Former journalist John Armstrong runs National’s line on health today:
The Cabinet’s loosening of rules on district health boards farming out non-urgent surgical operations to private hospitals is the logical step to take for a Government trying to get more from less…Monday’s decision is a step towards public and private providers eventually competing for the health dollar, thereby (in theory at least) providing more operations more cheaply through increased efficiency and higher productivity.
Such blind praise built on no actual evidence. The most important statement in that quote is the bit in brackets – “in theory”. Well, neo-lib ideology dressed as ‘theory’ has been telling us the private sector is this wonderful, flawless deliverer of efficiency for decades. We’ve yet to see it.
Armstrong dismisses opponents of greater privatisation with:
The few plaintive cries from the likes of the senior doctors’ union focused on the likelihood of already-scarce medical staff drifting away from public hospitals to better pay and conditions in private ones.
Yeah, what would the doctors know about what’s good for healthcare? No wonder National broke it’s promise to listen to the doctors when making decisions. Then, out comes the old saw:
The Clark Government effectively doubled the money going into health services during its nine-year tenure. Labour delivered in terms of primary care for the young and the old, but it struggled to cut waiting times for operations.
Um. No.
In Budget 1999, National budgeted $6.8 billion for health. In Budget 2008, Labour budgeted $12.4 billion. An 83% increase. If that’s ‘effectively double’, well, let’s just be happy Ryall and Armstrong aren’t structural engineers. Anyway, that’s only the beginning. The population has grown over 12% and there has been nearly 30% inflation since 1999. Take them into account and the increase is only 24%.
On top of that, the aging population increases the demand per head (can’t find a disaggregated number on that), health sector inflation has run higher than general inflation, and there’s a constant cost of new medical innovations, which mean better outcomes for the same number of procedures, and the effective funding increase was even smaller than that. Labour had to put in a huge amount of money just to keep per person services at the same levels and make small but important improvements.
Labour focused on putting the money where it counts – into primary health. No, it’s not sexy and it’s not as easily countable but primary health is where you invest to keep if you want the best bang for your buck, if you want maximum value for money in achieving the health system’s purpose – keeping as much of the population as healthy as possible.
Unfortunately, politics gets in the way. Ryall knows that it’s the waiting lists that get attention from the likes of Armstrong. So the money goes out of primary health and into electives. It’s like buying more ambulances to put at the bottom of a cliff by cutting spending on fence maintenance at the top. It’s dumb. But if you’re looking for a political win, not for improvements to the population’s health level, that’s what you do.
– Marty G
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