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Written By: - Date published: 2:33 pm, February 26th, 2009 - 33 comments
Categories: health - Tags:

If the 20 new elective surgery theatres Health Minister Tony Ryall has announced were going to be funded with new money, I would say ‘sounds good, let’s hope we can get the staff’. But Ryall is taking the money out of the existing budget and, so, I have a couple of issues to raise.

Ryall continually says ‘the health budget has doubled in the last decade but elective surgery has not kept up with population growth’. If you’re going to adjust for population growth, have the honesty to adjust for inflation too. Around half of the budget increase each year is just match the very high inflation in the health sector. Anyway, the way Ryall frames the issue, you would think that elective surgery is all the health budget is spent on. In fact, it’s just one small part. And the need for many elective surgeries can be avoided by effective primary health care, which is where Labour concentrated new investment. Just because there aren’t more elective surgeries being done doesn’t mean the health of the population isn’t being improved.

So, why Ryall’s obsession with elective surgery? It’s not unimportant but is it really the overriding priority? Since the money for these elective surgery super-clinics will come out of existing funds, something else will have to be cut to fund them, what will it be? Cancer treatment, emergency care, primary health? Where are the 800 new staff for these elective surgery theatres going to come from? What other specialities will lose as a result?

33 comments on “Electives”

  1. @ work 1

    Don’t worry Steve, it makes a great headline!

  2. No National is not cutting services to cancer patients or anything important, the public will not notice the difference in the cuts to health, well its not really cuts, its more like moving money to what is really needed.

    • Felix 2.1

      That’s nice Brett. Good to know you’re well informed about the issue and not just regurgitating the spin you heard from your hero John Key about “front line services vs bureaucrats”.

      So I’m sure you can answer this: when you say “moving money to what is really needed”, you mean from where to where exactly?

  3. Tigger 3

    National will be treating the symptoms, not the disease. So targetting obesity is out, operations for heart failure caused by obesity are in.

  4. Jum 4

    Electives are a priority for aging populations which tend to need hip ops and vote National. Ryall’s tapped into that.

    We all have olds. In spite of all this bleating by National to have individual freedom it eventually comes down to having someone to look after them in their old age – very socialist thinking.

    In NAct’s case they want men to be capitalists (money and power) and women to be socialists (caring about people and giving time voluntarily and for free).

  5. Chess Player 5


    Yes it does make a great headline. Nice to have some good news stories too….


    Operations for heart failure are not ‘elective’, they are ’emergency’.


    “not unimportant but is it really the overriding priority?”

    Well, yes, I would say that to those aging baby boomers who are the main users of elective surgery it is a very high priority. It’s their bodies that are wearing out, after all. Once again, National are just delivering to the promises they made before the election. The time to decide whether or not it was a high priority was last November, and clearly many people agreed…..

  6. Janet 6

    Providing services for people with disabilities is an expensive part of the Health budget, so blunt cuts there could fund more scalpels.

  7. Chess Player 7


    “In NAct’s case they want men to be capitalists (money and power) and women to be socialists (caring about people and giving time voluntarily and for free).”

    Interesting comment, but can you point out how this relates to the topic of elective surgery, if in fact it does?

  8. Jum 8

    And Tigger, soon National will tell the obese that they have given them the freedom to choose what goes in their mouths and if they get sick, they will have to pay for their hospital care.

    After that precedent has been set, everyone will be charged in some way for all medical help.

  9. Observer 9

    Here’s a thought

    let’s take elective surgery (which by its very label means something the patient WANTS rather than NEEDS) off the Health Service menu, and leave it to the patient to decide what they use their money for. I KNOW that surgery insurance costs me less than a pack of fags a day, and I am OLD and so in the high risk category!


  10. Chess Player

    A) do you really think that this swayed people’s votes?

    B) Just because it was in the winning party’s election promises does not mean it’s sensible policy.

    • Daveski 10.1

      I agree with your second statement but there was a tendency in the past for people here to use that same excuse to justify poor policy from Labour.

    • Chess Player 10.2


      A) yes, because much of the swing back to National came from NZ First, which previously had captured much of the ‘grey’ vote. I woudn’t say any one issue resulted in Nats winning, but policies like that are very attractive to the older generation, at least the one’s I’ve talked to anyway

      B) No, of course not, and people can continue to question policies, which is all well and good. I’m just saying that if a party goes to the polls with a certain policy, especially when others have tried hard to paint them as untrustworthy, it would seem pretty obvious that if/when that party gains power, the first thing they are likely to do is to get the things they promised to do done, and so prove that they are trustworthy after all. It’s the same tactic Clark used with the pledge card all those years ago.

  11. Felix:

    Steve was the one suggesting that money will be taken from cancer treatment and emergency care, I say it wont, and it will be taken from other areas that don’t directly effect patient’s treatment.

    • Felix 11.1

      And I’m asking you “from where?”

      You say you know it’s not from cancer treatment so you must know it’s from somewhere else. Then where?

      If you’re not just making shit up or regurgitating spin then you’ll have no problem answering the question. Maybe your mates from pandasport can help you out.

      • BLiP 11.1.1

        he’s saying it will come from areas that don’t affect patients treatment. So that means its coming from . . . no where . . . places like”thin air” . . . credit default swaps and things like that .. . you probably wouldn’t understand . . . please, don’t bother with the details . . .

  12. Jum 12

    Chess Player said, “Interesting comment, but can you point out how this relates to the topic of elective surgery, if in fact it does?”

    I’m glad you asked. Pay equity for women has been knocked back by Ryall, and the men have not volunteered to reduce their wage to meet women’s wage somewhere in the middle. Even though it was pointed out (including on this blog site) that many women are sole family earners that meant little to National. Especially hard will be where special needs teachers/teacher aides are on very low incomes. If they leave those particular positions the onus will go back on to the mother to care for that child.

    National will be cutting other services which match their ideology. Part time jobs will go and the majority of those are women workers. There has already been mention of unemployed workers being harnessed in the voluntary industry. Unemployed ‘volunteers’ will be expected to care for the elderly and infirm and guess who they will be.

    Elective surgery = aftercare = voluntary to save NAct money.

  13. Jum 13

    Chess Player
    You and others cannot continue to say that if a voter voted in National everything National promised (or even talked about) was everything that voter wanted.

    • Chess Player 13.1


      I didn’t realise that I was saying that? Oh well then, I’ll play along. Why not?

  14. BLiP 14

    Presumably Ryall is intending on building the new theatres in public hospitals?

  15. rave 15

    I know where his cuts will fall, on the already poor cousin of the health sector, mental health. The “shortfall” will be met by the private sector prisons, the armed offenders squad and undertakers off budget.

    Mind you even if he cut the whole mental health budget that wouldnt be enough to fund the high priced actors he needs for his theatres.

    At least we have transparency. A health system for the rich and greedy at the expense of the poor and needy. The elect vs the reject.

    • senzafine 15.1

      As an actual user of the mental health system, something inside me thinks that that may not be such a bad thing….

      • rave 15.1.1

        Zensafine not sure what you are getting at.
        But wouldnt you rather see more money spent on actually helping people instead of counseling them by phone when they are suicidal. I agree that money in itself doesnt provide cures, but with mental health funding already being used for other things (Auckland DHB in Herald last month) it means that people don’t get the attention they need.

    • northpaw 15.2


      such a wonderfully cynical sense of humor to your comment.. luv “undertakers off budget” and elect vs reject..

  16. Joshua 16

    I’m actually not averse to National’s stated plan of using the private sector more for elective surgeries. It makes efficient sense as you don’t need to waste money on duplicating operating theatres and employing more staff when the capacity exists in the private sector. As long as you get a good outcome for your dollar then you’d have to be an ideological numbskull to disagree (of course whether you WOULD get good value for money is another matter altogether).

    But what’s happened to that policy? Why are we wasting tens of millions on operating theatres that aren’t necessarily needed? Where is that money going to come from?

    • BLiP 16.1

      Josh said:

      ” . . . I’m actually not averse to National’s stated plan of using the private sector more for elective surgeries. It makes efficient sense as you don’t need to waste money on duplicating operating theatres and employing more staff when the capacity exists in the private sector. . . . ”

      The private sector would be the least efficient element in the provision of health care. What business would actively promote the benefit of LESS customers?

      • Joshua 16.1.1

        I’m not necessarily saying that the private system would be more efficient, I’m just saying that IF the numbers stack up then it makes sense to utilise the capacity (both of buildings and staff) of the private sector and the public sector to cut waiting lists.

        As far as I know, France and Germany utilise the private sector quite a lot in their health systems, and their systems are seen as some of the best in the world. Maybe we should look at how they do things?

  17. Stephen Whittington 17

    I’m not sure I understand what you mean by “new money.” Money spent by Government must come from somewhere – taxpayers, borrowing (future taxpayers), or inflation (decreasing purchasing power of current taxpayers). Even when such money comes from these places, it does not need to go towards elective surgeries – it could go towards the things that you think are more important, e.g. cancer care. Why would you support “new money” going to elective surgery when it could equally go to even more cancer care?

    In this sense, any increased spending has opportunity cost. Why are you so dedicated towards the status quo in terms of spending?

  18. quizzical 18

    Steve can you please provide a link to Minister Ryall stating the new elective surgery centres will be funded from existing money.

  19. Jum 19

    An older friend of mine has written confirmation of 3 friends having hip operations in private health clinics paid for by taxpayers under the previous Government. Labour was not averse to helping people when needed. I don’t know why NAct keeps saying all that help was available and Labour wasn’t using it.

    The problem is the specialist surgeons would not avail themselves for public health surgery when they can get huge sums from working in the private health sector and contracting out their services to the public health service. Private health insurance will eventually lead to a lesser public health system.

    Having watched relatives, etc. gradually withdrawing from life because of pain in hips or knees, etc from various degenerative diseases, I would not call that elective surgery; I would call it emergency surgery. What is the use of living longer if it is in pain.

  20. John Dalley 20

    Some 10% of surgery was done in private hospitals but paid for by the public health system and prior to the elections, National where down right liars about this fact.

  21. John Dalley 21

    What i find is fairly interesting is that at this point i don’t hear a mention of Private hospitals providing this service.
    What happened to Nationals’ love of Private Enterprise?

  22. BLiP 22

    Jum said:

    ” . . . What is the use of living longer if it is in pain. . . .”

    perhaps we should fire those people who are hurting. Make them redundant and cut off their entitlement to a dignified death? Yipee! Thanks, National.

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