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$2.3b Health funding shortfall

Written By: - Date published: 7:06 am, June 9th, 2017 - 45 comments
Categories: health, labour, national - Tags: , , , ,

Labour’s health spokesperson David Clark is doing good work:

Fiery exchanges over mental health as Minister fronts to Parliament’s health committee

Coleman’s appearance came at the same time the Labour Party released its own updated figures, claiming $2.3 billion had been effectively stripped from the health budget due to successive years of underfunding.

“The gap is why mental health care is in crisis and patients are being discharged into caravan parks, it’s why people aren’t going to the doctor because of rising fees, and it’s why elective surgery is becoming harder to qualify for,” Labour health spokesman David Clark said outside the meeting. …

A statement by Little:

$2.3 billion shortfall in health

The funding needed for health to be restored to the level it was seven years ago to keep pace with cost pressures has widened to a massive $2.3 billion, says Labour Leader Andrew Little.

“We used to have a health system that was the envy of the world, where people could access quality, free health care. As a parent, it saddens me that families are not getting the health services this country should be providing.

“The gap is why mental health care is in crisis and patients are being discharged into caravan parks, it’s why people aren’t going to the doctor because of rising fees, and it’s why elective surgery is becoming harder to qualify for.

“The huge sums of money missing from health are why workers in the sector are overstretched, exhausted and operating without the resources they need to care for Kiwi patients properly.

“The updated study by economic consultants Infometrics, commissioned by Labour, sees the gap since 2009/10 in core crown health expenditure that is required to meet cost pressures grow from $1.7 billion last year to $2.3 billion by June 2018. Infometrics used Treasury’s own modelling for calculating real health costs for core crown health expenditure. …

The Infometrics report is here. It’s not just Labour saying this:

Frustration, disappointment over health funding in Budget 2017

Patients and healthcare workers say they have been left frustrated and disappointed by “inadequate” funding for health in the 2017 Budget.

They said the Government’s announcements on Thursday would not go nearly far enough in addressing concerns about overworked staff, access to new medicines, and access to mental health treatment.

The Government said total health spending would be a record $16.77 billion in 2017/18 – an increase of $879 million, with an overall increase of $3.9b over the next four years.

However, the record claim does not take inflation into account, and sidesteps the fact that almost half the spending will go toward mandated wage increases as part of the pay equity settlement. …

Read on for more on the impact on mental health, overworked staff, and access to medicines.  Here’s what the nurses have to say:

Think of your health when voting this September, nurses urge

New Zealanders are being asked to think of the health system when they cast a vote this September. A nurses’ union released an open letter saying “it’s getting harder to do the work that we trained for”.

“Health underfunding means that sometimes we’re not able to give you the best. We are often short-staffed, rushed, and need a little more time to give you care,” the letter says.

“We are sad sometimes because of what we couldn’t do for your tamariki, your grandparents or your neighbour. Many of you are feeling frustrated by delays in getting the healthcare you deserve and expect. We are frustrated, too.”

The letter tells voters who they back is a personal choice and doesn’t name any political parties, but makes clear the organisation’s position that health funding is not adequate under the National-led Government. …

And a selection of recent headlines for context:

Study shows ‘damning’ level of unmet health care need. “The Government needs to demonstrate its commitment to the health of all New Zealanders by addressing the high levels of unmet health need as a matter of priority.”

Nurses spending their own money to help patients – union. “The Nurses Organisation says hospital patients are soiling themselves because there aren’t enough nurses to help them to the bathroom.”

Leaked document shows 10 District Health Boards face budget cuts: King. “Labour claims that health has been underfunded to the tune of $1.7 billion over the last five years…”

Researchers claim NZ health budget declining, publicly-funded surgery on way out. “New Zealand’s health budget has been declining for almost a decade and could signal health reforms akin to the sweeping changes of the 1990s, new research claims.”

Families’ despair as hospitals face severe shortages for acute mental health treatment. “Hospital beds for people suffering from extreme mental distress are stretched to breaking point, with double as many people being seen for crisis assessments as there are bed nights available.”

Auckland’s crumbling mental health services. “The problem was a lack of funding as more people accessed mental health services and Auckland struggled with an increasing population and rising house prices…”

Thousands of patients going without hospital care, figures show. “Dr Mackay says funding levels for health are a “disaster waiting to happen…””

Call to government to address rural health crisis. “Rural Health Alliance Aotearoa New Zealand (RHAANZ), representing over 40 rural based organisations, says the country’s rural health and social workforce is in crisis.”

Patients turned away. “Nearly a third of orthopaedic patients referred for a first specialist assessment are being turned away from Dunedin Hospital, and the situation is becoming “untenable”…”

Despite denials, poor service plagues our health system. “New Zealand’s public health system, which was once the pride of the developed world, is clearly ailing.”

New Zealand’s declining health care system is slipping behind other countries’. “Our national health system was once the envy of the world; it is no longer. The facts show that we underperform in many areas.”

There have been cuts, freezes, and underfunding everywhere to generate enough of a “surplus” to try and buy back some votes. In the end what it means in this sector is that a lot of real people not getting the care that they need.

45 comments on “$2.3b Health funding shortfall ”

  1. Wayne 1

    Who would have guessed, health unions saying they need more money.

    At least the language of health “cuts” has been changed to “underfunding”. So it seems the work by David Farrar has actually got through. That rather than cuts, there have been real increases to the tune of 10% per capita over the last 9 years.

    So the political debate is on the appropriate level of overall health spending.

    It seems to me that Labour is in a bit of a trap here, due their Budget Responsibility Rules. They say they won’t increase taxes, that the size of govt will not increase and that they will have surpluses. No-one seriously disputes Treasury figures. So where is Labour going to get $2.3 billion extra per year for health, especially when they also say education, conservation, foreign aid, social housing also need a lot more money.

    The latest tax and family package is almost certainly locked in. NZF will not backtrack on it. even if it is not locked in and it is all available for social programmes, it is not large enough to cover all of L:abour’s spending plans.

    The answer can’t be the capital spend on defence over the next few year, since that is not available for annual operating expenditure. The capital account can only be spent on capital.

    Similarly it cant be Police and Corrections, since Labour wants more police than National, and realistically more police will inevitably arrest more people. so that means more on Corrections. In some respects governmements don’t really control the Corrections budget, it is largely a function of police and judicial decisions.

    The conclusion has to be that the Budget Responsibility Rules will be broken. That even if Labour does not increases taxes, it will not have surpluses but instead will have deficits.

    • BM 1.1

      It seems to me that Labour is in a bit of a trap here, due their Budget Responsibility Rules
      They say they won’t increase taxes, that the size of govt will not increase and that they will have surpluses

      The Budget Responsibility Rules were last week Wayne, Labours moved on from that

      http://www.stuff.co.nz/business/money/80272365/Tax-increases-on-the-table-for-Labour-for-2017-campaign

    • One Anonymous Bloke 1.2

      They say they won’t increase taxes

      Do you ever bother to inform yourself before commenting?

      Pretty sure I told you at the time that your spin on Little’s statements was a lie. Perhaps you should pay attention next time.

      • The Chairman 1.2.1

        Was Little lying?

        “We’re not planning on any tax changes for the 2017 election” – Andrew Little.

        http://www.radionz.co.nz/news/national/326370/labour-party-won%27t-raise-taxes-little

        • One Anonymous Bloke 1.2.1.1

          Speaking on TV3’s The Nation, Mr Little said the exact levels of tax rates would be affected by decisions made by the government in the Budget due in May.

          “We’re not planning on any tax changes for the 2017 election. We will finally collaborate what we do once we see what the government does in its foreshadowed tax changes, which we assume will be in this year’s budget.

          No, he wasn’t. Not so sure about the sub-editor who wrote the headline, but.

          • The Chairman 1.2.1.1.1

            After the interview, a Labour spokesperson contacted Newshub to clarify Labour would definitely not increase taxes.

            http://www.newshub.co.nz/home/politics/2017/03/labour-probably-won-t-raise-taxes-andrew-little.html

            • One Anonymous Bloke 1.2.1.1.1.1

              An unnamed spokesperson, eh?

              I think the finance spokesperson and leader are probably right, and the unnamed spokesperson is wrong.

              • Enough is Enough

                Who cares if he did say he wouldn’t raises taxes.

                He now has the chance to go into the election promising tax hikes for the rich to pay for these health cuts.

                Its quite simple really.

                • The Chairman

                  Stating one thing and then quickly doing the opposite robs one of their credibility.

                  • Enough is Enough

                    It worked for Key and circumstances change.

                    We just had something called the Budget which introduced further mass cuts for the Health Service.

                    None of the rich pricks will vote for Labour/Green in any case so why bother appeasing them.

                    • The Chairman

                      Key had the talent of being able to sell things to the public. Whereas, Little struggles to communicate his stance let alone trying to explain such a quick contradiction.

                      Nevertheless, If Labour are planning on increasing taxes, it’s a shame Little couldn’t commit to correcting the health funding shortfall (on Morning Report) within their first term.

                      His failure to do so won’t entice voters. When raising such issues, Labour require to have an alternative with substance prepared. Little had little to offer.

                    • Enough is Enough

                      I agree with you.

                      Little’s confused messaging and narrative that “NZ Sucks” is a problem. People don’t think New Zealand is a bad place. We just want a positive vision of the future.

                      He needs to keep it simple and positive.

                      “We will fund the cuts that National has made to our Health Service. This will be paid for by those who can afford it- the rich. Vulnerable New Zealander’s will be looked after by the caring government that I lead. ”

                      Simple really.

              • The Chairman

                “I think the finance spokesperson and leader are probably right, and the unnamed spokesperson is wrong.”

                It leaves one envisioning a Labour Party rowing in different directions.

              • mordecai

                It really is entertaining watching you contort yourself trying to justify Little’s various positions. There’s an old game from the ’70’s called ‘twister’…

    • KJT 1.3

      Well they should be bloody broken.
      It has been blatantly obvious for decades that the Government share of the economy is too low for a successful country, and society.
      Allowing a few wealthy people to run of with all the money has resulted in the opposite to Waynes stated goals, in his advocacy for increasing inequality.

      We now have the lowest premium for education and skills in the OECD. And the highest for inherited wealth and speculation, outside the USA. Not the intended result.
      Wayne being one of the “party for individual responsibility” like all Nationals MP’s never! take individual responsibility.

      Why Labour Greens have signed up to a bullshit right framing baffles me.

      Because, unlike National/Labour, the Greens do stick to their election promises.

      • One Anonymous Bloke 1.3.1

        Dr. Mapp is lying.

      • Draco T Bastard 1.3.2

        Why Labour Greens have signed up to a bullshit right framing baffles me.

        Baffles me as well. They must be able to see the damage that radical right-wing capitalism does as well as I can but they refuse to acknowledge it and keep trying to make it work.

        • One Anonymous Bloke 1.3.2.1

          radical right-wing capitalism

          Looks like a mixed economy to me. Massive intervention in the housing market is hardly a radical wingnut proposal.

          • Draco T Bastard 1.3.2.1.1

            Looks like a mixed economy to me.

            That’s a little too broad to have any meaning. Under it even the government specifying a minimum wage would be a ‘mixed economy’.

            I think an actual definition of a mixed economy would be a better place to start and then we could compare the deregulation and under-taxing of the rich with it.

            IMO, a mixed economy would be: Where all infrastructure and necessary services are provided as a government service through government departments with the private sector then making up the ‘nice to haves’ and to provide everyone with a reasonable standard of living.

            Funding would be through the creation of money by the government and spent into the economy with taxes then used to control inflation.

            Obviously, anything that National does does not meet that definition and neither does Labour’s continued belief in the failed private sector.

            Massive intervention in the housing market is hardly a radical wingnut proposal.

            True but the RWNJs at National aren’t doing that and Labour’s only doing it in such a way as to protect capitalism from it’s own proven failures.

    • r0b 1.4

      Who would have guessed, health unions saying they need more money.

      I expected this utterly facile response. I didn’t expect it from you Wayne.

      • Carolyn_nth 1.4.1

        And doesn’t take into account the experience of those of us using the public health service.

        Had a sinus operation recently at Auckland Hospital. It and the pre-op were on Saturdays, because they are trying to clear a backlog of such non-urgent surgery. presumably they mostly only been able to deal with the most urgent surgery.

        The doctor and nursing staff were excellent, friendly, helpful and professional – but obviously worked to the limit.

        I was kept on a ward for a few hours after the op – Saturday evening. The ward was very busy. “My nurse” got called away to the emergency department for a period. She was kept extremely busy here and there in the ward. The nurses deserve medals for their composure under extreme pressure.

        My post op appointment is on a Sunday. I asked if the time could be changed because it will cause problems at my work – also stretched for staff on a Sunday. they said they can’t change post op appointments as they are on a tight schedule.

        it’s taken over 2 years to get any medical intervention for my ENT problems. My GP at one point recommended going private because “the public system is broken”.

      • Wayne 1.4.2

        r0b,

        The Standard is a political site, a little bit of politics is allowed.

        But in any event my comment about the health unions was not really the point of my post.

        OAB,

        Where is my “lie” in my post? I have simply raised what I see to be contradictions in Labour’s position. And Labour has been pretty clear that it is not going to raise taxes. If they are, they need to be clear about it and not try and fudge it.

        KJT,

        None of the political parties disputes Treasury figure. Especially Labour does not. It is after all the same Treasury and the same accounting systems that applied when Labour was in office from 1999 to 2008. If Labour did dispute them, they would look like fools.

        Draco,

        You are plain wrong. There have been real increases in funding over the last 9 years. That is quite different to a debate as to whether you think those increases have been enough.

        So in my view if Labour is to fulfill all its promises they can only do so by going into deficit. They will need to be upfront about that since there are plenty of commentators who will call them on it.

        • One Anonymous Bloke 1.4.2.1

          Wayne, the two links above (at 1.2 and 1.2.1.1) demonstrate quite clearly where your lies are.

          In chronological order:

          1. Little: ‘we’re not planning on tax increases [NB: present tense], and we’re going to wait for the budget to make a final decision.’
          2. Dr. Wayne Mapp: ‘Little promises no tax increase.’
          3. Robertson: ‘we’re going to announce tax increases before the election’.
          4. Dr. Wayne Mapp: ‘Labour promises no tax increase.’

          There are your lies, Wayne. Not all of them, I’m sure; the others can wait.

          • Wayne 1.4.2.1.1

            OK, I concede Robertson has said tax increases in his May 23rd speech, which i had previously missed.

            It will have to be on the rates or thresholds on income tax, if he is serious about getting at least a billion extra.

            A property speculation tax will not do it, since people change their behaviour to avoid such taxes (ie don’t sell within the specified period).

            • One Anonymous Bloke 1.4.2.1.1.1

              And they could take steps to significantly lift wages, and increase revenue that way. Reduce unemployment, ditto.

              What they won’t do is sit around waiting for the market to fix it and looking for ways to trade policy for lucrative business opportunities.

            • KJT 1.4.2.1.1.2

              It is disingenuous to claim an increase in funding, using overall figures, ignoring inflation and population growth, when the inflation adjusted per capita funding is decreasing.
              A typical National fudge of statistics.
              Especially when a lot of the funding is going to managing, and paying the extra for, farming out to the private sector, and paying the plethora of “Managers” needed for the right wing model

        • Draco T Bastard 1.4.2.2

          There have been real increases in funding over the last 9 years.

          Only according to National spin. The actual figures show a different result.

          And then we have the fact that our health system simply isn’t providing enough service and is going backwards under National.

        • greywarshark 1.4.2.3

          Wayne
          Politics under National seems to be mainly stirring the opposition when any questions demand straight answers.
          I think Google has a wider meaning and that making a sneer or slur about the opposition is not real ‘politics’,
          .
          the activities associated with the governance of a country or area, especially the debate between parties having power.

          If National got on with the activities associated with governance, lessened the amount of jeers and sneers which is what any debate tends to fall to, we copuld
          have a functioning country, not one on upper and downers with help from crutches.

      • greywarshark 1.4.3

        r0b
        It’s a default RW position from Wayne, slipped out in an unguarded moment.

      • tc 1.4.4

        Its the best he can do. Sad and pathetic and probably eyeing the end of his precious sinecures

    • Draco T Bastard 1.5

      That rather than cuts, there have been real increases to the tune of 10% per capita over the last 9 years.

      No Wayne, there’s been cuts to funding in real terms as you well know which means that you just outright lied trying to spin for this government.

      So the political debate is on the appropriate level of overall health spending.

      Which can be worked out scientifically.

      X number of population requires Y number of doctors requiring Z number of nurses and W drugs.

      We can be certain that under National none of those requirements are met.

    • DoublePlusGood 1.6

      Well the answer is obvious, isn’t it. Labour will confiscate your vast country estates, and sell of the lavish furnishings…

    • reason 1.7

      Labour could easily increase Government revenue by overturning John Keys legacy ….all the corrupt money laundering and economic apartheid legislation …. tax havens and bent rules that have been written by rich thieves.

      Once the providence of greedy individuals this disease against democracy is now embraced by nearly all corporations ….. through legalized theft all the biggest corporations are stealing our money ….. money meant for health, education, pensions etc etc.

      Apple, IBM, all the oil companies , all the cellphone and internet providers …. all using the tax haven/offshore economic apartheid system …… where the rich do not pay.

      The 2.2 BILLION that was recovered when John Shewans ‘tax vehicle’ for BNZ, ANZ, Westpac broke down and was exposed as a fraud in our high courts …..that shows the scale of theft the rich and greedy indulge in.

      Ending a system that takes from those who do not have enough …… to give to those who have more than they could ever use.

      And Wayne…., Farrar is a dirty swirler still engaged in dirty politics …..The show roles on with you guys … As his false flag partisan ‘Tax payers union’ …… with its continual printing by our dirty politics media demonstrates…

      Did he point out the $10 Billion war toys being purchased with Govt money goes to corporations … who dodge their taxes.

      It stuck out …. that you never referenced the increased suicide rates, misery, sadness and sickness when talking about our artificially constrained budget…. and predictable outcomes of that nice Mr Keys and Bills choices ….. Cows and Tax cuts … ecocide and loss of swimming spots for our country …. more money and speculation for the rich.

      Is that all meant to disappear ….. like Fatima

      Do they not count for anything ….. like Fatima

      Do we need to kill and exploit children overseas to have enough for ours in your world view . ?? ( trade deals/wars) .

      New Zealand once lead the world with our anti nuclear legislation …. I’d like and prefer our NZ government to lead the way against economic apartheid … Aside from the injustices and inequality in NZ …..Its a World issue

      slavery sweat shops, poverty, starvation, deforestation ….. and war… it survives on the corrupt system which Key thrives and networked us into….

      Lets lead ourselves and the world out of it…..

      Through simple fair legislation ….. and jail the bank robbers behind $2.2 Billion drive offs

  2. ianmac 2

    A few decades ago a National Government let the Public Health System fall into decay. The intent was then to justify Privatisation as a means of “rescuing” health care.
    This is currently happening in UK and the USA interests are the ones buying up selected Health Boards.

    • KJT 2.1

      SOP for the right wing. Fuck up State provision, then claim their failure was a result of it being State provided, rather than a typical right wing fuckup.

      Privatise. Get rewarded with Directorships in the in the privatised company.

      The next left wing Government, and tax payers, then have to unfuck it.

      At a far greater cost then we would have to pay if it hadn’t been fucked in the first place.

      Surprised the “Tax payers union” aren’t up in arms about it!

  3. Sorrwerdna 3

    Increase in funding = funding cut ???? That creative accounting

    • Macro 3.1

      Obviously you fail to understand that increased costs also feature in the equation. When increased costs are greater than the small increase in funding, the result is an effective cut in the ability to provide services. Since taking office National has effectively failed to provide the funding for around $2.3b of services in the Health Sector.
      That is why

      “The gap is why mental health care is in crisis and patients are being discharged into caravan parks, it’s why people aren’t going to the doctor because of rising fees, and it’s why elective surgery is becoming harder to qualify for.

      “The huge sums of money missing from health are why workers in the sector are overstretched, exhausted and operating without the resources they need to care for Kiwi patients properly.

      Is that clear now?

  4. greywarshark 4

    Neo liberal economics has a philosophy that observes people critically and finds them wanting as entities and inefficient. And people that have been brought up in the shadow of that are, in contrast, very efficient at absorbing the distaste for the general public and focussing kind consideration on themselves.

    So it’s no use arguing for what’s good for society, or what’s fair for the individual, in health. There is a financial imperative here to stop wasting money on humans which are inefficient entities. That attitude might be arrested if protesters can show that it is more costly to let services run down till they break down than it is to provide a right amount of skilled action, at the right time. But cutting costs is likely to win every time under this thinking regime, so the fight goes on.

    And it can be confusing when those in public health management are also owners and shareholders in private companies either operating in parallel with public, or supplying services to the entity they are accepting salary from, and ostensibly working for. It’s called conflict of interest, but can be hard to sort out, like a ball of string that has tangled. Sometimes it is better to cut the losses, and literally cut through the tangle and start again.

    In the case of health, it may be that talking to the people in national workshops and presenting them with a budget based on a percentage of GDP that they have to allocate. Are they prepared to allocate it fairly according to the needs of age and development, more for very young children so they don’t get chronic sickness that delays or prevents their growth affecting them lifelong etc. We all have ideas about suitable treatment, and all would have to change ideas to some extent after taking part in a health workshop that starts off looking at one’s own particular group environment, older people, rural people, pre-school, working parents etc and then looks at the regional and national needs. That could be good for Dunedin for example, so burdened with problems, and apparently with NZs greatest distances to travel in a more sparsely settled region, said to be severely underfunded because of the present population model budget.

  5. saveNZ 5

    The Natz keep adding more people onto the health service, but not giving any more money inspite of our fake rockstar economy.

    Plenty of cash for Natz cronies though like Sky City, private irrigation schemes with public money and zombie TPPA and free trade agreement bribes like the Saudi Sheep farm massacre.

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