Health service funding

Written By: - Date published: 7:44 am, September 25th, 2014 - 62 comments
Categories: health - Tags: ,

Not that you’d know it from most media coverage, but National has been steadily cutting funding to health and education in real terms (not keeping up with inflation and rising demand). Today yet another doctor broke:

Orthopaedics chief quits, slams health board

Orthopaedic surgeon Associate Prof David Gwynne-Jones has resigned as Dunedin Hospital’s orthopaedics clinical leader, citing frustration with the Southern District Health Board. … ”We are now performing significantly less joint replacements than the NZ average despite our increased demand.” …

Relationships had come under strain because of the lack of resources. …

Last night, patient services medical director Dick Bunton said the board’s managers should not be seen as the ”ogre”. Funding pressure was driven by the Government.

At a Dunedin North candidates’ meeting that I attended there were plenty of angry questions from the audience for the local Nat. The situation in Dunedin hospital is dire, and no doubt other hospitals are the same. Welcome to the brighter future.

62 comments on “Health service funding”

  1. Chooky 1

    What a pity the surgeon did not resign well before the Election..so as to make health funding an election issue

    The day before the Election ( Friday September 18) on the front page Christchurch Press was a National Party advertisement.

    ‘5 Reasons to Party Vote National’

    1.
    2.
    3
    4.Better healthcare and Teaching
    5.

    Lets hope the Christchurch Press examines this lie in detail …but I doubt they will. (I also doubt radionz will investigate this issue or television)

    ….another reason why the umbrella Left must have its own radio station and newspaper

  2. Jay 2

    I was diagnosed with hodgkins lymphoma about two months ago, and at present am undergoing chemotherapy. The standard of the treatment I have been and am receiving is nothing short of superb. In fact I constantly find myself humbled by the amazing men and woman working in medicine in nz, all of whom are completely focused on my wellbeing and on getting me fixed up. I am also humbled by the amount of money my country is pouring into getting me better so I can live a bit longer, I expect my care and treatment will exceed the total tax take of my income and spending over my lifetime. It has made me very very grateful, and believe it or not am filled with an urge to get back to work so I can pay nz back, and help pay for others who are in my situation or worse. Now that I have learned what being and feeling sick is really all about, I also find myself far less tolerant of able-bodied people who don’t or won’t contribute to our society, and those who take our health system for granted. I don’t know what is going on elsewhere in nz,but hats off to Auckland Hospital and all the amazing men and woman who are looking after me, and thanks to all of you who’s taxes are paying to give me my life back.

    • adam 2.1

      Best of luck Jay – and yes our medical profession are quite amazing. Socialised medicine, what a great thing that is.

    • higherstandard 2.2

      Thank you Jay.

      That’s a great post, all the best.

    • One Anonymous Bloke 2.3

      “I got treatment, therefore this doctor is wrong”.

      I hope you get well Jay, and can you ask the doctors if they can do anything about your logic deficiency while they’re at it: it’s affecting your hate levels.

      • tinfoilhat 2.3.1

        🙄

      • greywarbler 2.3.2

        @OAB 9.01
        It is one thing to be relentless in critiquing comments, it’s another to misread them and then critique that. And this person is ill. And could do with some kindness. Are you sick with something OAB? Perhaps you need kindness too.

      • adam 2.3.3

        *tickles* OAB then *Hugs* OAB. Now that over – *slap* OAB .

        Pick ya battles FFS.

      • infused 2.3.4

        Ah oab. Proving to everyone what a piece of shit you really are.

        gg.

    • AmaKiwi 2.4

      Good luck, Jay.

      A few years ago Obama and that rich Republican Mormon were having a presidential debate. The rich guy boasted, “America has the best health care system in the world.” My partner, who is in that profession, started rattling off America’s pathetic health statistics on infant mortality, recovery from strokes, life expectancy, cancer treatment, etc., etc.

      Yes, our system works. But then American’s are good at being delusional. I read on The Intercept that the 2009 Nobel Peace Prize winner (Obama) is now bombing his 9th Muslim country (Syria). I’m sure it’s all in the cause of peace.

    • Richard@Down South 2.5

      Best of luck… I had Hodgkin’s lymphoma in 1997… touch wood, still clear

    • Simon 2.6

      Nice post Jay, but I think this comment is problematic ‘I also find myself far less tolerant of able-bodied people who don’t or won’t contribute to our society’.

      The question is how do ‘you’ determine able bodied. I’m guessing that when you say ‘less tolerant’ you mean that you make judgements about the ‘abled-bodyness’ of some individuals. The problem is many individuals may appear to be able bodied when they are in fact not. Unless you know someone , and in fact, know someone very personally, you will not be in a position to make an inference such as this.

      I work with people who have had stroke(s) TBI’s etc. and many of them probably appear outwardly ‘able-bodied’, but in fact their cognitive problems or mental health problems means that they are unable to work (in most cases, despite wanting too).

      So in sum, I think that you have to be careful about making judgements/inferences about others, regardless of your own profound experience of cancer, and the NZ health system.

    • Murray Olsen 2.7

      I got diagnosed with liver cancer about 3 years ago. Three months ago I had a liver transplant. This was all in Australia, which still has a decent health system. Looking death in the face and surviving the experience because of the doctors, the nurses, and the working class Aussies who built the health system is an experience that has made me far less judgmental and more tolerant.

      On the day that there are two jobs available and one unemployed person in Aotearoa, and that person doesn’t want to work, I’ll think “Ah well, the work can wait.” Until then, I am intolerant of governments that plan an economy with a 5 or 6% unemployment rate, and of people who talk about those who “won’t” contribute.

    • greywarbler 2.8

      Jay 8.30
      Be careful in your stream of consciousness outpouring, including this statement:
      Now that I have learned what being and feeling sick is really all about, I also find myself far less tolerant of able-bodied people who don’t or won’t contribute to our society, and those who take our health system for granted.

      There are a lot of us – retired people who take the health system for granted. And some of us might retire at 65 or even 67, and then live to 99. That is one-third of our lives when we may not be earning. And we are likely to be quite able bodied until in our 80’s. Were you thinking of us when you made your critical judgment about those ‘not contributing to our society’. Is volunteer community work contributing? Or does it need to be paid work, as the health system does need lots of dollars?

      So don’t go making sweeping statements as you have, without thinking about the whole picture, and trying to understand what the government calls ’employment’ and ‘wages’ in its statistics, which often fudge the real figures through what they decide to count.

  3. yeshe 3

    Nats making a case to plunder the Cullen Fund and probably ACC funds as well …. and causing such suffering.

    Welcome to a tighter future.

    And with Lusk’s two tobacco boys safely installed in parliament now, watch for a dilution of many health and wealth protections. Gruesome.

  4. BM 4

    Unfortunately there’s only so much money to go around.

    Can’t just keep raising or creating new taxes either.

    • stever 4.1

      Even if that’s true (only so much money…) let’s talk about who it goes to, and why.

    • adam 4.2

      BM, from the right who raised g.s.t. From the right who gave a tax cut to the rich, then borrowed money to balance the books. Far out man, you wonder why people on the left look at your comments and shake their collective head.

      Any other t.i.n.a expressions of wisdom you want to impart. Any other pearls of the narrow ideological trip you’re on, you want to bark?

      I love you man, I really do – when capitalism finally burns up all the resources and there’s bugger all left – drop me a line, will find something for you to do.

    • minarch 4.3

      “Unfortunately there’s only so much money to go around.”

      because its all been “trickled up”

    • Foreign waka 4.4

      It will get ever so interesting. NZ has currently a distribution of wealth whereby 10% own 50% of all wealth, 45% have to carry the major tax burden and 5% counting as the very very very poor. With this further deteriorating, I think the 10% will have to pay more.

      • BM 4.4.1

        Expecting a boom time for tax accountants?

        • Foreign waka 4.4.1.1

          Well, it already is so otherwise this out of kilter distribution reminiscent on the 16th century Europe would not hold water. The worst part is that a lot of funds are being siphoned off to offshore accounts and people who do this truly belief that they are in the right. How distorted must the world view be to get to this conclusion? How sad and small those people really are.

    • AmaKiwi 4.5

      “Unfortunately there’s only so much money to go around” and the Nats are wasting it by parking the ambulance at the bottom of the cliff.

      My partner see numerous poor people who cannot afford to get treatment and pay for prescriptions when their ailments are in the easily curable stage. For lack of free government services they wait until it gets really bad. Then YOU, @BM, have to pay $700 and more per day for them to go into hospital.

      It’s called “preventative medicine.” The Nats ain’t interested in it. Cunliffe and the Left are.

      @ BM some advice: an ounce of prevention is worth a pound of cure. Did they leave that out of your economics lessons?

    • Andrea 4.6

      ” Can’t just keep raising or creating new taxes either.”

      Why not?

      Petrol and similar taxes. GST. Catching the sinners buying goods overseas and dodging tax here. Oh, there’s plenty of slop in the system yet.

      An offence to the mainstream middle New Zealanders? Hehehe. Smile, wave, ignore, rinse and repeat. They’ll LOVE it.

    • greywarbler 4.7

      @ BM
      The country could just charge us so much per comment to increase tax, like putting money into a swear jar. And you would be getting charged along with all of us. And you would gladly pay because you love telling us how we are wrong.

    • tricledrown 4.8

      blind monetarist why don’t we run the health system on a Cullen fund idea initially we all pay a little more but when the fund reaches a point where returns a high enough then we won’t have to pay any taxes
      we could run the whole of Govt. using this model
      kiwi-saver could be expanded to be a self funding model for the whole of Govt.!
      time for a rethink on the left!
      National and ACT have won the war on neo liberalism !
      The majority of New Zealand that vote have aspirations to be wealthy one day Most will never attain that goal but dream they will so are happy to play along with the neo liberal propaganda!

  5. Jay 5

    Thanks Adam I should be alright. Not counting on letting old anymore though!

  6. dv 6

    BM
    Nat Debt clock
    88,964,425,200

    Interest
    $4,358,741,701 per yr

    Shame about the tax cuts?

    • BM 6.1

      Shame about the WFF and the interest free student loans and the DPB and the dole and all the other hand outs people now expect.

      I have no problem with the people who provide the income for all the above services to get a small break.

      Lets be honest, it’s not like that money is being stashed in a mattress, it’s out their keeping people employed.

      • repateet 6.1.1

        I’m looking forward to getting home from my employment to count my tax cut. It’ll be easier to understand than 88,964,425,200. Which won’t be 88,964,425,200 any more of course, it’ll be closer to 89,964,425,200 by then.

      • AmaKiwi 6.1.2

        “it’s not like that money is being stashed in a mattress, it’s out their keeping people employed.”

        Building highways that will create ever larger traffic jams, urban congestion, CO2, and dirtier air. Brilliant.

        I wonder how much Fulton Hogan donated to Key.

      • dv 6.1.3

        BM The small break was about 1 billion

        Heard of GST BM?

        How come SFC got bailed out?
        Tiwai pt?
        Solid energy
        Joyces radio stn

        etc

        • Rob 6.1.3.1

          This is a reply to dv in 6.1.3

          SFC

          So what would have happened if SFC did not get bailed out, remember it was actually Labour that brought in the original finance company protection scheme as they could also see the risk to the predominately baby boomer population as well. The damage that has been done to baby boomer investors in the very unregulated financial investment markets through Labours last years will probably become the defining summary of that Govt. National probably did not have a choice but to extend the scheme as they could see the huge societal risk as well.

          Tiwai Point.

          It will probably be gone in 2017 as I think that is when the next round of electrical negotiations come around . It will also probably mean the end of of regional Bluff as a contributing and growing city. You want to keep people in employment in the regions?

          Solid Energy

          Yep too many tries at loose innovation, particularly in Bio oils and the like. Bloody expensive and risky to get that type of innovation successfully commercialised. Management team did spend money like drunkin sailors on new initiatives. History shows that they should have kept to their core business of mining coal.

          Joyces radio station.

          So you would like the whole commercial mass media market to reduce to one player and one voice. You complain about compliant media now, imagine what that model would have looked like.

          • dv 6.1.3.1.1

            My point was that BM was one eyed in terms of who got help from the govt.

            It seems to me BM can’t have it both ways.

            However the SCF case is smellier.

            These are notes made from a Paul Caruthers video from memory may be 2- 3 weeks ago, source from a DimPost comment by Victoria Adams

            Interesting that video has now been taken down.

            It is a 25 min listen.Some key pts from memory

            The notes

            English and Key renewed the Govt guarantee the day after they got into power against treasury advice

            The got Hubard to put a couple of his own valuable company into SCF – scale and helicopter line(?), which he did willingly.

            Lotsa comments made that hubbard was fraudulent- thus reducing the co value!!
            Day after the assets were transferred? they charged him with fraud

            Powers ‘illegally’ used an act to freeze the assets

            Westpac got quite a lot from the Govt under the guarantee
            Power moved to Westpac
            Sold the a very valuable asset (Scales) to Keys next door neighbour (across the rd) for 44m
            Later listed the next year on stock market for 144m?

            And when Hubbard died in the crash, he had a court case pending against the govt.
            Apparently the autopsy reports and all the file re the the case are sealed!!!

            • Sarah 6.1.3.1.1.1

              Those comments are just so far out of touch. Paul Carruthers means well but timing is all out .

              Allan Hubbard place assets in to SCF 28 Feb , the same day the anonymous complaint was written (and originally said to have been received at secom). 28 May Hubbard resigns within days the George Kerr equity is changed to Debt (more cost to Taxpayers aka compliments of MOF Treasury) and the inspectors are only then sent in to Aorangi (given the compliant was acknowledge 28 Feb)

              SCF was accepted in to original GG on the day Key took office, but PGGW and Marac were the first entities accepted …. that is the key to all this.

              The value of hubbard’s assets were talked down in media – as another company did and noted in media with it share value prior to rights issues but for different reasons, one to successfully recap the other to destroy the company and reap assets at firesale prices

              AH died one week out from a court hearing that would have likely seen him released from Stat Management . He was the day he died to sign a deal that would ensure investors would deal with Tur Borren and others rather the Managers that now have stripped aorangi alone of $12 million plus in fees, that Aorangi was never INsolvent is a crime in my opinion given the consequences of the action taken against the Hubbard’s.

              A number of valuable assets ended up firesaled and Govt got some assets – Scales the biggy but much worse and hidden amongst non transparency.

              Hubbard was stoned to death basically by media via parrots of power without a trial and is still on trial via SCF – Media was well used by regulators especially SFO and off the record with a certain media in Timaru, frequently as OIA show and inside information- that should be proven in an investigation and someone held to account. This affair stinks to high heaven , the only consolation is the fact that George Kerr appears to be facing a lot of scrutiny now via three different issues – so maybe just maybe people might begin to follow their noses back and see where the smell began regards SCF…

              • dv

                Thanks Sarah.

                I really don’t know much about SCF. And that may show in my comments

                BUT my basic thesis is that it was smelly, and you appear to agree with that.

                What is your reaction to the sealing of autopsy report and the case agin the govt.

                Is anyone investigating,

      • minarch 6.1.4

        “Lets be honest, it’s not like that money is being stashed in a mattress”

        nope it stashed in the Caymans, the BVI, Bermuda, The Cooks, Labuan

        take your pick, theres plenty more !

      • Foreign waka 6.1.5

        With the wealth distribution getting more and more out of kilter, many more people will get angry. Rhetoric about benefits will not help as the rich take more and more advising the ones the take from to eat cake. God help NZ.

        • BM 6.1.5.1

          Families with 1 kid who earn 50k pay basically no income tax, more kids you have, the more money you get.
          Quite a few receive more money back than what they’d pay in tax.

          That doesn’t seem particularly fair.

          The irony of those same people bitching about the more well to do paying their fair share is not lost on me.

          • Liberal Realist 6.1.5.1.1

            “Families with 1 kid who earn 50k pay basically no income tax, more kids you have, the more money you get.
            Quite a few receive more money back than what they’d pay in tax.

            That doesn’t seem particularly fair.”

            Your argument is moot BM. Why does WFF even exist? Because wages in NZ are too low to support a family with. If workers are paid a fair, livable wage then WFF wouldn’t need to exist.

            “The irony of those same people bitching about the more well to do paying their fair share is not lost on me.”

            And before you’re tempted to lump me in this group, no, I do not have children. I’m well into the top tax bracket and do not have any problem paying my FAIR share of income tax.

          • Richard 6.1.5.1.2

            Whole things cock eyed BM, why is there WFF, a bribe for voters? Why are wages so low families need assistance. Why compulsory pre schooling, why forcing mums back into work. Why do families have to both work was a time when one earner was enough to keep a family.

            There’s a lot of questions BM that’s just the Tip of it. However if you want to talk, lets talk without the party blinkers on. Because I’m telling you the fact is all parties are to blame for the mess we are in, and National is currently taking that to new heights whether you care to admit it or not. If you think another ten years of Keys idea’s, and everything will be swell your more deluded than a loony left conspiracy theorist.

            The only thing I see going on, is rich people praising keys top tax cut and making employee’s a cheaper outgoing for which they have no respect for.

            You expect everyone to treat you(the company owners, Nationals support base) with respect because business makes the world go round, but actually pass on higher wages for increased productivity and profit?, not unless your forced too, lets argue that point.

            Trickle down my ass,
            Show me trickle down that’s not a fairy story.

            You want the working man to respect National start treating US with a little fucking respect.

          • Foreign waka 6.1.5.1.3

            Why would you say that a family with 1 kid does not pay income tax? Any money claimed in income tax would be refunded after a year of trying to make it through the year. If you break it down, the income is 25k before tax per person. You are aware of the living costs these days? Daycare assistance is $ 4.00 per hour at the highest rate for 20 hrs. Childcare can cost up to $400 per child per fortnight (perhaps even more). The organization for Economic Development has found that NZ spends on average 28% of income on childcare – the fourth highest in of 32 industrialized countries – and this was 2 years ago. So lets revisit that income of 50k – and reduce this to 36k for a starter, not even inflation adjusted. I hope you see where this is going?

          • Occam 6.1.5.1.4

            Not true. We are a single ‘taxed’ income family, my partner earns $59 K. I earn a reasonable tax free income (post-grad scholarship),so doesn’t count for WFF.

            We have two kids and don’t receive any WFF. In our case the cut-off is about $80k, at which point we would get about $7 p/week.

            So in fact you are totally wrong.

          • tricledrown 6.1.5.1.5

            families on $50,000 pay way more Gst than single people they also are bringing up a new generation of taxpayers so we want them to be healthy and successful our low end wages are not enough to pay for all of the needs of a family!
            now you will say they don,t deserve to breed ,now you are fighting nature

      • Occam 6.1.6

        DPB doesn’t exist anymore. It’s sole parent support till the kids are 5 then job seekers.

        Dole also doesn’t exist, it the job seekers.

        Student loans are only interest free if you stay in NZ. Outside of that ex-students pay above market rates (7%).

        Keep in mind that every dollar that the govt lends out in a student loan they get 15c back straight away with GST.

        Plus grads typically earn more, so pay more income tax and GST over their lifetime, cost less in terms of health system, justice system, and have kids that are more educated/healthy and so on saving the govt a huge amount of $$ over their lifetime.

        Carry on with your ignorant rants thought….don’t let me stop you!

  7. tc 7

    A senior ENT surgeon confided to me earlier this year they are being driven mercilessly to breaking point by administrators and management obsessed with numbers.

    He’s considering retiring even though he’s got many years left in his globally experienced hands but he’s shattered after years of it.

  8. AB 8

    We are in the USA right now getting what we believe (after long investigation) is world-leading neurosurgery for a child with cerebral palsy.
    The treatment is not available in NZ and not funded. Total cost for us is about NZ$130-140k. Luckily our extended family can help us to afford it. Other NZ families are doing it via public fund-raising.
    It seems likely to me that this procedure will become in time the preferred ‘standard of care’ for certain types of CP, at least in the developed world.
    But given that the intense cost-containment focus we already see in NZ is likely to intensify under National, I can’t see most NZ kids with CP having this option available to them.
    The silly thing is, I suspect that proper health economic analysis would show that it makes sense in pure economic terms because of surgical treatment avoided in later life and reduced future dependency on health services generally.

    It is this sort of decline in our healthcare from first world status we are going to see with National. Those of us with enough money will get by. But I despair for everyone else.

  9. KJS0ne 9

    My theory is this, they will continue to cut public healthcare over their 3rd term, with the express purpose of trying to kill Universal free healthcare. At some point they’ll turn around and say: ‘Look, see public healthcare just doesn’t work. The only way to bring NZ healthcare into the 21st century is to privatize it.’

    Then they’ll proceed to institute a system similar to the USA. Their corporate lobbyist mates will cream their pants, retiring Nat MPs will get cushy jobs in return for supporting the change and lots of money will be made at the expense of the New Zealand public.

    Money has no place as the driving force in healthcare. I support private option to work as competition to public healthcare, but universal free healthcare is the only way to prevent profits overtaking the hippocratic oath. The USA system of healthcare only benefits the rich, and it leaves an underclass of uninsured former middle class people who have had to sell their houses and entire life savings and borrow hundreds of thousands of dollars just to pay for their medical expenses. Many people who do not have, or cannot afford health insurance die each year as a result. Even a lot of people who have basic healthcare insurance die because their healthcare insurance doesn’t provide the best care necessary. When the ‘wallet biopsy’ is performed in the ambulance, if the card isn’t good enough they get sent to a mediocre hospital with mediocre doctors who cannot provide the same level of care that one would receive in the top tier institutions.

    Monetizing healthcare just creates another dimension of inequality. Sometimes I get the feeling the corporates just see us as crops to be farmed. We are the trees upon which the money grows, and their job is to harvest it. It’s not too far removed from the machines harvesting human energy in the Matrix.

  10. StarSpangledBallet 10

    SDHB (formally Otago and Southland DHBs) has had financial challenges through periods of significant funding growth and lower funding growth. For most of the time of the DHB model, the area has run financial deficits. The area has a history of over intervening in terms of specialist and institutional services relative to many other areas of the country. They need to get their own business in order relative to the funding they receive through the equity-weighted population-based funding formula.

    • Andrea 10.1

      “They need to get their own business in order”

      Look: the answer is actually absolutely obvious. Isn’t it.

      It is dazzlingly clear they aren’t paying their top management enough salary and incentives to rein in those stroppy medics trying to improve their skills and care for their clients/patients.

      Do you suppose a little 10% tweak would be encouraging? Too meagre? But these are Hard Times…

      😛

  11. Michael 11

    Labour has only itself to blame for this state of affairs: it lost the Party Vote in both Dunedin electorates and even managed to lose the votes in the University booths, for the first time in living memory. It did so as a result of offering a timid, pusillanimous, National-lite policy platform that convinced no one. I frankly doubt whether the caucus is (a) interested in, or (b) capable of, reconnecting with the Party’s base, in which case it is doomed to irrelevance and slow political death. I’d really love to believe otherwise but the spectacle of the caucus shredding the stock of political capital that I, and many other people, spent years building up in and around Dunedin, tells me Labour is now terminally fucked.

    • r0b 11.1

      Factually incorrect, Dunedin North won the party vote for Labour (albeit by a tiny majority which may be overturned by specials). But Labour + Green demolished the Nats in Dunedin North.

  12. whateva next? 12

    It’s inevitable, they have hacked all other government departments, and sure as night follows day, it’s the health service that will have it’s turn now, just like Thatcher did…Key has done everything else she did, why are we surprised?

  13. Occam 13

    In 2013 the Govt gave ADHB an extra $10 mill for elective surgeries on the proviso that they push through a large number of easy and cheap surgeries, so that the govt can make the claim that they have achieved an increase in elective surgeries through the ADHB system. The ADHB agreed an completed the surgeries and met the targets.

    In 2014 they tried the same thing but the ADHB told the govt that there wasn’t enough ‘easy/cheap’ surgeries left (only challenging, expensive ones) to meet the targets for the $10 mill. The govt decided not to fund.

  14. AsleepWhileWalking 14

    Under funding of health has to lengthen time spent on benefits, coincidentially those that are by the governments own research have bee increasing in numbers for the last few years.

    When a client is signed onto either the Jobseeker + medicial dispensation (previously Sickness) or the Supported Living payment he government is paying for a resource.
    In the absence of proper health funding this resource is going to be wasted in many cases.

    PATHS is limited in funding and only funds health related expenses that have a clear nexus with working. If you need longer term or complex intervention you are out of luck, or more specifically out of funding.

    Tis a real shame for everyone involved. Perhaps it is now time to look at the two together before allocating budgets.

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