Written By:
Marty G - Date published:
2:20 pm, June 30th, 2009 - 8 comments
Categories: health -
Tags: corporate welfare
The government has changed the rules so that DHBs can make standing contracts for private hospitals to perform public elective surgeries.
If DHBs start to contract large numbers of electives to these private providers, they will have to hire more medical staff and they’ll have to poach them from the public system. It’s not like there are surgeons on the dole queue.
Indeed, Tony Ryall acknowledges that, saying medicos could earn extra income from doing public jobs contracted to private hospitals. Problem is, if they’re doing more work at the private hospitals, they’ll have to do less at the public hospitals, worsening the staff shortage which is the very reason for turning to the private sector in the first place. You have to wonder how Ryall is going to staff the 20 new elective surgery theatres he has promised when everyone’s off doing publicly-funded ops at private hospitals.
We’re talking the same medical staff performing the same operations. The only difference will be a private profit-making company (in the best tradition of New Zealand business) clipping the ticket on the way through. Nothing has been done to lower the per operation cost. The private hospitals charge for the operation and take their profit, then lump any problems back onto the public system. There’s no actual efficiency gain. It’s ludicrous and it’s clearly designed to undermine the public provision of health-care.
Three concluding remarks:
– National promised that they would include ‘frontline’ medical staff in decision-making. That has not happened. The Association of Salaried Medical Professionals and the Public Helath Association have both criticised the plan.
– National’s obsession with elective surgeries shows they care more about spin than actual results. Electives are good for spin because they’re easy to count (‘electives up 5%!’) but if you’re serious about the health of individuals you put money into preventative and primary health, ensuring people don’t get sick and need costly treatment in the first place. National has cut money to preventative and primary health to put more into electives.
– medical resources are limited and less than demand. Therefore, there needs to be some kind of rationing. That can either be by who has more money or who has greater need. This creeping privatisation of health shows us which National favours.
-Marty G
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I dont know anything about this sector but I recall being told a few years ago by an inside source that the reason there are so few surgeons in NZ is because the surgeons themselves get to decide how many surgeons can become appropriately qualified each year. Namely, they limit the number of surgeons in NZ in order to keep their price up. True story. Perhaps that particular logjam needs clearing (with dynamite it sounds like) to help the situation.
Fundamentally I think this is an OK idea – why not use all available resources in the system – private or public?
However, there are issues that need to be addressed to ensure that the outcomes are beneficial and not adverse. With some tinkering I think this could be a good thing though.
Good to see this response to a news item which played this morning like an entirely laudable proposition… Minister Ryall explaining how more electives could be done etc..
But I have a question or so concerning the other side of this.. and asks whether the public purse might in fact be propping a recession-hit demand or paying patient loss in the private sector..?
And if so why not be transparent about such a reality..?
Of course if they are getting contracts from the government that makes them private only in a fairly ironic sense.
This post is a little weird. If resources were fully used in the private sector, then it would make more sense. The point is that (as I understand it) they have spare beds, spare staff, and so it makes sense to utilise that.
“Electives are good for spin because they’re easy to count (‘electives up 5%!’)”
It’s not a trade-off between elective and preventative medicine! Goodness. There are heaps of easily measurable non-elective procedures. Presumably these would be performed in place of the (currently performed) elective procedures at the public hospitals.
The Budget cut money from preventative. put it in electives. The PHA was complaining that it’s a stupid and wasteful way to run a health system earlier today.
Tom – Zetetic is on the right track and the PHA is right. Electives are an easy political target because they’re easy to count. There IS a tradeoff between the two as recent cuts demonstarate.
However, the biggest problem is that while the idea sounds right – use available resources – in fact, it has never worked, anywhere in the world. In fact all the evidence shows that putting public money into private medicine does one thing – it undermines the public system. The growth of a private health sector is inversely proportional to that of a public health sector.
So in the end this is a political move to LOOK good as elective waiting lists go down
and
an ideological move as the Tories start looking after their mates.