Has the public health system really improved under Labour? Obviously the Health Minister Pete Hodgson thinks so, declaring that 'despite recent bad publicity, most people remain confident in the health system because of their own positive personal experiences'. See - Health system working despite errors - Hodgson. However, building on previous blog postings about the inadequacy of the health system, the post below covers some recent news stories, which add up to indicate that Labour has failed to deliver. It seems that the political topic of health is no longer an electoral area of advantage for the Government, and perhaps it'll be one of the reasons for Labour being turfed out at the 2008 election. Maybe someone will make a 'comedy' documentary about this to rival Michael Moore's new SiCKO. [Read more below]
In a move that has increased the cost of healthcare for the sick, the Labour Government decided last year that they would allow District Health Boards to charge for laboratory charges. This has essential meant user charges have been increased by Labour, as DHBs have sought to cut costs by making patients pay out of their own pocket in certain instances. Already two Wellington region DHBs have decided to charge patients that use laboratory tests ordered through specialists (as opposed to GPs). Similar plans are being implemented by the Otago and Bay of Plenty DHBs. In the BoP, Doctors Want Answers Over Non-Essential Charges, as the DHB have, without consultation, decided that screening tests of the healthy aren’t essential and therefore should be charged for.
Such targeting health care normally results in perverse outcomes. In Wellington it has led to the ridiculous situation whereby patients are forced to go to their GPs to ask them to order the tests instead of the specialist, which according to one Wellington doctor has lead to ‘a lot of headaches for GPs, patients, private specialists and the lab’. Even the Royal NZ College of General Practitioners has condemned the DHB’s decision – see GPs help patients dodge test fees
The Royal NZ College of GPS has also voiced their concern about the lack of government funding for mental health services. In wake of a successful campaign about depression featuring John Kirwin, Chair Dr Jonathan Fox says GPs are forced merely to write a prescription for anti-depressants, saying 'we are a bit handicapped because publicly funded resources are not there to help'. According to the news article Kirwin ad campaign reveals lack of resources, ' primary mental health care has been neglected. One leading psychiatrist 'says as well as offering medicine, GPs ought to be able to offer their patients access to talk therapy sessions because that gives a better outcome, requires less medication and costs less in the longterm'.
Universalism is also failed by the regional health approach to public health management. Under the current arrangements, New Zealanders face ‘healthcare by postcode’, whereby there is a huge discrepancy in the availability of elective surgery, dependent on which DHB you live under – see Ratings expose variations in access to surgery, which outlines the unevenness of the health system. You can check out how lucky or unlucky you are online at: www.nzhis.govt.nz/stats/surgical/tables.html
Regardless of where you live in New Zealand, your ability to access new and better cancer drugs is very poor, according to a Swedish study, published in the cancer journal Annals of Oncology – see NZ patients denied cancer drugs. The international study as NZ is on a par with Poland, Czech Republic, and South Africa, and that our current uptake of new cancer drugs is ‘low and slow’. This comes on the back of Governments drug funding body Pharmac choosing this month to fund only 9-week courses of the medication, instead of the standard 52-week option.
Even in terms of staffing, there now appears to be a crisis in the public health. Since coming to office Labour has commissioned a huge amount of reports to deal with the workforce crisis in the public health system. The 43rd report has just been released and the Government says it will implement its proposals to increase the number of doctors. Currently the system relies on importing overseas-trained doctors – 40% of our doctors in fact. The Medical Students Association is unimpressed with the Government’s solutions – see Proposals to overcome doctor shortage 'do little'
More recently, the Herald has reported (Doctor shortage heavy cost for hospitals) that there is an unprecedented shortage of junior doctors. Up to a third of roles in some specialties are vacant'. According to a Waitimata DHB spokesperson, 'This is not a "blip" - this is a sustained national problem that is getting worse'.
Another recent report says that the poor pay and conditions of nurses in the public health system means there could soon be a crisis – see Nursing levels near critical – researcher. NZ is losing thousands of qualified nurses each year to countries offering better pay and conditions – for example about 900 are going to Australia each year.
According to the news report, Hospital errors kill 750 patients a year. The cases of ‘adverse events’ in the public health system that become public are only ‘the tip of an iceberg’. This is the view of the chief medical officer of the Canterbury District Health Board. Compared to other similar countries, NZ’s potentially avoidable deaths in hospitals was ‘unacceptably high’.
Comparative statistics released by Save the Children shows that NZ is poor in basic indicators such as child mortality. The charity says that ‘. Out of 43 more developed countries, New Zealand ranks 20th in child wellbeing. In fact, New Zealand falls well behind Malta and Slovenia’. Save the Children also complains that the Government doesn’t even produce an ‘annual child wellbeing report so that child welfare in New Zealand can be monitored and addressed effectively’.
Looking at the state of health system under the Labour Party, perhaps we might see some calls by the medical world for Helen Clark’s government to be removed at the next election? This might sound fanciful, but note that the highly-respected British-based Lancet magazine has just published an editorial calling for the defeat of Australia’s Howard government in this year’s federal election because of the damage it is inflicting on public health and medical research. It therefore makes sense that they should do the same in New Zealand. Only, it’s pretty clear that National wouldn’t be any different to Labour.
Or perhaps an NZ documentary maker just needs to make a native version of Michael Moore’s new documentary, SiCKO, which the director has described as ‘A comedy about 45 million people with no health care in the richest country on earth’. Apparently the film ‘does for the US health system what Fahrenheit 9/11 did for Mr Bush and Bowling for Columbine did for the American obsession with guns’. So where is New Zealand's Michael Moore?