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.
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...
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.
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.
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.
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
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.
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
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.
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.
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...
Btw what were your misgivings?
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.
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?
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.
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.
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.
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
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.
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
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.