Lifting productivity

Written By: - Date published: 9:45 am, June 17th, 2011 - 14 comments
Categories: health - Tags:

So, the statement of intent from the Ministry of Health  has just been released. This document outlines how our health service will operate during the next three years; so what does it actually say? Is health truly safe under National?

Let me first start by doing a DPF disclosure type statement; I work in public health, I have a strong social science background and I truly believe that the social determinants of health are an area that most of NZ neglects to consider (if you are unsure what I am on about have a look here)

Anyway, back to the document; after a quick read it is very easy to do a quick, very simplistic discourse analysis of the content. Arguably one of the biggest issues facing New Zealand are the raft of illnesses and disabilities that, by virtue of cause and effect, are preventable – examples type 11 Diabetes, cardiovascular disease, bowel cancer, etc. These cost the country a small fortune to treat, but it would be more cost effective to prevent.

Right at the outset Tony Ryall points out the agenda of ‘lifting productivity’ – straight out of his capitalist doctrine (remember though we are talking about that ‘unproductive’ sector that doesn’t actually make money for the country, therefore are hated by the right). At least they identify how much time is lost from work by ill health, but little is offered to provide solutions for this. Again it is all down to dollars and cents.

Prevention – a simple word, it means to stop something happening – appears just three times in the whole  document; if you use ‘prevent’ then you get six instances, with three around preventable sentinel events, e.g. medical mistakes.

Targets – now there’s a business word – 33 times, targets for this, targets for that. Cost-effectiveness comes in around nine times; not that that is a bad thing. But this then begs a further question; why have we moved away from a health system that wanted to maintain the fiscal integrity of the service by reducing demand for expensive treatments by preventing disease (the recognised cost-effective way of working), to a system that only wants to have targets for fixing the already broken? (an expensive solution that is unsustainable)

Lastly, how can you lift productivity without investment; doctors, nurses, radiographers, beds, wards, etc. are all finite. Yes you can tinker with processes, but medicine and health are two very different things; fixing physical ailments does not necessarily make the population healthier! Arguably health should be one area where performance measures are most harmful, or could we be seeing the start of privatisation by stealth, as the only available extra resources are in that sector.

– ianupnorth

14 comments on “Lifting productivity ”

  1. queenstfarmer 1

    All good points. But has the system ever really focussed on prevention? And where should the line be drawn on what “prevention” includes?

    • Blighty 1.1

      the line should be drawn where it makes economic sense.

      We need to get beyond saying that controls on the healthiness of food, for example, are nanny state and consider the issue rationally – can investing in healthy food save higher costs down the track in healthcare costs? If so, the state, on behalf of society, should spend money at save more.

      Junk food out of school canteens, for example. Just plain good economics.

      • Tigger 1.1.1

        Good economics for the taxpayer but not for corporates. And we all know whose tune this government dances to.

    • ianupnorth 1.2

      That is a very good point -another way of putting it is do we have a health service or an illness service?
      Prevention can fall into three main areas

      Health protection – that is preventing the spread of communicable disease by having good drinking water supplies, good sewage systems, preventing airborne pollution, exposure to harmful substances etc.
      Health promotion – that is the process of empowering individuals to select health behaviours which sustain and prolong healthy lifestyles; thiffers from ‘health education’, as health promotion works on building community capabilities, involves having healthy public policy and changing service delivery (as per the Ottawa Charter)
      Screening for the possible indicators that disease processes are occurring.

      Arguably New Zealand has been good at number one, has at times done well in number two and has some good practices in number three.
      The problem is this though; under Labour we were developing number two very effectively; there were a range of policies that came through that sought to improve the health and well-being – the example that Blighty gave is perfect; get rid of junk food from schools and you should see a change in the general health of the student population (and there is strong anecdotal evidence to support this)
      Whilst Tony Ryall’s statement is big on ‘screening’, the focus has moved to a focus on a repair service.
      A good analogy is this; you buy a new car – if you follow the recommended guidelines, use the right oil, have services done, drive it as per the manual,etc, it should last a long time. if, however, you use the wrong parts and oil, don’t service and abuse it, it will need expensive repairs.
      People are exactly the same; regrettably Tony Ryall wants a fleet of quick response garages and not a fleet of well maintained, smooth running people!

  2. How about a health system based upon ‘wellness’ – not ‘sickness’?

    Oh – yes – pharmaceutical companie$ would lose a fortune………..

    Penny Bright
    http://waterpressure.wordpress.com

    • rosy 2.1

      Not necessarily so Penny. If our health service was based on wellness a significant number of people would be eligible for some very expensive drugs that allowed them to get their lives back, rather than cheaper drugs that simply stave off future health system expenses but do not reduce restrictions on physical function and life choices/chances.

      Pharmaceutical companies may also find it worthwhile to invest in research that may lead to prevention of some diseases rather than relying on cures to enhance their bottom-line.

  3. Adele 3

    Teenaa koe,

    If our health system was based on wellness, it would be integrated with the other determinants of health – socio-economic, education, justice, and housing. Whare Tapa Wha is a Māori model of wellness that was introduced to the medical model over 20 years ago. It sought to broaden the focus of the medical beyond the alleviation of physical ailment to incorporate other aspects that would ensure longevity in health.

    Having read the statement of intent I agree that it appears to emphasize the “business” rather than the “purpose” of health care and that “more for less” is the actual intent.

    • ianupnorth 3.1

      Agree totally.

    • rosy 3.2

      +2 It is also interesting to read the latest statement of intent with earlier ones for instance the 2007 statement of intent and compare the focus…
      from 2007

      A whole-of-government approach is critical to ensuring whanau and communities are better able to take control of the circumstances affecting them and to improving the health and wellbeing of whanau. For Maori whanau to participate fully in New Zealand society, co-ordinated and effective service development across all sectors must be in place to ensure equitable access to resources and services

      The later statement, as well as being focussed on the ‘business of health’ also isolates health from the social and economic determinants of health.

  4. ZeeBop 4

    I know someone who is sick and unemployed and not on a benefit, welcome to the new world order, they don’t trust to fight for their just entitlements to equity since there is no culture and understanding for those rights, and equity in NZ. How do they know this?

    There are two kinds of people, the wallet people, and the people people. The wallet people have shuffled and shifted their way to the top where all the money and levers are. And the people people have let them because profit was easy to make, unforeseen consequences could easily be covered by ‘market’, so the people in positions of power didn’t need to worry about foobar.

    Oh, growth at any expense is going to back fire. In fact most engines you work over to the point of producing excessive amounts of torque are burnt out quicker, and are off the road longer. So we know in our inner auto-mechanic that economic activity justified solely for profit is detrimental to us all.

    I welcome our new foreign overlords, 6th most traded currency means the door is wide open for any opportunity to grab our economy. Of course National want to keep the door open and throw more stuff onto the asset fire sale. Burn NZ, burn.

    • Colonial Viper 4.1

      +1 it’s looking ugly

      There are a few more things going on which are going to become obvious in the next month or two as well.

  5. Pdogge 5

    Your slip is showing…Type 2 Diabetes is of genetic origin,

    • ianupnorth 5.1

      Evidence? Type one has a genetic component, but the actual cause is unknown; type two is heavily associated with a highly glycaemic diet.

Recent Comments

Recent Posts

  • EV road user charges bill passes
    Transport Minister Simeon Brown has welcomed the passing of legislation to move light electric vehicles (EVs) and plug-in hybrid electric vehicles (PHEVs) into the road user charges system from 1 April.  “It was always intended that EVs and PHEVs would be exempt from road user charges until they reached two ...
    BeehiveBy beehive.govt.nz
    15 hours ago
  • Bill targets illegal, unregulated fishing in international waters
    New Zealand is strengthening its ability to combat illegal fishing outside its domestic waters and beef up regulation for its own commercial fishers in international waters through a Bill which had its first reading in Parliament today. The Fisheries (International Fishing and Other Matters) Amendment Bill 2023 sets out stronger ...
    BeehiveBy beehive.govt.nz
    16 hours ago
  • Reserve Bank appointments
    Economists Carl Hansen and Professor Prasanna Gai have been appointed to the Reserve Bank Monetary Policy Committee, Finance Minister Nicola Willis announced today. The Monetary Policy Committee (MPC) is the independent decision-making body that sets the Official Cash Rate which determines interest rates.  Carl Hansen, the executive director of Capital ...
    BeehiveBy beehive.govt.nz
    17 hours ago
  • Stronger protections for apartment owners
    Apartment owners and buyers will soon have greater protections as further changes to the law on unit titles come into effect, Housing Minister Chris Bishop says. “The Unit Titles (Strengthening Body Corporate Governance and Other Matters) Amendment Act had already introduced some changes in December 2022 and May 2023, and ...
    BeehiveBy beehive.govt.nz
    19 hours ago
  • Travel focused on traditional partners and Middle East
    Foreign Minister Winston Peters will travel to Egypt and Europe from this weekend.    “This travel will focus on a range of New Zealand’s traditional diplomatic and security partnerships while enabling broad engagement on the urgent situation in Gaza,” Mr Peters says.   Mr Peters will attend the NATO Foreign ...
    BeehiveBy beehive.govt.nz
    19 hours ago
  • Keep safe on our roads this Easter
    Transport Minister Simeon Brown is encouraging all road users to stay safe, plan their journeys ahead of time, and be patient with other drivers while travelling around this Easter long weekend. “Road safety is a responsibility we all share, and with increased traffic on our roads expected this Easter we ...
    BeehiveBy beehive.govt.nz
    22 hours ago
  • Cost of living support for over 1.4 million Kiwis
    About 1.4 million New Zealanders will receive cost of living relief through increased government assistance from April 1 909,000 pensioners get a boost to Superannuation, including 5000 veterans 371,000 working-age beneficiaries will get higher payments 45,000 students will see an increase in their allowance Over a quarter of New Zealanders ...
    BeehiveBy beehive.govt.nz
    22 hours ago
  • Tenancy reviews for social housing restart
    Ensuring social housing is being provided to those with the greatest needs is front of mind as the Government restarts social housing tenancy reviews, Associate Housing Minister Tama Potaka says. “Our relentless focus on building a strong economy is to ensure we can deliver better public services such as social ...
    BeehiveBy beehive.govt.nz
    22 hours ago
  • Kermadec Ocean Sanctuary plan halted
    The Kermadec Ocean Sanctuary will not go ahead, with Cabinet deciding to stop work on the proposed reserve and remove the Bill that would have established it from Parliament’s order paper. “The Kermadec Ocean Sanctuary Bill would have created a 620,000 sq km economic no-go zone,” Oceans and Fisheries Minister ...
    BeehiveBy beehive.govt.nz
    23 hours ago
  • Cutting all that dam red tape
    Dam safety regulations are being amended so that smaller dams won’t be subject to excessive compliance costs, Minister for Building and Construction Chris Penk says. “The coalition Government is focused on reducing costs and removing unnecessary red tape so we can get the economy back on track.  “Dam safety regulations ...
    BeehiveBy beehive.govt.nz
    23 hours ago
  • Drought support extended to parts of North Island
    The coalition Government is expanding the medium-scale adverse event classification to parts of the North Island as dry weather conditions persist, Agriculture Minister Todd McClay announced today. “I have made the decision to expand the medium-scale adverse event classification already in place for parts of the South Island to also cover the ...
    BeehiveBy beehive.govt.nz
    1 day ago
  • Passage of major tax bill welcomed
    The passing of legislation giving effect to coalition Government tax commitments has been welcomed by Finance Minister Nicola Willis.  “The Taxation (Annual Rates for 2023–24, Multinational Tax, and Remedial Matters) Bill will help place New Zealand on a more secure economic footing, improve outcomes for New Zealanders, and make our tax system ...
    BeehiveBy beehive.govt.nz
    2 days ago
  • Lifting economy through science, tertiary sectors
    Science, Innovation and Technology Minister Judith Collins and Tertiary Education and Skills Minister Penny Simmonds today announced plans to transform our science and university sectors to boost the economy. Two advisory groups, chaired by Professor Sir Peter Gluckman, will advise the Government on how these sectors can play a greater ...
    BeehiveBy beehive.govt.nz
    2 days ago
  • Government announces Budget priorities
    The Budget will deliver urgently-needed tax relief to hard-working New Zealanders while putting the government’s finances back on a sustainable track, Finance Minister Nicola Willis says.  The Finance Minister made the comments at the release of the Budget Policy Statement setting out the Government’s Budget objectives. “The coalition Government intends ...
    BeehiveBy beehive.govt.nz
    2 days ago
  • Government to consider accommodation solution
    The coalition Government will look at options to address a zoning issue that limits how much financial support Queenstown residents can get for accommodation. Cabinet has agreed on a response to the Petitions Committee, which had recommended the geographic information MSD uses to determine how much accommodation supplement can be ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • Government approves extension to Royal Commission of Inquiry into Abuse in Care
    Cabinet has agreed to a short extension to the final reporting timeframe for the Royal Commission into Abuse in Care from 28 March 2024 to 26 June 2024, Internal Affairs Minister Brooke van Velden says.                                         “The Royal Commission wrote to me on 16 February 2024, requesting that I consider an ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • $18m boost for Kiwis travelling to health treatment
    The coalition Government is delivering an $18 million boost to New Zealanders needing to travel for specialist health treatment, Health Minister Dr Shane Reti says.   “These changes are long overdue – the National Travel Assistance (NTA) scheme saw its last increase to mileage and accommodation rates way back in 2009.  ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • PM’s Prizes for Space to showcase sector’s talent
    The Government is recognising the innovative and rising talent in New Zealand’s growing space sector, with the Prime Minister and Space Minister Judith Collins announcing the new Prime Minister’s Prizes for Space today. “New Zealand has a growing reputation as a high-value partner for space missions and research. I am ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • Concerns conveyed to China over cyber activity
    Foreign Minister Winston Peters has confirmed New Zealand’s concerns about cyber activity have been conveyed directly to the Chinese Government.     “The Prime Minister and Minister Collins have expressed concerns today about malicious cyber activity, attributed to groups sponsored by the Chinese Government, targeting democratic institutions in both New ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • Independent Reviewers appointed for School Property Inquiry
    Independent Reviewers appointed for School Property Inquiry Education Minister Erica Stanford today announced the appointment of three independent reviewers to lead the Ministerial Inquiry into the Ministry of Education’s School Property Function.  The Inquiry will be led by former Minister of Foreign Affairs Murray McCully. “There is a clear need ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • Brynderwyns open for Easter
    State Highway 1 across the Brynderwyns will be open for Easter weekend, with work currently underway to ensure the resilience of this critical route being paused for Easter Weekend to allow holiday makers to travel north, Transport Minister Simeon Brown says. “Today I visited the Brynderwyn Hills construction site, where ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • Speech to the Infrastructure Funding & Financing Conference
    Introduction Good morning to you all, and thanks for having me bright and early today. I am absolutely delighted to be the Minister for Infrastructure alongside the Minister of Housing and Resource Management Reform. I know the Prime Minister sees the three roles as closely connected and he wants me ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • Parliamentary network breached by the PRC
    New Zealand stands with the United Kingdom in its condemnation of People’s Republic of China (PRC) state-backed malicious cyber activity impacting its Electoral Commission and targeting Members of the UK Parliament. “The use of cyber-enabled espionage operations to interfere with democratic institutions and processes anywhere is unacceptable,” Minister Responsible for ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • NZ to provide support for Solomon Islands election
    Foreign Minister Winston Peters and Defence Minister Judith Collins today announced New Zealand will provide logistics support for the upcoming Solomon Islands election. “We’re sending a team of New Zealand Defence Force personnel and two NH90 helicopters to provide logistics support for the election on 17 April, at the request ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • NZ-EU FTA gains Royal Assent for 1 May entry to force
    The European Union Free Trade Agreement Legislation Amendment Bill received Royal Assent today, completing the process for New Zealand’s ratification of its free trade agreement with the European Union.    “I am pleased to announce that today, in a small ceremony at the Beehive, New Zealand notified the European Union ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • COVID-19 inquiry attracts 11,000 submissions
    Public consultation on the terms of reference for the Royal Commission into COVID-19 Lessons has concluded, Internal Affairs Minister Hon Brooke van Velden says.  “I have been advised that there were over 11,000 submissions made through the Royal Commission’s online consultation portal.” Expanding the scope of the Royal Commission of ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • Families to receive up to $75 a week help with ECE fees
    Hardworking families are set to benefit from a new credit to help them meet their early childcare education (ECE) costs, Finance Minister Nicola Willis says. From 1 July, parents and caregivers of young children will be supported to manage the rising cost of living with a partial reimbursement of their ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • Unlocking a sustainable, low-emissions future
    A specialised Independent Technical Advisory Group (ITAG) tasked with preparing and publishing independent non-binding advice on the design of a "green" (sustainable finance) taxonomy rulebook is being established, Climate Change Minister Simon Watts says.  “Comprising experts and market participants, the ITAG's primary goal is to deliver comprehensive recommendations to the ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • Chief of Army thanked for his service
    Defence Minister Judith Collins has thanked the Chief of Army, Major General John Boswell, DSD, for his service as he leaves the Army after 40 years. “I would like to thank Major General Boswell for his contribution to the Army and the wider New Zealand Defence Force, undertaking many different ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • Minister to meet Australian counterparts and Manufacturing Industry Leaders
    25 March 2024 Minister to meet Australian counterparts and Manufacturing Industry Leaders Small Business, Manufacturing, Commerce and Consumer Affairs Minister Andrew Bayly will travel to Australia for a series of bi-lateral meetings and manufacturing visits. During the visit, Minister Bayly will meet with his Australian counterparts, Senator Tim Ayres, Ed ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • Government commits nearly $3 million for period products in schools
    Government commits almost $3 million for period products in schools The Coalition Government has committed $2.9 million to ensure intermediate and secondary schools continue providing period products to those who need them, Minister of Education Erica Stanford announced today. “This is an issue of dignity and ensuring young women don’t ...
    BeehiveBy beehive.govt.nz
    5 days ago
  • Speech – Making it easier to build.
    Good morning, it’s great to be here.   First, I would like to acknowledge the New Zealand Institute of Building Surveyors and thank you for the opportunity to be here this morning.  I would like to use this opportunity to outline the Government’s ambitious plan and what we hope to ...
    BeehiveBy beehive.govt.nz
    6 days ago
  • Pacific youth to shine from boost to Polyfest
    Minister for Pacific Peoples Dr Shane Reti has announced the Government’s commitment to the Auckland Secondary Schools Māori and Pacific Islands Cultural Festival, more commonly known as Polyfest. “The Ministry for Pacific Peoples is a longtime supporter of Polyfest and, as it celebrates 49 years in 2024, I’m proud to ...
    BeehiveBy beehive.govt.nz
    7 days ago
  • 2024 Ngarimu VC and 28th (Māori) Battalion Memorial Scholarships announced
    ...
    BeehiveBy beehive.govt.nz
    7 days ago
  • Speech to Breast Cancer Foundation – Insights Conference
    Before moving onto the substance of today’s address, I want to recognise the very significant and ongoing contribution the Breast Cancer Foundation makes to support the lives of New Zealand women and their families living with breast cancer. I very much enjoy working with you. I also want to recognise ...
    BeehiveBy beehive.govt.nz
    7 days ago
  • Kiwi research soars to International Space Station
    New Zealand has notched up a first with the launch of University of Canterbury research to the International Space Station, Science, Innovation and Technology and Space Minister Judith Collins says. The hardware, developed by Dr Sarah Kessans, is designed to operate autonomously in orbit, allowing scientists on Earth to study ...
    BeehiveBy beehive.govt.nz
    7 days ago
  • Speech to the New Zealand Planning Institute
    Introduction Thank you for inviting me to speak with you today and I’m sorry I can’t be there in person. Yesterday I started in Wellington for Breakfast TV, spoke to a property conference in Auckland, and finished the day speaking to local government in Christchurch, so it would have been ...
    BeehiveBy beehive.govt.nz
    7 days ago
  • Support for Northland emergency response centre
    The Coalition Government is contributing more than $1 million to support the establishment of an emergency multi-agency coordination centre in Northland. Emergency Management and Recovery Minister Mark Mitchell announced the contribution today during a visit of the Whangārei site where the facility will be constructed.  “Northland has faced a number ...
    BeehiveBy beehive.govt.nz
    7 days ago
  • Celebrating 20 years of Whakaata Māori
    New Zealanders have enjoyed a broader range of voices telling the story of Aotearoa thanks to the creation of Whakaata Māori 20 years ago, says Māori Development Minister Tama Potaka. The minister spoke at a celebration marking the national indigenous media organisation’s 20th anniversary at their studio in Auckland on ...
    BeehiveBy beehive.govt.nz
    7 days ago
  • Some commercial fishery catch limits increased
    Commercial catch limits for some fisheries have been increased following a review showing stocks are healthy and abundant, Ocean and Fisheries Minister Shane Jones says. The changes, along with some other catch limit changes and management settings, begin coming into effect from 1 April 2024. "Regular biannual reviews of fish ...
    BeehiveBy beehive.govt.nz
    7 days ago

Page generated in The Standard by Wordpress at 2024-03-28T19:14:39+00:00