web analytics

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

  • Tokelau Language Week reminds us to stay united and strong
    Staying strong in the face of challenges and being true to our heritage and languages are key to preserving our cultural identity and wellbeing, is the focus of the 2020 Tokelau Language Week. Minister for Pacific Peoples, Aupito William Sio, says this year’s theme, ‘Apoapo tau foe, i nā tāfea ...
    BeehiveBy beehive.govt.nz
    5 days ago
  • NZ announces a third P-3 deployment in support of UN sanctions
    The Government has deployed a Royal New Zealand Air Force P-3K2 Orion (P-3) maritime patrol aircraft to support the implementation of United Nations Security Council (UNSC) resolutions imposing sanctions against North Korea, announced Minister of Foreign Affairs Winston Peters and Minister of Defence Ron Mark. “New Zealand has long supported ...
    BeehiveBy beehive.govt.nz
    1 week ago
  • Pacific trade and development agreement a reality
    Pacific regional trade and development agreement PACER Plus will enter into force in 60 days now that the required eight countries have ratified it. Trade and Export Growth Minister David Parker welcomed the announcement that the Cook Islands is the eighth nation to ratify this landmark agreement. “The agreement represents ...
    BeehiveBy beehive.govt.nz
    2 weeks ago
  • Securing a pipeline of teachers
    The Government is changing its approach to teacher recruitment as COVID-19 travel restrictions continue, by boosting a range of initiatives to get more Kiwis into teaching. “When we came into Government, we were faced with a teacher supply crisis,” Education Minister Chris Hipkins said. “Over the past three years, we ...
    BeehiveBy beehive.govt.nz
    2 weeks ago
  • Border exceptions for a small number of international students with visas
    The Government has established a new category that will allow 250 international PhD and postgraduate students to enter New Zealand and continue their studies, in the latest set of border exceptions. “The health, safety and wellbeing of people in New Zealand remains the Government’s top priority. Tight border restrictions remain ...
    BeehiveBy beehive.govt.nz
    2 weeks ago
  • First COVID-19 vaccine purchase agreement signed
    The Government has signed an agreement to purchase 1.5 million COVID-19 vaccines – enough for 750,000 people – from Pfizer and BioNTech, subject to the vaccine successfully completing all clinical trials and passing regulatory approvals in New Zealand, say Research, Science and Innovation Minister Megan Woods and Health Minister Chris Hipkins. ...
    BeehiveBy beehive.govt.nz
    2 weeks ago
  • International statement – End-to-end encryption and public safety
    We, the undersigned, support strong encryption, which plays a crucial role in protecting personal data, privacy, intellectual property, trade secrets and cyber security.  It also serves a vital purpose in repressive states to protect journalists, human rights defenders and other vulnerable people, as stated in the 2017 resolution of the ...
    BeehiveBy beehive.govt.nz
    2 weeks ago
  • Ministry of Defence Biodefence Assessment released
    The Ministry of Defence has today released a Defence Assessment examining Defence’s role across the spectrum of biological hazards and threats facing New Zealand. Biodefence: Preparing for a New Era of Biological Hazards and Threats looks at how the NZDF supports other agencies’ biodefence activities, and considers the context of ...
    BeehiveBy beehive.govt.nz
    2 weeks ago
  • New Approaches to Economic Challenges: Confronting Planetary Emergencies: OECD 9 October 2020
    New Approaches to Economic Challenges: Confronting Planetary Emergencies: OECD 9 October 2020 Hon David Parker’s response following Thomas Piketty and Esther Duflo. Good morning, good afternoon, and good evening, wherever in the world you might be. I first acknowledge the excellent thought provoking speeches of Thomas Piketty and Esther ...
    BeehiveBy beehive.govt.nz
    3 weeks ago
  • Kaipara Moana restoration takes next step
    A Memorandum of Understanding has been signed today at Waihāua Marae between the Crown, local iwi and councils to protect, restore and enhance the mauri of Kaipara Moana in Northland. Environment Minister David Parker signed the document on behalf of the Crown along with representatives from Ngā Maunga Whakahī, Ngāti ...
    BeehiveBy beehive.govt.nz
    3 weeks ago
  • New Zealand and Uruguay unite on reducing livestock production emissions
    Agriculture Minister Damien O’Connor and Uruguayan Minister of Livestock, Agriculture and Fisheries Carlos María Uriarte have welcomed the launch of a three-year project that will underpin sustainable livestock production in Uruguay, Argentina, and Costa Rica.  The project called ‘Innovation for pasture management’ is led by Uruguay’s National Institute of Agricultural ...
    BeehiveBy beehive.govt.nz
    3 weeks ago
  • 3100 jobs created through marae upgrades
    Hundreds of marae throughout the country will be upgraded through investments from the Provincial Growth Fund’s refocused post COVID-19 funding to create jobs and put money into the pockets of local tradespeople and businesses, Regional Economic Development Minister Shane Jones and Māori Development Minister Nanaia Mahuta have announced. “A total ...
    BeehiveBy beehive.govt.nz
    3 weeks ago
  • Health volunteers recognised in annual awards
    Health Minister Chris Hipkins has announced 9 teams and 14 individuals are the recipients of this year’s Minister of Health Volunteer Awards.  “The health volunteer awards celebrate and recognise the thousands of dedicated health sector volunteers who give many hours of their time to help other New Zealanders,” Mr Hipkins ...
    BeehiveBy beehive.govt.nz
    3 weeks ago
  • Community COVID-19 Fund supports Pacific recovery
    The Minister for Pacific Peoples, Aupito William Sio says a total of 264 groups and individuals have successfully applied for the Pacific Aotearoa Community COVID-19 Recovery Fund, that will support Pacific communities drive their own COVID-19 recovery strategies, initiatives, and actions. “I am keen to see this Fund support Pacific ...
    BeehiveBy beehive.govt.nz
    3 weeks ago
  • Community benefits from Māori apprenticeships
    Up to 50 Māori apprentices in Wellington will receive paid training to build houses for their local communities, thanks to a $2.75 million investment from the Māori Trades and Training Fund, announced Employment Minister Willie Jackson today. “This funding will enable Ngāti Toa Rangatira Incorporated to provide its Ngā Kaimahi ...
    BeehiveBy beehive.govt.nz
    3 weeks ago
  • Training fund supports Māori jobseekers
    Rapidly growing sectors will benefit from a $990,000 Māori Trades and Training Fund investment which will see Wellington jobseekers supported into work, announced Employment Minister Willie Jackson today. “This funding will enable Sapphire Consultants Ltd. to help up to 45 Māori jobseekers into paid training initiatives over two years through ...
    BeehiveBy beehive.govt.nz
    3 weeks ago