They are going to privatise health, aren’t they
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4:28 pm, July 28th, 2024 - 50 comments
Categories: Christopher Luxon, health, national, same old national, Shane Reti -
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This Government continues its trend to resembling something akin to Liz Truss’s rule of England.
And Health is clearly among its targets.
You can determine this by the level of its propaganda.
In the past week the Government has replaced the board of Health New Zealand with a commissioner. There were only two board members left out of seven including Lester Levy who was subsequently apointed Commissioner. Two others had resigned and three opted not to seek another term.
One of the board members who had opted not to seek a new term was former National Minister Amy Adams. The writing was clearly on the wall. I am sure the next National Party conference will be an interesting thing. And the phrase “they would eat their young for political advantage” has gained a whole new meaning.
Levy’s appointment was preceeded by a claim that there was a budget crisis. Any time a recently elected Government announces there is a budget crisis you have to be wary. The announcement is almost inevitably followed by a radical response.
Mountain Tui has analysed the background to the crisis in detail in this excellent piece. Basic version, this happened under National’s watch, and has nothing to do with Labour.
And the right’s normal response to any crisis is to privatise. In their view the private sector is always cheaper and better at providing services, despite the overwhelming evidence to the contrary built up over decades. In their view it is better to let their mates and sponsors make a quick buck than do the more difficult task of managing people well to get the best out of them.
Quickly after announcing a $150 million a month deficit in health for the past six months Prime Minister Christopher Luxon claimed that National was putting in record amounts of money into health, in fact a record record $16.7b into health in the May budget. While this is strictly true it hides the reality that this was an effective cut.
As pointed out by Clint Smith a 2.9% increase to the health services budget at a time when inflation was 3.3% and population growth was 2.6% has us going backward. Population ageing adds more cost pressure. The increase means in real terms a cut to health funding.
Luxon’s claim that “[t]here’s plenty of money in the system” needs to be taken with an unhealthy amount of salt.
And despite Reti’s claims that front line staff hirings are not being affected the on the ground situation appears to be remarkably different.
From Rowan Quinn at Radio New Zealand:
RNZ has heard from multiple hospital workers around the country who say clinical jobs in their departments are being left vacant — and a senior hospital leader has written to staff about the “overly complex and bureaucratic” recruitment process.
In June, Te Whatu Ora instigated a hiring freeze on all roles that were “not patient facing” to try to rein in its budget, but its language around whether that applied to any medical jobs was murky.
It said all clinical roles that “needed” to be filled would be, but did not answer questions about what that meant in practice and whether any were being turned down.
But the senior doctors’ union, and other health workers who contacted RNZ, said in many cases clinical recruitment had ground to a halt – even the straightforward replacement of a departing doctor or nurse.
There was now a quota on how many jobs could be filled for each region and every appointment had to be approved by a regional committee.
To add to the sense of unreality surrounding anything that Reti for for that matter Luxon says claims that Health has 14 layers of management levels and these should be altered to six has proved to be not necessarily correct.
From Thomas Manch and Luke Malpass at the Press:
Prime Minister Christopher Luxon made much of a claimed 14 layers of management at Health NZ this week, as he criticised the organisation for a monthly $130 million overspend.
But there’s a problem: the Government can’t prove there are 14 layers of management.
Luxon made the claim on Monday, when announcing the appointment of Lester Levy as commissioner to Health NZ as the Government took greater control of the healthcare provider to eliminate a claimed $1.4b annual overspend.
“Between the CEO and the senior leaders at the top and patients, there can be up to 14 layers of management,” Luxon said, three times over.
Health Minister Shane Reti also described a “mind boggling” organisational chart.
“I could not name the different layers of way finders, pathfinders, boundary spanners ‒Lord knows what else ‒ from A to B. I could not name them for you,” he said.
Reti’s office was asked for a copy of the organisational chart and this is when the Government started to resemble something out of either Keystone Cops or the Thick of it.
Again from the Press:
Asked for an organisational chart, Reti’s office took two days to produce a list of the supposed 14 layers of management.
It includes the “patient”, who could not be classed as managers at Health NZ, as well as the board chairperson and chief executive.
Between the patient and the chief executive, there are 11 job titles, and not all appear to be managers. It includes the “team member”, feasibly a nurse or doctor, and the chief executive’s chief of staff.
“It sounded off when I heard it, and seeing this chart makes me realise it’s false,” said Ayesha Verrall, Labour Party health spokesperson.
“Two layers are incorrect. The chief of staff is not the second layer of management, and the patient isn’t on the organisational chart.
“When I fly in a plane, I’m not appearing on the organisational chart of Air New Zealand. This is ridiculous.”
Do we have to fact check everything the Government says? And why are important discussions about really vital matters being clouded by claims that are clearly not true?
Clearly the Government wishes to cut into Health budgets. And if possible hock off as much of it to private interests. The first thing that they always do is create a crisis. And this week has seen their crisis creation skills in full flight.
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A Bill to modernise the role of Justices of the Peace (JP), ensuring they remain active in their communities and connected with other JPs, has been put into the ballot. ...4 days ago
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- Release: Nightmare before Christmas for Nicola Willis
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- Release: National Party urged to support modern slavery legislation
Labour is urging the Prime Minister to walk the talk and support legislation combating modern slavery. ...2 weeks ago
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The Government has done the right thing in moving to ban greyhound racing. ...2 weeks ago
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So a sort of 'super' centralisation – sold off as a single entity Or sold off piecemeal with each portion in competition with the others?
More likely just run it into the dirt so those that can get insurance the rest can go quietly suffer and die.
Their cancellation of school building projects indicates it will not only be the health sector.
That Levy has indicated no appreciation of the dynamic of amalgamation (or the IT issue at all) suggests he has not been hired to make it work, but run it down.
explained here.
https://thestandard.org.nz/open-mike-27-07-2024/#comment-2006107
"As pointed out by Clint Smith a 2.9% increase to the health services budget at a time when inflation was 3.3% and population growth was 2.6% has us going backward. Population ageing adds more cost pressure. The increase means in real terms a cut to health funding."
No it doesn't. Clint is making the basic mistake of comparing an increase in future funding with an historic increase in costs. The 2.9% extra spending is for the 2024/25 year, when inflation is forecast to fall back into the 1-3% band. Economic outlook – Budget 2024 – 30 May 2024. That increase represents a real increase in spending per capita.
And as I have previously pointed out (https://thestandard.org.nz/mountain-tui-can-we-talk-about-new-zealands-health-system/#comment-2005896), per capita core crown spending on health has increased significantly since 2008.
The difficulties being experienced by the health system are not about funding, they are about delivery. And there are plenty of examples.
Analysis: What ever happened to the $2 billion that was poured into mental health? | Newshub
Your claims are incorrect.
https://www.nzdoctor.co.nz/article/print-archive/follow-money-see-what-budget-2024-spends-health
Which claims are incorrect?
As per Clint Smith, the increase in vote health was 2.9%
Inflation over the same period is going to reduce to within the 1-3% band. Well within based on the graph at the link.
What are the population numbers used in the calculations you have quoted from – the article is behind a paywall. If the 2.6% quoted is correct, the budget saw a real per capita increase.
PS – can you please limit your responses to just one. You have duplicated this exact response on another thread, which means what can be an informative conversation becomes disjointed.
And yet Reti keeps asserting that National are spending more on health than any previous government.
In dollar terms perhaps, but that is pretty meaningless because our population has also higher than it has ever been and inflation is still there.
National justifies everything with spin. The so-called 14 layers of management – if you dealt into any organisation you could come up with this – is built on spin and facetiousness but little fact.
Folks our public services are being chopped up so the CoC can afford its tax cuts for landlords and to the other rich pricks who think they are entitled to rule this land.
As long as them and their mates have full wallets, f…. anyone else.
That is what National believes.
I've checked NZ Doctor's numbers.
The NZ Doctor quote states that it uses Stats NZ population figures and the Reserve Bank's May inflation forecast for its calculations.
The Stats NZ dataset is here National population projections, by age and sex, 2022(base)-2073 (stats.govt.nz). That shows a median forecast population growth rate for 2024 to 2025 of 0.73%.
The RB May inflation forecast states “Today's progress on core inflation has us growing in confidence that the RBNZ's 2 percent target will be achieved in 2025."
If the core crown health expenditure increased by 2.9%, inflation is under 2% and population growth 0.73%, the calculations produce a real spending per capita that is either the same (at between 1.8 and 2) or higher (at anything under 1.8) than the previous year.
Feel free to check my numbers, but the only way I can see that the NZ Doctor calculations come even close is if they take the 2024 historical inflation rate (instead of the forecast future rate), and heroic assumptions of population growth.
[given you are already in premod, in the absence of a link for that RBNZ quote, I’m taking you out of the debate for the rest of the day to slow things down and take out some heat. – weka]
Make shit up economics. Classy. Got some links for your myth making?
Because lets face reality shall we. Most rates are going to go up in this country by at least 10% Auckland less, everyone else pretty much more
Inflationary much?
Then their is the downward pressure on wages. But Tory wanker like that sort of shit, and never talk about it when talking about inflation because well worker rights, like they give a rats ass. So why should shit wages matter – when you can make shit up.
Oh but wait – Household living costs have increase 5.4 percent. Funny wages have not. Love how Tory wankers use consumer price index as their go to inflation measure to justify all sorts of their shit. But even that has been running at 3.3%
So I'm confused Will – what rabbits ass did you pull inflation is under 2%? Have the boomers stopped retiring?
"what rabbits ass did you pull inflation is under 2%? "
The RBNZ.
The Reserve Bank (RBNZ) expected inflation to fall back into its 1-3 percent target zone this year, and when it is convinced it will stay there, only then will rate cuts begin.
Inflation dips to 3-year low, prices rise just 0.4% in 3 months | RNZ News
Did you read the link? Their figures were 3 -3.8% on the CPI measure. Which is a bullshit measure, for real people, living in the real world. Where the figures are much higher.
So fantasy stuff from you. 2% is a pipe dream of ideologically committed.
Hey Will you are full of it ….Google medical inflation NZ
Simply put, medical inflation is the rising cost of medical care. In New Zealand, in recent times, this has been in the region of around 9 – 11% each year. That means the rate is significantly higher than the country's inflation rate.
The RW and their bloody 'Magical Efficiency Tree' no you lot are not geniuses, no you can't get the same or better results while cutting resources and staff you are lying or deluded and I'm not sure which is worse.
Will is intentionally spreading misinformation. To think it's unintentional would be a mistake.
[deleted]
[Please don’t do that here. We really don’t want people publicly guessing about other commenter identities, thanks – weka]
Mod note
Yes that is the case. In recent times. But it isn't always the case. For example, in the US:
Using the CPI, overall prices grew by 3.5% in March 2024 from the previous year, while prices for medical care increased by only 2.2%. As a result, overall prices excluding medical care grew by 3.6%.
How does medical inflation compare to inflation in the rest of the economy? – Peterson-KFF Health System Tracker
That's why we use broader economy wide markers.
please provide a link for that quote.
Mod note
It's not just health. It's in every sector and includes selling off state entities like Kiwibank too.
https://mountaintui.substack.com/p/what-makes-us-tick
Yep this is the biggest one and the one clearly under attack right now. No sector is safe.
I wish they (Labour or Nats) had sold TVNZ in the past. Now it's worth about as much as Stuff, Kiwirail or Torpedo 7… which if memory serves me correctly were all sold at some stage for $1.
Kiwirail is a bad example. Private Enterprise ran it into the ground and the state had to pay for the repairs. Do you think there should be space for the state to run sectors that are vital to all of us? Like health?
There are some sectors of public service delivery in which a mixed model (private-public) can work. Health is one of those. But a significant shift from the current balance would be disastrous, and most likely politically unpalatable.
Isn't what you describe above, essentially what we have in NZ now? And it's working really well isn't it! (Well for the few wealthy who can afford private health service it is.)
Na bullshit, rich power brokers can afford private so don't care about public, ban politicians from health insurance then you'll see things change
Applying profit models to public service areas is non-sensical. I've favoured for a long time a public good/private good split.
Public good funded through taxation, including taxing to need levels, private good funded through fees and charges.
Health is is a good example where the private sector does what is profitable but you don't go there for your car crash or your heart attack. Some of the problems too in health (doctors and dental) is the move from individually owned practices to corporate type franchises. Instead of the money going into the doctors pockets some is siphoned off and in dental you get given quotas to do so many (profitable) things a month. The creaming off of dentists and doctors incomes is part of the push to have government payments increased.
(We've been here before – childcare, caring for the old and disabled)
Roads, rail, electricity – all have a public/private good component. Working out where this sits should help determine more clearly how things do get funded. The Auckland Hamilton train is a good example – how much is a public good – eg fewer cars on roads, fewer accidents, reduced emissions etc versus private. Roads proportion funded through fees vs normal taxation.
I'm thinking rail for instance would have a greater public good than roads in terms of funding. This seems obvious given the trucking industries desire to have a monopoly. There is clearly money to be made.
It's about time to mobilise people.Enough is enough.
any budget crisis started the day Willis borrowed $12 billion for tax cuts. niothing new about National starving health of money, Key and English did it last time in govt. Luxon and Reti promised to close the pay gap for nurses outside of Te Whatu Ora and fix the staffing crises. Let them try and sell things, that way it becomes nice and transparent rather than using mirrors to hide behind
IMO, absolutely ! Good work MS, Mountain Tui and…others who are looking straight through the NACT1 smoke and mirrors, to the creeps behind.
If we dont show them up for what they are …and where they would take us, NACT1 will destroy/privatise our NZ Health System (and of course the others on their agenda)
Keep up the good work !
By George, Micky has got it!
Of course the fuckers want to privatise–except the tricky more expensive procedures–National Ministers apart from working in Tobacco, have also worked in Private Health Care. They want to run public health care down to the extent people are driven to private…but how the hell can working class people afford the one off payments and policies?
I think it is completely right that the government looks to reduce the administrative burden not only in health but in every area of government.
The reason I have this view is that I think the impact of AI will have a major effect on reducing admistration costs in government departments in the same way it is in the private sector. Already, we have adopted AI in our own company in various ways. For example automatically scanning in bills into our accounting system rather than manually entering them (if that can be called AI). Also, we are looking to impliment Microsoft Copilot in the near future.
Government departments should have the resources to find much more wide-reaching uses of AI that not only reduce administrative burdens, but also make services to the public much more effective.
Bearing in mind that kind of process was being done at least two decades ago in one company I did some work for. It was done without needing generative AI, I don’t think that AI has much to do with it now. At most, it is a minimal refinement reducing the number of human checks that need to be made.
However I’d bet that it still needs exactly the same kind of human training that older automated scanning systems required. ie pointing out what to look for and what to ignore. Which was where most of the work went into. It shifted from manually punching, to pointing to parts of the images so the the programs knew about variations.
35 years ago I was working on automatically matching transactions to GL codes.
Basically I find most of the hype about generative AI to be mostly bubble hype. It is just another tool for fools to bet on and to implement badly. An excuse for a bubble and companies to skim capital. Probably why the market did a rather large tech trim on AI stocks last week.
Much of that type of work was getting dropped out anyway in the decades since with business to business protocols. Haven’t looked at it recently, but based on the complete lack of ‘paper’ in my life, I’d take a bet that most companies (outside of tradies) have that automated and across networks these days.
Work in local government and can confirm. Adopting PEPPOL, for example, is slowly removing paper (and even PDF) invoices.
I guess the sort of thing that might become more automated and sophisticated with AI could be the increasing use of chat bots in call centres. A lot of sites seem to use these now. At the moment they are a bit annoying. But they might end up performing better than humans, and reduce the time wasted waiting for a real human to respond.
Another area I can see AI technology being useful is in areas such as reviewing tax returns. AIs could scan all tax returns looking for inconsistencies to be followed up with from a tax inspector, thus making their time more effective.
Something on the news recently that has the potential to increase productivity dramatically is the use of virtual building inspections. Probably in the area of technology and innovation rather than AI. This method may not be appropriate in every circumstance. But, is probably quite adequate when dealing with experienced builders who have a good track record. But, the time saved in travel etc will help ease the construction lag, and get houses built more quickly.
The thing is they are downscaling the IT workforce, so questions have to be asked about the chances of realising a national integrated information system on which to utilise AI.
Where I find AI quite useful is things like early drafts of basic presentations for training on a specific topic that is well documented across the net and for locating reference documents.
In both cases it doesn't replace the in depth knowledge required to pick up errors and reorganise but it certainly does save quite a few hours in preparation and organising each time and certainly picks up some really good references that search engines don't pick up – though seems to ignore really good ones that are easy to find.
Rather than work related use it seems to be most useful for me in putting things together for community groups and for helping non-techy people do the same. That may be where productivity gains may come – helping ordinary people who have expertise build something using technology they don't have expertise in.
Bring back community education. There is so much opportunity to upskill ordinary citizens.
That is my favourite usage. But mostly I tend to use wikipedia to fact check the AI summary because there is often complete trash in the generative AI.
Summarising comments on PBTech on products is an effective usage. But much of the time the comments themselves are better.
This is a reasonable example.
https://www.pbtech.co.nz/product/UPSDNX1600/Dynamix-UPSD1600-Defender-1600VA-960W-Line-Interac
I seldom use them or any voice in any form when searching for information. I have never managed to get one to provide any information that is of any use to me. It is not for the want of trying. Typically what I get after going through the process is I get stuck in a line waiting for a human.
Generally if you want to get information these days, I usually tell people to go on to the websites and look it up. Failing that, use the chat bot on the website or send email to their support contact and clearly state the issue. You'll usually get a callback or contact from a human, and it doesn't involve trying to keep a voice line open for several hours. The response may be several days later, or even weeks in a couple of cases.
But you don't have to play phone failure roulette.
It has gotten to the point now that I check the websites now before joining services and routinely asking a question to find out the response times when purchasing to ask a routine question that isn't in their FAQ. Poor services on that and I purchase elsewhere.
Hmm AI to the rescue well…….
https://www.livemint.com/ai/artificial-intelligence/openai-likely-to-go-bankrupt-by-the-end-of-2024-report-11691815279479.html
NACT1 and 14 shades of BS.
OK.. repeated
Luxury Luxon still with the 14 layers
And Dr Reti's mind is blown..14 ways
Hey you NACT1 creeps , your lies are being exposed !
Easy fix – get rid of the patients and the problem is solved!
Think of the savings ! Oh and there is : (paraphrased) In order to save the Health System..It became necessary to destroy the Health system : (
Yeah, the health system would be going great if it wasn't for all those stupid people who take up doctors' time by getting sick or having accidents.
As I, and others have said, NACT1 aim to privatise. Everything. They are going full speed to bring the changes necessary. Any lie they can get away with…just enables that.
Sad thing is, a lot of those who will be shafted by them, also voted for them. Go figure : (
Anyway for the rest of us : Fight Back !
Fight back. Any suggestions as to how we mobilise andi fght back? (Serious question)
Questions to MP's.
Support Left MP's and Parties
Also Groups affected by Fast Track/privatisation such as Environmental ones ( a lot of common ground there)
Keep abreast of Political news…The Standard and others who expose NACT1 lies and subterfuge
Calls to March.. be seen and heard
I remember that during the National Bolger government, there was a strong rumour that Masterton Public Hospital was going to be closed down. The locals took action and staged a public gathering with hundreds of people linking arms in the grounds of the hospital surrounding the hospital, showing National what they felt about it.
People power can work, but it has to be organised properly.
Arguably, privatisation of health in NZ has been underway for quite some time.
https://theconversation.com/the-real-cost-of-new-zealands-two-tier-health-system-why-going-private-doesnt-relieve-pressure-on-public-hospitals-206491 [published May 30, 2023, i.e., before the General Election]
Just straight up lying.
First do no harm ‘Dr’ Reti. Or are you released from that when you join the Nats?
Another day and more Nats bullshit.
Allowing a bullshit culture war party to be bullshit is one thing.
Straight out lying about a core, core function of government like healthcare is different.
Hickey from the link in the last post:
Health NZ has been very clear in recent months that the increase in costs above its budgeted levels of around $130 million a month was actually because of Holidays Act leave entitlements, new collective agreements with staff, pay equity increases and extra nursing costs because of extra hours being worked in jam-packed hospitals.