to privatise.

This govt's policies will continue to widen inequities that the system was making some progress towards reducing.

And can someone tell Casey Costello she's way out if her depth. Treasury officials must look at each other and ask "what next". I tell you it's bloody hard when you're clever and you have to draw straw figures for your Minister...

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founding
Oct 3Liked by Mountain Tui

Btw what were your misgivings?

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founding

Totally hear you.

The simple answer to a single minister being … um … “interesting” … is you have to rely on the wider government and executive (cabinet) team. A team led by the Prime Minister.

The has to be an expectation that there is executive alignment driving to a common outcome. So you’ld be expecting broader support.

This doesn’t exist in this coalition.

The consequence is that we have independent ministers pushing individual agendas. There is no collective agenda. There is only collective agreement not to critique each others ministers and policies.

Consequently what we have is a fragmented government with individual ministers pushing individual outcomes. It has become quite transactional policy area by policy area, lacking any cohesive whole.

It will end in disaster because of that. And we are seeing this emerging already.

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Oct 3Liked by Mountain Tui

That's all on Luxon. He blinked and Peter's and Seymour are running rings around him as a result. So much for boardroom prowess. That counts for nothing in the political arena.

Anybody else think Seymours the PM?

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founding
Oct 3Liked by Mountain Tui

Yes. But let’s not forget that:

- the National Party (the wider institution not Luxon) are ok with that

- Labour (as opposition) are silent.

So it’s more than one individual that’s creating/enabling these problems.

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Oct 4Liked by Mountain Tui

Good point!

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Oct 3Liked by Mountain Tui

There’s nothing stopping private hospitals establishing themselves independently now, but why would they? Because a well-funded public health system puts them at a competitive disadvantage, significantly narrowing the scope for profit maximisation.

Better to get their buddies in government to handover the keys of existing health infrastructure, allowing external wealthy interests to exploit the natural monopoly to maximise profits without genuine competition.

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Oct 3Liked by Mountain Tui

The play book has been written in Britain under the Tories. Private interests have been leased land long term, built hospitals and leased them back short term. Making profits with much more in the future

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author

That's why I know if they cared about our country and people they wouldn't do this. We're so lucky to see the examples play out....

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Oct 5Liked by Mountain Tui

The private health system is more 'productive', ie profitable, because they cherry pick the easy cases, and leave those messy unprofitable chronic conditions for the public system.

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Oct 3Liked by Mountain Tui

Like all privatisations of essential services the world over and forever, this will be a conveyor belt of money from goverment to corporation. Once the utility is privatised, the funder will 'discover' that they actually *can* find the money. Then several years and many billions of dollars later a government will be forced to renationalise it to rescue it from years of under-investment.

Always the same story.

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author

Yes, this appears to be the business model behind it. I wonder why Luxon needed to liquidate 2 properties recently, perhaps new investment opportunities abound too.

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Oct 4Liked by Mountain Tui

I suspect some kind of ‘insider’ knowledge re. the future of property market in NZ is behind Luxon’s house sales. Or perhaps he needs funds to buy a bolthole to run away to once he’s trashed his home country- maybe become John Key’s neighbour in Hawaii?

Any investment opportunities created would prob. be be via the ‘usual suspect’ fund managers- Blackrock etc.

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author

I forecast the future is bright for private healthcare companies in NZ too....and I know a hedge fund manager who can help with that.

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Oct 3Liked by Mountain Tui

Contracting out maintenance is, and has always been, a disaster. Health care is a maintenance issue.

The contractors are profit driven, not health/reliability driven. Let's face it if they're too successful they'll lose revenue.

Classic examples, are our roads, our infrastructure builds, our power prices, 3 waters supply. Can't see health being any different.

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Oct 3Liked by Mountain Tui

There were Health Workforce Taskforce Planning Reports published by the Public Health Commission through the 1990's and 2000's (and earlier, but the PHC was disbanded in the 2000s) warning that health sector staffing was heading for crisis: we weren't training or retaining enough doctors, nurses, or allied health professionals and the boomers were due to start retiring.

The recommendations were ignored and look! lo and behold! here we are at a health workforce crisis!

As entirely manufactured situation caused by inadequate funding and lack of MoH planning, just the same as for hospital buildings and health facilities as discussed here by Rob and Ian, some 30 years in the making

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author

It is a long time in the making but this government's response is short sighed and self serving. Privatisation is an easy fix, but as you can see in the UK (in the article above) the problems never go away - in fact, they get worse, they deepen, and health, patient & economic outcomes all suffer.

This government has plenty of money to spend on its own ideological priorities but all the evidence and case studies show health care is and should be a primary priority and responsibility.

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Oct 3Liked by Mountain Tui

YES! Let’s all get out on the 23rd and join the NZCTU protest. Let’s DO it.

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author

I'll prepare some visuals for it even though I have 0 skills. :-)

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The last comment by Rob Campbell points to Ministry of Health/Te Whatu Ora (managerial?) staff misleading the Te Whatu Ora board. Completely unethical and so far outside the expected behaviour of public servants.

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author

100% and a great point Andrew.

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Oct 5Liked by Mountain Tui

Rob Campbell is great

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Oct 4Liked by Mountain Tui

🙋🏽‍♀️👍🏾👏🏾💓Thanks for investigating the organising of a nationwide protest. In some ways the Union is obvious as their members & whanau are always the "ordinary NZers" affected by EVERYTHING - either directly or indirectly. They have the infrastructure to co-ordinate so let's get behind it I say (already registered to attend 😉)👏🏾👏🏾👏🏾💯

The only problem I had with Rob Campbell was in mixing up his roles - if he wanted to keep being an activist he should have stayed doing that OR resigned & explained WHY ... However, it is now invaluable that he has both the insights and the complete freedom to share them. We need all the information about the TRUTH that we can share in order to fight back.

Unfortunately most people are too busy living their lives to take much interest in what goes on in other countries, but for those who do the myths about private hospitals are both blatantly false but also dangerous, as many point out.

🤔Health care is one of those things that at the pointy end is beyond an individual's ability to do for themselves 🤷🏾‍♀️- yes we can eat the right food, keep up the exercise, not smoke, take care to have mental health breaks when necessary, etc.etc.etc. But if our heart fails, our appendix bursts, we have a brain aneurism, we have a cancer diagnosis ? It is vital that there is adequately equipped hospital facilities & trained medical personnel (and their support staff) to do the best for us or our whanau to get us through, or at least give us a chance. And that facility, those medical personnel, should NOT be only for those who can afford PRIVATE care now,🤬 nor should our taxes go towards privatising what we already own & just need to fund adequately now and into the future.😢 There is so much information about how much economic sense it makes for the govt to leverage their borrowing power at much cheaper rates than corporations etc. which means more bang for the same buck$.

Happy to keep holding the Coalition-of-Cruelty to account in every possible way - LET'S DO THIS! 🫂😁

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author

Yes it's still brave of him to speak up against these bullies.

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