Mountain Tui: Crashing New Zealand’s health system is not the way to prosperity, Prime Minister

Written By: - Date published: 2:44 pm, July 16th, 2024 - 15 comments
Categories: Christopher Luxon, david seymour, health, Shane Reti, uncategorized - Tags: , ,

Cross posted from Mountain Tui‘s substack post.

Another day, and yet another piece of bad news for New Zealand’s health system.

Reports have come out that General Practitioners (GP) may have to close doors, or increase patient fees to survive. The so-called ‘capitation’ funding review, which supports GP practices to survive, is under way, and primary care practitioners are concerned.

First, let’s do a quick recap to examine our health system landscape since Prime Minister Luxon, Health Minister Shane Reti and Finance Minister Nicola Willis have taken over their porfolios.

In May, MP for Whangarei, Shane Reti, was selling his Government’s health credentials:

“Our Government has set ambitious targets for the health sector…(Our) budget prioritises frontline health services & workers “

But just a month earlier, in April, a series of information leaks had already forced Health NZ to confirm it had brought PWC consultants in and were directing all public hospitals to save a total of $105 million by July 2024.

For example, Auckland was asked to cut $15.5m from its hospitals, Northland $4.5m, Canterbury & South Canterbury $14.5m, Nelson $3m, Bay of Plenty ~$7m etc.

The directive confirmed “the Government is asking the public sector to make efficiencies to manage significant cost pressures.”

Could this have anything to do with the $12-14bn of tax cuts the National Government was going to gift us all in May?

The one that Nicola Willis made on the back of public service cuts and lowering beneficiary incomes. The one she then borrowed an additional $12bn for, pushing us into a government debt ratio of ~45% and with a larger budget deficit than any of Grant Robertson’s budgets, bar Covid?

Furthermore, Reti had, as soon as he got into office and through to the budget:

  • Put on indefinite hold the Whangarei hospital re-build despite the previous government’s committed funds of $800m to it.
  • Put into limbo Nelson’s hospital plans, after plans had already been procured and agreed to for optimal patient care and capacity.
  • Deferred Dunedin hospital investment without a clear timeline, putting into doubt previous National Party promises
  • Did not fund any of the mental health doctors they promised
  • Funded half of the promised new medical registrars, and trying to blame that decision on the Universities!
  • Broke their promise of funding cancer drugs in the May budget, then spectacularly u-turning after public backlash.
  • Cut funding for the Health and Disability Commissioner (HDC) who is already dealing with a 3 year backlog of complaints
  • Cut $381 million in planned digital health investment, after Labour had committed the funds, leaving the health system in a disarray of paper records, and paper trails

And as Ministers Reti and Willis plugged their budget as being good for healthcare, doctors and medical professionals simultaneously warned:

This budget leaves our health system treading water, our workforce over-stretched and patients left waiting longer and longer.

About hospitals again –

It’s been confirmed again this week that frontline hospital roles are going unfilled, amidst Health NZ’s budget cuts.

Don’t forget that this austerity doesn’t apply to landlords ($3bn over 4 years), pothole contractors ($4bn over 3 years), and road build spend ($70bn over 10 years)

Make no mistake – this is about priorities, not forced austerity.

Last month, Health NZ denied a hiring freeze despite suddenly freezing new graduate nurse intakes. At a time of critical nursing shortages, it was a bizarre move to not support our home grown graduates and leave them in the lurch like this.

Health NZ had already ordered an immediate hiring freeze on all non-frontline roles – as if that imaginary line between front-line and non-frontline means anything in practice.

This week, Whangarei hospital nurses stepped out to warn that conditions for patients and staff in Northland hospitals were deteriorating rapidly. “Eventually somebody will die.” They feared Government cutbacks on staffing was affecting patient care and risked lives –

Hospitals are not the only frontline staff feeling the heat.

Back to primary care –

We are in a GP crisis. It’s not new. Weeks long waits to see one are common, if access is available at all. General Practitioners Aotearoa’s Dr Burrell has said New Zealand’s GP-to-patient ratios is “embarrassing”. Only 25% of practising doctors now work in primary care, a stark fall from years before.

The GP body wrote to Health Minister Dr Shane Reti 5 months ago to discuss how to address this crisis.

Two months after that, Shane Reti showed us how that went. On a segment on Q&A with Jack Tame, he said he didn’t include GP targets into his Government’s ‘ambitious’ public service targets, because that was “too hard.“

Once again, this Government demonstrates a keen lack of seriousness and responsibility, instead giving themselves homework that’s more suitable for crayons than serious governance.

I could go on, but let’s start to wrap it up.

In Lower Hutt, National Minister Chris Bishop’s electorate, one practice had one GP for over 9000 patients. Today, after a lot of publicity and pressure, they hired a new GP.

The health system is in crisis, and it will need bold leadership to correct. The previous Government had started a number of those measures, and it is up to the current one to not only advance them, but also improve on it. Not roll them back and make it worse, or redirect investment to tax cuts and roads instead.

Before the election, ACT promised “care and dignity” to primary care practitioners. 13% funding per patient was what they said they would offer to GP practices if they won.

Fast forward to over a year later.

New Zealand’s GP practices have just been offered 4% in “capitation” patient funding support from the Government – that’s less than inflation, and well below their cost pressures. The profession said this could hurt an already struggling sector and force some practices to close. But they are also being told they can increase patient fees by nearly 8 per cent to compensate.

That means, this Coalition Government wants sick New Zealanders to stump up the extra, with 1% still missing, at a time when cost of living, and the reinstatement of prescription fees is already hurting many.

The consultation process is now underway and as always, we hope the Government will capitulate to common sense.

Still how much of all the gifted tax cuts will be eaten up by ongoing fees caused directly by this same Government?

Is it any surprise that two more Health NZ Board members have suddenly and ‘surprisingly’ quit before their term has ended? That leaves only 2 members left after others opted to opt-out as well.

Make no mistake, our health system is in crisis. The decisions of the present count much more than any number of road cones.

These are not only significant health infrastructure deficits, they are health system deficits of skill, morale, capacity, and leadership too.

15 comments on “Mountain Tui: Crashing New Zealand’s health system is not the way to prosperity, Prime Minister ”

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  1. Macro 1
    16 July 2024 at 4:40 pm

    How anyone could vote for this current shower of no hopers is beyond my comprehension. We saw exactly the same 12 years ago, only this time it is even worse. Those who can get out of the country now are leaving in their thousands – as evidenced by the latest migration statistics.

    I know from personal experience how this stupid policy of social service austerity affects a family. Once gone they will never return even though their home is NZ.

  2. Psych Nurse 2
    16 July 2024 at 6:05 pm

    Where I work the rosters clerk retired, not to be replaced. Their duties included replacing sick staff and data entry to ensure people were paid, fairly crucial. Their role has been covered by redeploying a Registered off clinical duties. Great, not.

  3. Champagne Socialist 3
    16 July 2024 at 6:38 pm

    This has all been done before in the UK and it has very little impact on voting behavior. In 2010 the UK government started a program of austerity and underfunding across the public service – including health. That government was able to win 2 more elections convincingly despite the obvious detereation of the health system.
    Those who depend on public health care are likely to be a minority of voters – especially given the widespread use of private health insurance in NZ. Given this fact and the nature of the modern voter, paying $10 less in tax each week will be far more appealing than a new hospital or properly funded GP's.
    In a democracy we must accept the will of the voting majority and that majority has consciously chosen significant under-funding and under-investment in our public health care system. Until that view changes there isn't much we can do about it.

    • Kay 3.1
      16 July 2024 at 7:06 pm

      I'd say there's still a significant group who are totally dependent on the public system. And let's not forget that the best health insurance means nothing in NZ when ED level acute treatment is required. The Ambos would deliver even Luxon and co. to the nearest public hospital.

      Where I doubt they'd forced to lay on a trolley in the corridor for hours.

    • thinker 3.2
      17 July 2024 at 7:19 am

      Plus, people who feel genuinely screwed over by having done their part of a bargain and then been unceremoniously dumped won't feel happy about doing so again, we hope.

      It's all up to the opposition to warn voters not to go for the rhetoric "You've had the tough times, don't waste the good times just around the corner".

    • Mountain Tui 3.3
      17 July 2024 at 12:11 pm

      I wrote a too long post https://mountaintuihere.substack.com/p/the-folly-of-retreat-in-the-face

      It's the misinformation, disinformation and faux culture wars that lead people to vote against their own interests, in my view.

      • PsyclingLeft.Always 3.3.1
        17 July 2024 at 2:13 pm

        Hi Mountain Tui, I read your Link. And found it not to long at all…very interesting and full of Info !

        I have followed Politics, with particular reference to Climate Change, for many years. I am but a layman, however do like to read the Science . I also am proud to be of the Left : )

        When I did see your mention of the Koch brother/s, I recall many of their NZ connections….You might well have seen this link?

        https://newsroom.co.nz/2020/10/21/who-the-hell-is-gideon-rozner-anyway/

        And ACT/Dirty Politics…I was kinda shocked at the time when I read this….Of course this was just normal for those kind of creeps, as was revealed. Some Psychopaths : (

        Cactus Kate

        I've done a post for Saturday on whale blog as can't run myself as too close to work. The leaks he is involved with include tens of thousands of rich Chinese. Mainland and HK. It would be a disaster if they all knew where he lived. He may even need police protection. … Chop chop for Nick.

        — Cathy Odgers[10]

        https://en.wikipedia.org/wiki/Cathy_Odgers

        Keep on putting it out there . Def breath of fresh air for the mind : )

  4. KJT 4
    17 July 2024 at 1:02 am

    Disaster Capitalism.

    Deliberately underfund to fuck up the public system.

    To justify replacing it with private, for profit, corporate raiders.

  5. benby 5
    17 July 2024 at 11:12 pm

    Had to book a 15min video chat with the GP two fucking weeks ahead. In fucking Karori. I sure hope these fascists get the boot very soon.

    • Rolling-on-Gravel 5.1
      17 July 2024 at 11:15 pm

      What is the GP so I understand?

      • roblogic 5.1.1
        17 July 2024 at 11:37 pm

        General Practitioner, i.e. Doctor

      • benby 5.1.2
        17 July 2024 at 11:41 pm

        GP == General Practicioner

        This one is Karori Medical Centre. I assume government straps them of cash so they're unable to run a responsive service

        Does that answer it?

    • benby 5.2
      17 July 2024 at 11:45 pm

      To clarify, I think finance minister Nicola Willis lives here in Karori, which makes things extra disastrous. Do these people have a separate health service or what!?

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