Ryall: do it or else

Written By: - Date published: 3:30 pm, November 25th, 2008 - 32 comments
Categories: health, national/act government - Tags:

Health Minister Tony Ryall’s first policy will be to impose maximum waiting times for hospital emergency departments. No word on extra funding for achieving those goals (the UK achievement in shortening waiting times that Ryall cites came with large health budget increases) or what will happen if they are not met.

Now, it’s great to shorten wait lists. Nobody, least of all the medical professionals, wants people to have to wait any longer than necessary and DHBs are continuously implementing new procedures to make gradual improvements across the range of their activities. But let’s be clear, Ryall’s policy is not a plan to shorten waiting times, it is just a demand that waiting times be shortened. Ryall used to spend most of his time making similar demands to health ministers but, now he is health minister, he’s not developing ways to shorten wait times, he’s just shifted who he is demanding results from. And what will he do if they don’t meet his demands? Will he cut funding? How will that make health providers more able to meet the medical needs of Kiwis?

We have a reasonable expectation that, after years of complaining, National/ACT will improve health outcomes even more than they improved under the Labour-led Governments. It is looking distressingly like Ryall has no plan to meet those expectations, and is already looking for someone else to blame.

But perhaps that is the long game. The word around town is that Ryall has one clear, overriding objective in the health portfolio – cut spending. A failure to meet targets will be just the excuse he needs.

32 comments on “Ryall: do it or else”

  1. higherstandard 1

    Bah

    Fantasy ! The best way to start shortening waiting times in EDs is to refuse to treat anything that is not an emergency – of course if we start doing that there’ll be all hell to pay.

    I expect Ryall will join the long list of useless twats we have had as Minister of Health in recent times and not make any of the changes that would really make a difference.

  2. bobo 2

    That’s all the over stretched A&E staff need.., some pencil neck politician banging his fist on the table saying there are no problems only solutions.. The biggest problem is that A&E is used by people who can’t afford a GP visit and it’s likely to get worse if National allow GP’s to charge more or cut gov subsidies.

  3. DeeDub 3

    Ryall was the guy who said the cost of a GP visit isn’t ‘uppermost’ in the mind of most NZers, right?

    The guy’s a total twat.

    Row faster everyone . . . or else!

  4. gingercrush 4

    I don’t for a second believe health will improve much if at all under National. But where is the evidence that health improved when Labour was in power? Successful at deflecting most right-wing attacks sure. Making waiting lists look good by dumping thousands of people off them. That isn’t improving health.

    The reason Labour was so successful in the area of health. Was not that it improved much if at all. Its not because they spent billions. National 1990-1999 also spent billions on health. The reason Labour was successful because they had the smartest Labour MP for years as its spokeperson meaning Annette King was able to essentially make health a non-issue.

  5. Billy 5

    The word around town is that Ryall has one clear, overriding objective in the health portfolio…

    The word around town! The word around town! Is that all ya got? The word around town is that I am hung like a rogue baboon. The word around town is that the moon is made of beef jerky. The word around town is that randall sucks cold farts from dead chickens.

    [lprent: Billy – just out of interest – does that include the interesting facial problems and strange arse? ]

  6. Kevin Welsh 6

    As someone who has experienced A&E, my sympathies are with the staff that work in these departments. Chronology of events: (Times are after admittance)

    1. Broke leg playing football. Friends took me to A&E.
    2. Filled in appropriate form and wheeled to examination room. 10 minutes.
    3. Examined by junior doctor who confimed leg was broke. 20 minutes.
    4. Examined by Orthopaedic Specialist to make sure no structural problems. 50 minutes
    5. Leg X-Rayed. 3.5 bloody hours. This was where the bottle neck-was. No dedicated X-Ray facility for A&E. As radiology is probably the most understaffed/resourced sector of health, this was the biggest part of waiting. X-Ray procedure took 10 minutes.
    6. Leg set in cast and checked out of hospital. 4.5 hours.

    The staff I dealt with were friendly, sympathetic and helpful and incredibly busy, but at no time was I made to feel like I was an inconvenience. With the resources they had, they performed as could be expected.

    I doubt whether Tony Ryall waving his finger would have made any difference to the speed at which I passed through the system (no pun intended).

    I look forward to seeing him on the receiving end in the house next year.

  7. gingercrush 7

    Oh National will prove pathetic trying to deflect left-wing attacks on Health. National does do awful in health.The 90s saw so much reform over the years. Labour reformed the health system once at the start of their first term then left it alone. That undoubtedly helped.

    Ryall isn’t that impressive either. Health will be a bogey for National. Not because Labour did much better but just that Labour will be far more effective in opposition than National ever was for health.

  8. National’s ‘media honeymoon’ with The NZ Herald began in 2004 and is still very much in progress.

    As for Tony Ryall, he’s a classic ‘kiss up / kick down’ party hack.

    All mouth and no ears. Arrogant as hell while declaring people a fraction as arrogant as himself to be unbearable – of course.

  9. QoT 9

    I’m really just depressed at the prospect of rightwing fanboys screaming “SEE? National’s doing things to cut waiting lists!!!” with their usual blissful ignorance of the difference between self-destructive rhetoric and actual changes in service delivery and health outcomes.

  10. Ianmac 10

    The huge increase in funding of Health over the last nine years has been in developing infrastructure: new hospitals, new theatres, increased staff numbers, significant wage increases for nurses/doctors, technology, medicines. Sadly the long-term benefit is now beginning to show in time for Ryall to take the credit. The waiting lists are a very tiny reflection of just how good our Health system is. I think our Public Health System is just fantastic.

  11. Tigger 11

    Wow, seems like Ryall’s leadership strategy is to whip the horse until it dies. Way to go Tony.

  12. burt 13

    Helen Clark could teach Ryall a thing or two about slashing health budgets from her past experience as minister of health. Perhaps A&E departments could be devolved to the community…. It worked sooooo well for Mental Health!

  13. Rex Widerstrom 14

    Would this be the appropriate time to resurrect a tired old joke?

    Health Minister Tony Ryall today announced a bold new plan to shorten hospital queues. “All A&E staff will be issued – at significant expense, I might add – with tape measures,” the Minister explained. “They will ensure that in future, the people who form the queues that stretch through their departments, out the door and down several city blocks, will stand no more than 4 centimetres apart.

    “This wasteful slouching – especially by those on crutches – that’s been going on has seen gaps of up to a metre between patients. Or, was we like to call them, ‘applicants for client status’. This new four centimetre rule will have the immediate effect of shortening queues and will introduce added efficiencies in that those who opt to ‘discontinue their application process’, as we call it, will be that much closer to the hospital morgue”.

  14. Millsy 15

    Let’s hope they dont bring back CHE’s and RHA’s and all sorts of nasty acronyms..

  15. rex widerstrom,

    “…This new four centimetre rule will have the immediate effect of shortening queues and will introduce added efficiencies in that those who opt to ‘discontinue their application process’, as we call it, will be that much closer to the hospital morgue’.

    🙂

    BTW: did this joke of yours originate in the French health service.?

  16. higherstandard 17

    Millsy one of the best things they could do would be to cull the numbers of DHBs and bring back something along the lines of the regional health authorities.

  17. Rex Widerstrom 18

    northpaw: It’s a lengthy recitation of what was a very short “Two Ronnies” news headlines gag. I think it came right after “Police tonight are investigating the theft of several toilets from their station. At this point, they say they have nothing to go on”. 😀

  18. ak 19

    HS: you mean forget about local accountability and democracy and head back to that debacle brought in by …who was it now…that’s right, that health expert name of Winston Peters. Got a link to that report that says how much “culling” DHBs would save? Any such report exist?

  19. TimeWarp 20

    Issue identified immediately in the Herald when reporting on this – although as often the case, no analysis resulting:

    http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10544867

    The problem with ED delays actually stems from resource constraints elsewhere in the hospital system.

    National got elected on sloganeering – are they going to govern on it as well? It’s so bloody simplistic to think you can read DHB CEO’s the riot act and things will get better, when the problem isn’t just in ED management or resources but dependant on the entire hospital system.

    I’m sure the entire problem will be resolved by Monday….

  20. deemac 21

    any manager worth their salt can achieve an arbitrary target – but at what cost? in the UK, the time limit on waiting times in A&E led to ambulances circling hospitals until they were allowed to deposit patients in the emergency room. Tough if the ambulance was needed for another emergency, but hey the target was met.

  21. TimeWarp 22

    Exactly dee….. watch the Law of Unintended Consequences kick in.

    ED targets are hit, then elective surgery waiting lists go from 6 months to 2 years maybe.

  22. Without providing extra resources (namely doctors and nurses), Ryall is just blowing hot air. As Deemac points out, it is no problem to cook the system so that you meet the targets. Without the basic resources nothing will change.

    The irritating thing is, we know the correct staffing levels for ED as they have been really well-researched (1 doctor per patient per hour on average and 1 nurse FTE per 1000 patients per annum). We have known these figures for over 10 years. I have yet to see an emergency department staffed to these levels.

  23. bill brown 24

    At least his mates at the Hawke’s Bay DHB will be back in a job soon.

  24. Chris G 25

    Will this mean that down the track during question time and in statements to the media the Nats can parade “Waiting lists have been reduced under a National Government” Maybe even with a graph showing the difference from 2008 to 2009?

  25. Mr Magoo 26

    High Standards (for me, but not from) wrote: Fantasy ! The best way to start shortening waiting times in EDs is to refuse to treat anything that is not an emergency – of course if we start doing that there’ll be all hell to pay

    Yes there will. Many of those “non-emergencies” will become expensive emergencies later when those people don’t get treatment at all. Eventually people will just stop going and will wait to see what happens – leading to real, expensive emergencies.

    It is similar to heart attacks. They are ridiculously expensive to treat. Of course most of them would have been easily solved by “putting down the bloody fork”.

    But investing in anti-fork campaigns is seen in “nanny-state” by Nationalites. (or is that now Labourlites??)

    National’s plan is to have the severely under-funded ambulance at the bottom of the very high, man-made cliff. The cliff having a great big sign on it saying: “tax cuts this way”.

    If the fool is simultaneously running around with the “cut stick”, then things are about to get bad for the sick. About as bad as they were last time National did exactly the same thing.

    Let’s not forget how public departments react (or at least their admin) when idiotic and short sighted “targets” are given to them as a spin stunt. They game the system – because they have to to keep their jobs.

  26. Chris G 27

    “The best way to start shortening waiting times in EDs is to refuse to treat anything that is not an emergency”

    I agree that it would work, but I dont think its the best option.

    There is no substitute for a good healthy diet and lifestyle, if that is emphasised more a la Push Play ads.. That ultimately leads to: Healthier citizens, less ED waiting times.

    Furthermore, someone may have the stats showing the amount of ED lines ballooned by Alcohol related incidents? Are we willing to point the finger at our binge culture yet? I certainly am.

    In addressing these societal issues and hoping that it occurs at a policy level, no doubt I’m a ‘nanny stater’?

  27. higherstandard 28

    Chris

    Patient mix into EDs varies dependant on the time of week and year.

    As a very general rule of thumb weekends and Mondays are the busiest times and there tends to be spikes in numbers during flu season.

    For a fuller breakdown have a look at the link below.

    http://www.moh.govt.nz/moh.nsf/238fd5fb4fd051844c256669006aed57/dad5d4ad464df06bcc25714d00104db3?OpenDocument

  28. Mr Magoo 29

    “Without providing extra resources (namely doctors and nurses), Ryall is just blowing hot air.”

    Unfortunately this is not the case. As I mentioned in my previous post, changing the goal posts on public departments can cause massive shifts in how existing treatment and funding is applied. Most of the time towards inefficiency and harm when there is no real plan as such.

  29. Chris G 30

    hs,

    An interesting link, cheers.

    It seems that the most at 30% of ED patients came under the category of Injury/poisoning. Im not sure what that includes, but it sounds like a ‘preventable’ category.

    I would definately like to know the % of patients in for alcohol related reasons.

  30. lenore 31

    So we can expect to magically have more available beds and staff to care for people. Unfortunately it will take alot more time than that. On the plus side for every negative side of the health system we hear in the media, there are positives. My daughter needed her skin to be checked out and we waited a week before seeing a specialist. likewise, I waited two weeks to see a specialist at our local hospital.

  31. TimeWarp 32

    “The best way to start shortening waiting times in EDs is to refuse to treat anything that is not an emergency’

    We previously had that principle applied to the 111 emergency system. You could refer to the result as the Irena Asher syndrome.

    Granted, both sytems are abused. But you can’t take a one-dimensional approach (as Ryall seems hell-bent on doing) to solving the problem. You thereby invoke the Law of Unintended Consequences, with nasty results as occured with 111.

    To paraphrase, “it’s the system, stupid”. Only by looking at the overall system end-to-end can you solve the problem. Especially as the ED problems are created at other points in the hospital system (see my link in previous post above).

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    1 week ago
  • Redline on the Labour Party
    No-one on the anti-capitalist left in this country today puts forward a case that Labour is on the side of the working class.  There are certainly people who call themselves ‘socialist’ who do, but they are essentially liberals with vested interests in Labourism – often for career reasons. Nevertheless, there ...
    RedlineBy Admin
    1 week ago
  • New Fisk
    No Right TurnBy Idiot/Savant
    1 week ago
  • Labour’s failure
    When National was in government and fucking over the poor for the benefit of the rich, foodbanks were a growth industry. And now Labour is in charge, nothing has changed: A huge demand for emergency food parcels means the Auckland City Mission is struggling to prepare for the impending arrival ...
    No Right TurnBy Idiot/Savant
    1 week ago
  • Ardern attempts to vaccinate Clarke Gayford live on television to prove that it’s safe
    Gayford, pictured here on The Project, before things got wildly out of control. A bold public relations move by the Government to encourage parents to vaccinate their children has gone horribly wrong. Prime Minister Jacinda Ardern appeared on tonight’s episode of Three’s The Project, where the plan was for her ...
    The CivilianBy admin
    1 week ago
  • Has Mr. Whippy gone too far by parking on our front lawns?
    Mr. Whippy’s business model has driven it down a dark road of intimidation. Residents in major centres around the country are becoming disgruntled by the increasingly aggressive actions of purported ice cream company Mr. Whippy, who have taken to parking on people’s front lawns and doorsteps in a desperate attempt ...
    The CivilianBy admin
    1 week ago
  • Cleaning up the water
    Today the government released its Action Plan for Healthy Waterways, aimed at cleaning up our lakes and rivers. Its actually quite good. There will be protection for wetlands, better standards for swimming spots, a requirement for continuous improvement, and better standards for wastewater and stormwater. But most importantly, there's a ...
    No Right TurnBy Idiot/Savant
    1 week ago
  • Fronting up
    Today I appeared before the Environment Committee to give an oral submission on the Zero Carbon Bill. Over 1,500 people have asked to appear in person, so they've divided into subcommittees and are off touring the country, giving people a five minute slot each. The other submitters were a mixed ...
    No Right TurnBy Idiot/Savant
    1 week ago
  • Politics of science – making a silk purse out of a sow’s ear
    Anti-fluoride activists have some wealthy backers – they are erecting billboards misrepresenting the Canadian study on many New Zealand cities – and local authorities are ordering their removal because of their scaremongering. Many New Zealanders ...
    1 week ago
  • Democracy – I Don’t Think So
    So, those who “know best” have again done their worst. While constantly claiming to be the guardians of democracy and the constitution, and respecters of the 2016 referendum result, diehard Remainers (who have never brought themselves to believe that their advice could have been rejected) have striven might and main ...
    Bryan GouldBy Bryan Gould
    1 week ago
  • Government says it will now build just one really nice home
    Following publication of this article, the Ministry has requested it to be noted that this supplied image is not necessarily representative of what the final house will look like, and it “probably won’t be that nice.” As part of today’s long-anticipated reset of the Government’s flagship KiwiBuild policy, Housing Minister ...
    The CivilianBy admin
    2 weeks ago
  • Imperialism and your cup of coffee
    Over the next week or two we will be running three synopses of parts of the opening chapter of John Smith’s Imperialism in the 21st Century (New York, Monthly Review Press, 2016).  The synopsis and commentary below is written by Phil Duncan. Marx began Capital not with a sweeping historical ...
    RedlineBy Admin
    2 weeks ago
  • Still juking the stats
    The State Services Commission and Ombudsman have released another batch of OIA statistics, covering the last six months. Request volumes are up, and the core public service is generally handling them within the legal timeframe, though this may be because they've learned to extend rather than just ignore things. And ...
    No Right TurnBy Idiot/Savant
    2 weeks ago
  • Hard News: Time for a New Deal: 25 years on
    In 1994, I was editing an ambitious street mag called Planet, from a fabled office at at 309 Karangahape Road. The thirteenth issue of the magazine was published in the winter of that year and its cover embodied a particularly ambitious goal: the end of cannabis prohibition.I wanted to do ...
    2 weeks ago
  • Not impressed
    KiwiBuild was one of the Ardern government's core policies. The government would end the housing crisis and make housing affordable again by building 100,000 new homes. Of course, it didn't work out like that: targets weren't met, the houses they did build were in the wrong place, and the whole ...
    No Right TurnBy Idiot/Savant
    2 weeks ago
  • Solar beats coal
    As the climate crisis escalates, it is now obvious that we need to radically decarbonise our economy. The good news is that its looking easy and profitable for the energy sector. Wind is already cheaper than fossil fuels, and now solar is too:The levellised cost of solar PV has fallen ...
    No Right TurnBy Idiot/Savant
    2 weeks ago
  • A Step Too Far.
    A Crown Asset? For reasons relating to its own political convenience, the Crown pretends to believe that “No one owns the water.” To say otherwise would re-vivify the promises contained in the Treaty of Waitangi – most particularly those pertaining to the power of the chiefs and their proprietary rights ...
    2 weeks ago
  • Where Money Comes From
    Most people would say, no doubt, that they have a pretty good idea of what money is. They live with the reality of money every day. It is what is needed to buy the necessities of life and to maintain a decent standard of living. You get money, they would ...
    Bryan GouldBy Bryan Gould
    2 weeks ago
  • Banned by the Green Party leadership: Jill Abigail on women’s rights and trans rights
    The article below was an opinion piece that appeared in the Spring 2019 issue of Te Awa (the NZ Green Party’s newsletter) and on the Greens website.  In keeping with their policy of hostility to women defending women’s right to female-only spaces, Green bureaucrats have since removed the opinion piece.  ...
    RedlineBy Admin
    2 weeks ago
  • The fallacy of the proximity argument.
    Longer term readers may remember my complaining that, as a political scientist, it is burdensome to have non-political scientists wanting to engage me about politics. No layperson would think to approach an astrophysicist and lecture him/her on the finer details of quarks and black holes, but everybody with an opinion ...
    KiwipoliticoBy Pablo
    2 weeks ago
  • Where We Stood: Chris Trotter Replies To Stevan Eldred-Grigg.
    Joining The Fight: Stevan Eldred-Grigg's argument for New Zealand staying out of the Second World War fails not only on the hard-headed grounds of preserving the country’s strategic and economic interests; and not just on the soft-hearted grounds of duty and loyalty to the nation that had given New Zealand ...
    2 weeks ago
  • Universities back the climate strike
    On September 27, School Strike 4 Climate will be striking for a future to pressure the government for meaningful climate action. This time, they've asked adults to join them. And now, Lincoln University and Victoria University of Wellington have signed on:Victoria University of Wellington has joined Lincoln University in endorsing ...
    No Right TurnBy Idiot/Savant
    2 weeks ago
  • Another constitutional outrage
    Another day, another constitutional outrage in the UK. This time, the government is saying that if parliament passes a law to stop Brexit before being prorogued, they may just ignore it:A senior cabinet minister has suggested Boris Johnson could defy legislation to prevent a no-deal Brexit if it is forced ...
    No Right TurnBy Idiot/Savant
    2 weeks ago
  • Ending dairy in Canterbury
    Environment Canterbury has finally proposed nitrogen limits to stop dairy farmers from poisoning Christchurch's water supply. And naturally, farmers are whining about it:A proposed move by Environment Canterbury (ECan) to protect Christchurch's drinking water by setting tough – some would say, draconian – nitrate reductions in the decades ahead and ...
    No Right TurnBy Idiot/Savant
    2 weeks ago
  • Is National the party of climate arson?
    The Zero Carbon Bill is currently before select committee. While its targets are weak, its a generally sensible bill that promises to establish a long-term framework to guide emissions reductions. But National hasn't made up its mind on whether it will support it - and according to Andrea Vance in ...
    No Right TurnBy Idiot/Savant
    2 weeks ago
  • Experts warn Harold the Giraffe “well past” typical giraffe life expectancy, may not have long
    Dum-de-doo. Children across New Zealand have known him for generations as the lovable giraffe who tells them to exercise, hydrate and not to shove lit cigarettes up their nostrils. But a world renowned giraffe expert says we shouldn’t be getting attached to Life Education’s Harold the Giraffe, as he is ...
    The CivilianBy admin
    2 weeks ago
  • August ’19 – NZ blogs sitemeter ranking
    Image credit: 22 BLOGGERS WITH ADVICE FOR RESEARCHERS AND EVALUATORS, ILLUSTRATED I notice a few regulars no longer allow public access to the site counters. This may happen accidentally when the blog format is altered. If your ...
    2 weeks ago
  • Bye, bye to the collusion lie
    Sums it up, really. ...
    2 weeks ago
  • Opinion: Treat your car by buying extra petrol to snack on while you aren’t driving
    By Mike Hosking. Yesterday morning, I waltzed into work, and as I walked past the drones aggressively typing out news on the computers I’ve repeatedly asked to be moved further away from, I caught a glimpse of the words “climate change”, and noticed that suspiciously they weren’t in condescending quotation ...
    The CivilianBy admin
    2 weeks ago
  • US imperialism, Huawei, racism and imperial anxiety
    by Tony Norfield US political opinion against China has two solid bases. The first is the longstanding racist and protectionist sentiment in the white working class; the second is a more recent anxiety about China’s economic prowess in America’s ruling elite. This article notes some historical aspects of anti-Chinese racism ...
    RedlineBy Admin
    2 weeks ago

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