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Daily review 09/11/2022

Written By: - Date published: 5:30 pm, November 9th, 2022 - 69 comments
Categories: Daily review - Tags:

Daily review is also your post.

This provides Standardistas the opportunity to review events of the day.

The usual rules of good behaviour apply (see the Policy).

Don’t forget to be kind to each other …

69 comments on “Daily review 09/11/2022 ”

    • SPC 1.1

      no tertiary debt repayment required while working in public health (nurses/doctors – and make it zero after 10 years).

      have a plan to increase wage levels in public health to the Oz wage (year by year over 10 years).

      • gsays 1.1.1

        "no tertiary debt repayment required while working in public health (nurses/doctors – and make it zero after 10 years)."

        Also, while training, receive a weekly payment of $300. No need to pay it back if still working after 5 years.

    • Incognito 1.2

      He needs to front? Not again …

      Andrew Little fronting

      • Anker 1.2.1

        naked painting of Andrew Little. Big no thanks.

        little has to take responsibility for this catastrophe and the lives lost.

        remind me again of how much money NZ health has cost and what it has achieved?

        • roblogic 1.2.1.1

          What catastrophe are you blathering about. Covid?

          Or are you saying we should not bother to modernise and upgrade our health infrastructure and let it continue to rot like the Nats did??

          And you've accused Little of "lives lost". Evidence please.

          • gsays 1.2.1.1.1

            It doesn't matter how modern the equipment or how flash the new logo will be.

            If Little adheres to the same neo-liberal playbook;
            play hardball in the pay parity negotiations,
            out-source the training of staff (immigration),
            have bean counters and accountants run the hospitals
            and continue the race to the bottom attitude with sub-contracting food, security, laundry, IT and maintenance, not a lot will change.

            Squandering a once in a lifetime opportunity to make real change…

            • roblogic 1.2.1.1.1.1

              The NZ public health sector has 80,000 staff, making HealthNZ/ Te Whatu Ora the largest employer in Aotearoa. Getting the IT systems aligned is a big part of the reforms. Your resentment of recruiting skilled workers is weird. I don’t get your problem with contracting out various services either.

              The “opportunity for real change” is being realised. The end goal is to cut waiting lists and balance health services across Aotearoa as effectively as possible by working together instead of 20 separate DHBs

              https://en.m.wikipedia.org/wiki/Health_New_Zealand

              • Anker

                Their aims are impressive Roblogic. Meanwhile back at the coal face wait times are increasing because the Minister is failing to settle the pay dispute, nurses are burnt out and will look to go to greaner pastures.

                The minister should have made his one and only priorty fixing the workforce shortages. Until that happens our health system will remain at crisis

              • gsays

                If recruiting experienced workers from overseas worked, we wouldn’t have the issues we have now as this has been the tactic for the last few administrations. Also our health staffing should reflect our population ie more Māori and PI, we don’t need more UK, Phillipino,Indian staff.
                Let’s face it, not training/upskilling is a consequence of neo-liberal thinking. witness hospitality and construction industries. Staff are seen as an expense, a cost rather than an asset to be invested in.

                As for bringing support roles in-house l, it’s a wonderful way to build a resilient workforce where loyalty and a sense of belonging can be nurtured. Some hospital food contracts are about frozen food being delivered from outside the district and reheated. Hardly ideal for folk that are convalescing.

                The whole ‘efficiency’ argument is akin to trickle down.

                No comment on the Health Minister’s lack of enthusiasm for settling the pay parity?

                • Incognito

                  The whole ‘efficiency’ argument is akin to trickle down.

                  Not sure what you mean by that. In hospitals and other medium-large complex organisations people on the ground and at the lower/lowest management levels pick up most of the slack caused through inefficiencies. Often, they don’t realise it or just accept it as ‘par for the course’ or as ‘part of the job’ but it can take up a significant portion of their time, energy, and efforts and thus acts as a drain on primary and vital resources. Even worse is when they must actively battle the system and try ‘repair’ or ‘clean up’ the mess caused by inefficient organisational management. A top-heavy management and bureaucracy is both cause and effect of intrinsic problems with(in) the organisation.

                  • gsays

                    Just that efficiency was cited by Chicago School acolytes as a reason for out sourcing.

                    I hear what you say about workers battling the system. I live with someone with a moral injury.

                • roblogic

                  I didn't say 'efficiency'

                  I said 'effectiveness' … i.e. delivery of good outcomes for patients & whanau

                  Nothing wrong with either, unless 'efficiency' is taken to the extreme end of cost-cutting madness (per Elon Musk)

          • Anker 1.2.1.1.2

            "What catastrophe are you blathering about?"

            Perhaps I should quote the whistleblower from Rotorua Hospital

            "We are facing extrem staff shortages. We are currently 13.89 FTEs down and increasing, that is equivalent to 140 shifts a fortnight in gaps"

            "While Daniels (nurses union) declined to discuss any specific hospital or department, she said that NZ is short of 21,000 nurses….patient risk increases without the right nursing staff in the right areas"…" asked toperform as before "in dangerous situations", with ED full, but not enough nurses"

            From Stuff 22 October 2022 (will try and post the link)

            "The patient left the ED and deteriorated shortly after leaving and returned to Ed where they were seen immediately. Sadly the patient did not respond to medical treatment and they died the following day….ED was very busy during this period which meant wait times were longer than usual"

            And from Stuff 24th August 2022. "The findings from an investigation into a patints death at Middlemore Hospital emergency department in June highlight the extreme pressureit had been operating under due to staffing shortages and surging patient numbers. ……The patient arrived at MM ED with a severe headache and was told it would be hours before she could be seen and she left…..she returned to the hospital some hours later in an ambulance having experienced a massive brain haemorrhage and died the following day"

            There have been more of these cases.

            But by all means pat Little on the back for putting all his time and energy into a shiny new bureacracy. When the ship is finally turned around (Health NZ estimates it will take 5 years to see any real change, don't be surprized if you find there is no health system…….those people who are the health system, you know people who treat you if you are sick will have buggered off to somewhere where they are well treated (rather than having to fight for the pay and conditions, while being told their is racsim in the Health system and they must "reflect" on this).

            BTW Ian Powell, the former Executive Director of Salaried Medical Specialists, writes extensively on the state of our Health System, and in one of his columns he recounts how in 2017 he spoke to David Clark about what needed to happen in the health sector. He told David there were three problems: workforce shortage, workforce shortage and workforce shortage. Labour have had five years on this.

            Shane Reti spoke well on Q and A about what he would do to fix the health service. Clear concrete ideas. I posted it recently.

        • Incognito 1.2.1.2

          Well, it was formally launched just over 4 months ago. Your question is rhetorical and/or unanswerable as it stands, and IMO it does not easily lead to anything useful.

          https://en.wikipedia.org/wiki/Health_New_Zealand

          • Sacha 1.2.1.2.1

            Huge change process. Turning a supertanker, etc. Wasting our time with anyone who refuses to learn the basics before flapping their gums.

            • Anker 1.2.1.2.1.1

              Sacha this was my response to Roblogic which I have copied and pasted in response to your comment about "flapping their gums". I made the assumption that this refers to me.

              I often find on the Standare when people use such puts downs it is because their argument is weak.

              "What catastrophe are you blathering about?"

              Perhaps I should quote the whistleblower from Rotorua Hospital

              "We are facing extrem staff shortages. We are currently 13.89 FTEs down and increasing, that is equivalent to 140 shifts a fortnight in gaps"

              "While Daniels (nurses union) declined to discuss any specific hospital or department, she said that NZ is short of 21,000 nurses….patient risk increases without the right nursing staff in the right areas"…" asked toperform as before "in dangerous situations", with ED full, but not enough nurses"

              From Stuff 22 October 2022 (will try and post the link)

              "The patient left the ED and deteriorated shortly after leaving and returned to Ed where they were seen immediately. Sadly the patient did not respond to medical treatment and they died the following day….ED was very busy during this period which meant wait times were longer than usual"

              And from Stuff 24th August 2022. "The findings from an investigation into a patints death at Middlemore Hospital emergency department in June highlight the extreme pressureit had been operating under due to staffing shortages and surging patient numbers. ……The patient arrived at MM ED with a severe headache and was told it would be hours before she could be seen and she left…..she returned to the hospital some hours later in an ambulance having experienced a massive brain haemorrhage and died the following day"

              There have been more of these cases.

              But by all means pat Little on the back for putting all his time and energy into a shiny new bureacracy. When the ship is finally turned around (Health NZ estimates it will take 5 years to see any real change, don't be surprized if you find there is no health system…….those people who are the health system, you know people who treat you if you are sick will have buggered off to somewhere where they are well treated (rather than having to fight for the pay and conditions, while being told their is racsim in the Health system and they must "reflect" on this).

              BTW Ian Powell, the former Executive Director of Salaried Medical Specialists, writes extensively on the state of our Health System, and in one of his columns he recounts how in 2017 he spoke to David Clark about what needed to happen in the health sector. He told David there were three problems: workforce shortage, workforce shortage and workforce shortage. Labour have had five years on this.

              Shane Reti spoke well on Q and A about what he would do to fix the health service. Clear concrete ideas. I posted it recently.

          • Anker 1.2.1.2.2

            My point is Incognito, that restructuring the bureacracy should have been the lowest priority, in a pandemic and when we are facing the workforce shortage we have.
            If you have time read my response to Roblogic above. It outlines what a catastropic situation with are in.

            • Incognito 1.2.1.2.2.1

              You completely ignore the inefficiencies & duplication in the current system that’s hopelessly fragmented and is wasting huge amounts of money and time of good people on bureaucracy & ‘management’. You also ignore the need for better coordination and sharing of epidemiological intelligence in future pandemics. Your approach is to let this haemorrhaging continue until and only after we’ve fixed all the other issues. The best approach is, IMO, to do both because both must be done simultaneously, although on different time scales. The many huge workforce issues (e.g., recruiting and retaining skilled staff where they’re needed most) are not even unique to NZ, partly because this nation competes for skilled healthcare workers on the global market, but the structural reorganisation is specific to this country.

              • Anker

                I would never say the old DHBs were great and all was good. However they served us well enough during Covid.

                The main issue I give upmost priority to is the health workforce staff. Recruiting and retaining them and keeping them safe in their work environment.

                Can you give me some examples of the duplication and time wasting in the old DHB system.

                I have a close contact who worked in the old system and now Health NZ.

                This person is quite high up. They say that Health NZ is in a complete shambles and in their opinion is unlikely to achived equity (I realize that is only their opinion, but I do value it).

                There was another article in Stuff recently where senior Drs said all they have noticed so far from the health reforms was a change of logo.

                I am not entirely against health reforms, but during a pandemic? I seem to recall one Minister saying that one reason Ashleigh B left is because he didn't have it in him to manage the reforms.

                Having worked in the health system many moons ago, I know that things that happened in Wellington have very little impact on what we did (as long as we had adequate staffing, good mentoring and the chance to do meaningful professional development). Adequate staffing (as there was back then, ) allowed us to get on a do our best work.

                Health professionals are exhausted.

                • Incognito

                  Can you give me some examples of the duplication and time wasting in the old DHB system.

                  Look, if you don’t read the comments made here then replying to you is just a waste of (my) time.

                  IT has already been mentioned. The DHBs have their own IT fiefdoms departments.

                  Procurement is another obvious candidate for centralisation.

                  The provision of very highly specialised medical services in and by only a few lead DHBs should be coordinated (and funded) through one national agency instead of individual DHBs and MoH.

                  These are just a few high-level examples, and I could go on …

                  • I can speak a bit about IT.

                    Yes the various historic health boards all have their own legacy IT systems. None of which speak to one another (which is why hospital patients being transferred from one hospital to another – even within the same historic health board (e.g. Waitakere and North Shore) – come complete with a paper dossier (it's the folder you're given to clutch as they load you into the ambulance – OK, sometimes the ambos keep it, if you're really sick)

                    https://www.nzherald.co.nz/nz/functionally-obsolete-it-system-at-auckland-hospital-to-be-scrapped/2KWD4MTSLNWCGSGKQTWXLHCXGU/

                    The IT companies (mostly international) are rubbing their hands with glee at the prospect of a nation-wide IT system in health. Millions (if not billions) of dollars, and a multi-year implementation plan (migrating legacy data is not a trivial exercise). The dollar signs are lighting up all over.

                    In the meantime – each IT department will absolutely need to retain their own staff (in order to keep their own legacy systems operational – we saw the disaster at Waikato when they went down). AND they will have to hire new staff to participate in this major project (potentially they'll hire the new staff to run the legacy systems, and transfer existing staff to the project – but it all means more FTE)

                    This is a state-of-play summary from 2020. It seems highly unlikely that anything has significantly improved since then.

                    https://www.rnz.co.nz/news/national/418645/hospital-stocktake-shows-14b-in-upgrades-required-and-outdated-it-systems

                    Poor and outdated systems – mean that users and administrators are highly motivated to change (not to be sneezed at, institutional inertia is always a drag in projects) – but it also means that legacy data is likely to be difficult to extract, validate and export/import.

                    Possibly, 10-years down the track when everything is bedded it, the IT dept FTE will decrease. But it certainly isn't going to happen sooner.

                    I can't speak to procurement – but I will note that all of the procurement, and service booking systems are run off the IT core – so with fragmented IT systems, it's going to be a devil of a job to co-ordinate effectively across the whole of the new health system.

                • Incognito

                  I would never say the old DHBs were great and all was good. However they served us well enough during Covid.

                  Sure, but it came at a price.

                  Contact tracing across the DHBs was not centrally coordinated and neither was there proper oversight of the number of ventilators or ICU beds.

                  • Anker

                    I don't argue with the need for IT upgrades.

                    What I am saying is that the health workforce is in utter crisis (that is why I continue to post articles about it). If you don't have a well resourced health work force, you have nothing.

                    The health work force has been saving lives and treating people, long before the internet.

                    • Incognito

                      It is not an either-or.

                      Have you been to the GP and/or Pharmacy lately? Have you noticed their computer screens? Have you had an MRI or CT-scan done lately, or an ECG? Computers, software, and IT systems make that work. Do you know that medical records are increasingly becoming digitized, including test results, prescriptions, DNA sequencing data, image data & processing, treatment planning (e.g. radiotherapy), et cetera? Do you know that making appointments and internal bookings (rooms, equipment & materials, people) rely on automated booking systems? Do you realise that stock & storage are now computer-controlled? Have you heard of tele-medicine or Zoom consults? And when was the last time you paid cash at the doctor’s?

                      We don’t live in the 20th century anymore and this is not just about stitching up people or plastering arms.

            • gsays 1.2.1.2.2.2

              I struggle to understand why we are having to repeat the same stuff over and over to an allegedly left leaning crowd, underneath a red standard.

              Doubly so with a majority MMP government and a firmer union man as Health Minister.

              • Anker

                Completely agree Gsays.

                Its very obvious to me that the most pressing priority is the health work force.

                Everyday there are articles in the major news sites about the state of the workforce. Today an article about a patient who had a long wait attacking another patients and abusing hospital staff. Shouldn't the Minister be putting out a statement that this is completely unaccepable? And a few days back staff in Chch being attack by a patient.

                They don't seem to care a dam about the health work force

                • roblogic

                  Yawn. Get some new material. Labour has made more progress in the Health portfolio than National could be bothered with in its 9 years. Nine years of pay freezes and waiting lists cut for no reason apart from political convenience.

                  When I busted my arm in early 2020 — a severe break needing surgery — I couldn't even get an *appointment* at Orthopaedics in Whangarei. Went to Auckland instead and finally got someone to look at the damn X ray, they said "oh" and rushed me in to surgery – about 9 days later.

                  The DHB system sucked

                  • gsays

                    "Yawn. Get some new material. Labour has made more progress in the Health portfolio than National could be bothered with in its 9 years. Nine years of pay freezes and waiting lists cut for no reason apart from political convenience."

                    Damning with faint praise there rob.

                    `

                  • Anker

                    I don't argue with the need for IT upgrades.

                    What I am saying is that the health workforce is in utter crisis (that is why I continue to post articles about it). If you don't have a well resourced health work force, you have nothing.

                    The health work force has been saving lives and treating people, long before the internet.

                  • Anker

                    Yes so much has improved under Health NZ……( I am sorry to have to stoop to sarcism here)

                    But really that you couldn't get an orthopaedics appointment in Whangarei. That is my whole point. If we are short of health professionals and there is a the sort of crisis we are seeing as I have documented, then that is where Andrew Little's attention needs to go. Now

  1. Poission 2

    Heaven to hell in 24 hours in cryptoland.

  2. gsays 3

    While I'm here, go Captain Kane and the team. Semi-final vs Pakistan @ 9pm.

    Even though the alarm goes off at 5.15, I aim to watch the game.

  3. weka 5

    What's happened in the US today?

  4. weka 6

    Incredible

  5. weka 7

    Do you see the utterly regressive and sexist nature of gender ideology yet? And why so many women are saying no. (see if you can separate the ideology from transness)

    • roblogic 7.1

      3 types of "trans"

      1. Children… 100% caused by parental influence (munchausen by proxy)

      2. Adolescents… 99% caused by social media and psychological problems

      3. Adults, usually male to female.. very likely caused by pr0n and sexual fetish aka "autogynephilia"… the most toxic aggressive and vocal of the 3

      None of the above have any basis in biology, unlike actual intersex/DSD related.

      • weka 7.1.1

        how do you explain fa'afafine?

        If you're going to include AGP in your analysis, then Blanchard himself (who developed the definition) says that not all transwomen are AGP.

        Your comment is incredibly dismissive, pathologising many people who are gender non-conforming.

        Much of human experience isn't based in biology in the way you inply, but it still has meaning.

        • roblogic 7.1.1.1

          While it may be unkind to view adult behaviour and lifestyles as pathological, it is much worse to channel children into a lifetime of dysfunction and difficulty because of a phase or a fad.

          "Self Love not Surgery"

          (ps. I support gender nonconformity but not the present TRA movement, which looks a lot like MRA in drag)

        • Sabine 7.1.1.2

          Trans is a western concept of categorizing people who are not living their 'sex' as prescribed by society – with the end goal of medically and surgically modfying bodies for the supposed mental wellbeing of the people identified as trans and the very handsome profits of the medical industrial complex. Trans creates people who will end up living their lives totally and utterly dependent on the medical complex, much like a person who is type 1 diabetic is
          livelong depended on government to setting affordable prices for insulin.

          Fa'afafine is the concept / word for categorizing people who are not living their sex stereotypes in the Samoan culture, but as far as i am concerned they are still male, still play sports with the men, physically stay men, but live their lives in a societal fashion more attributed to females.
          I would never even consider comparing the two as they are very different.
          I doubt that there is a movement in Samoa trying to remove the word mother/woman from people with the ability to get pregnant, stay pregnant and then ‘birth’ a child. While here in our western world we are very much agitating to remove the word mother – implying ownership over the child to a term that could literally be a job describtion. Birth giver, birthing person, birthers – which implies one is doing a thing, but implies no ownership. After all a dog / cat / horse / dairy cows are all birth givers.

          In fact maybe our western social concept of trans could learn some from the Samoan concept of Fa'afafine – like a women vs trans – is a woman no different at all to the things we no longer want to call women in order to not be offensive to people who want to be men and the people who want to be women.

          • Molly 7.1.1.2.1

            "how do you explain fa'afafine?"

            Fa'afafine is a descriptor of those that exhibit certain behaviours within the Samoan culture. Unlike the TWAW mantra, they are recognised as men. That clarity is significant. The fact they are now used as legitimacy for current gender ideology is through convenience not accuracy.

            "Your comment is incredibly dismissive, pathologising many people who are gender non-conforming."

            Given the ever increasing numbers of behaviours and groups sheltering under the trans umbrella, I think this is an understandable overreach, but one that still could apply to a significant percentage the third group roblogic identified.

            As you clarified those who are just gender non-conforming, will most likely not be AGP.

        • roblogic 7.1.1.3

          This subject is such a minefield, ripe for misunderstanding to blow up.

          I am happy to see people living free from gender stereotypes.

          I am not happy to see young people rejecting their natural bodies and attempting to conform to an opposite stereotype via drastic surgery and dangerous doses of hormones.

          Research into the causes of gender incongruence isn't "pathologising" people, it is exploring why they exhibit these behaviours. Understanding leads to compassion, and might open up new treatments for those who choose it.

      • Anker 7.1.2

        Now this we do agree on Roblogic.

        I think Blanchfield also talked about the passive male to female trans, who had identified with female gender stereotypes as a young child and wants to be a very submissive "woman"

  6. Poission 8

    Tech correction continues with Meta transferring 13% of staff to the underverse,after loosing investors 211b$ so far this year.

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