For some time there has been this cascade of bad news from the Health sector.
As a recent example there is this touching story about a family whose two year old son is sick with cancer whose treatment was compromised by a lack of resources. Although the family are clearly grateful for the help being provided to them they cannot help but fault the health system for its failure to provide adequate care.
From Radio New Zealand:
The mother of a toddler whose cancer treatment was delayed due to staff shortages at Starship Hospital says often her son was screaming and writhing in pain while they tried to get help from a nurse.
She said she was heartbroken and doubted the health minister’s assurances the jobs were being recruited for.
Some chemotherapy and bone marrow treatments have been delayed at the children’s hospital for up to seven days due to lack of staff.
Tanya Lapu’aho’s two-and-a-half year old son Killian was diagnosed in January with high-risk neuroblastoma.
He’s since had multiple stays at Starship for rounds of chemotherapy and two bone marrow transplants, and is moving on to radiation and immunotherapy.
Lapu’aho said timing is everything with cancer treatment – but her son’s second bone marrow transplant was delayed at least a week because there were not enough specialist nurses to carry out the treatment.
She said babies were bearing the brunt of delays.
Lapu’aho said and her son had been in Starship Hospital many times with the two longest stays lasting just over a month and it was obvious that the nursing staff were under a huge amount of pressure.
Initially they thought delays to her son’s surgery were for medical reasons but they were then told it was due to staffing shortages, she said.
“On a day to day basis it looked like our son screaming and writhing in pain and us calling for our nurse and her wanting to come straight away but her not being able to because she had too many other things to do – you know duties to carry out, other patients to take care of – to the point where it was taking on average about 20 minutes, half an hour on a really busy day for a nurse to come to the room and respond to you pressing the nurse call button.
“And most of the time we were pressing that button for pain relief because our boy is in so much pain from the cancer, from the chemo, from everything.”
Something that is not reported in the article based on her interview is her intention on how she is going to vote this election.
She said this:
It has got my non political family ready to hit the polls on election day to vote this Government out. It is so unfair what is happening to the nurses at Starship.”
Her heartwrenching story comes on top of news that Auckland Hospital’s Oncology Department has had to delay treatment because of a shortage of nurses.
From Lane Nichols at the Herald:
The nurses’ union says nearly half of shifts on Starship children’s hospital’s oncology ward were below safe staffing levels this year, and health bosses should have hired more nurses rather than delaying cancer treatment for sick kids.
“It shouldn’t have come to this,” New Zealand Nurses Organisation (NZNO) president Kerri Nuku said.
“Health Minister Simeon Brown can argue oncology services are being postponed and not suspended, but such semantics are unlikely to be important to whānau with children with cancer.”
The Herald revealed today that, because of nursing shortages and high demand at Starship’s paediatric haematology/oncology service, some cancer treatments had been “rescheduled”.
Health New Zealand Te Whatu Ora confirmed this afternoon that 20 cycles of chemotherapy had been delayed over the past four months by up to seven days.
A source told the Herald that staff were horrified to learn of the developments last week, and that management was “terrified” about the information leaking out.
Simeon Brown claimed it was a “handful” of chemotherapy sessions and that two bone marrow transplant operations had been “slightly delayed”. Note to Simeon 20 equates to four handfulls of fingers not one.
Then to really have you scratching your head was separate news that the Government had issued a direction to limit nurse enrolments. The TEC has asked Nursing Schools to limit enrolments to 2025 levels because there was not enough room for extra student nurses to complete clinical placement.
I mean what?
When the pressure on the health system has not been more pronounced we want to reduce the number of norses being trained? Please make this make sense.
And National has this behaviour tick of engaging in the most horrendous rhetoric. Truth is bent within an inch of its life.
Like National’s claim that it has trained over 2,000 nurses when the truthful answer is that it has funded the training of 56 nurses and all the rest were funded by the last Labour Government.
You know how National repeatedly claims that the spend by the last Government was wasteful and that there was nothing to show for the extra spend?
Another piece of rhetoric that National engages in is to claim that the health spend is at record levels.
While this is numerically correct if you factor in population change, inflation and the increasing cost of providing health care for an increasingly ageing population then the spend is going backwards.
And the crises in our hospitals is clear evidence of what is happening.
Of course Labour’s rather cautious fiscal policy does not leave much roomm ot move. But if you are looking for a party that will address the health crisis and make sure it is properly resourced then vote Labour.
Good post. I think health is the issue that will lose the election for the CoC.
There have been so many bad health headlines (both during this government’s term and during the election campaign) that must be resonating with the voters. The CoC's response has been sticking-plaster spending (geddit?) to try to look like they are doing something.
Most of the Cabinet are so entitled they wouldn't know what a public health service is.
The wrecking job in health has cost lives, they have blood on their hands here and continue with the lies.
Their lack of humanity manifests itself in how they've treated our health system.
Yes I had to wait two and a half years to see an ENT specialist. I had two referrals turned down I changed GP to get my third referral accepted waited 5 months saw a specialist who said it's post code lottery we can't to anything for you but see you again in another years time. In the meantime I have a hole in my eardrum and my hearing is deteriorating further. So why am I paying taxes.
[Please fix the error in your e-mail, thanks _ Incognito]
Mod note
As long as too many NZers don't want to pay taxes/pay more tax/tax the ultra rich/expand the tax base, etc, etc, then our health system will continue to deteriorate.
Both main parties have had 40 years to forward plan for health infrastructure and workforce, and have made the deliberate choice to either do nothing (National) or just tinker around the edges at a glacial pace (Labour). Neither can deny they could not anticipate population increase, the baby boomer bulge, or the GP crisis that has been building for decades now.
To even remotely improve the health system will require some extreme decisive action taken after the election, without any mention during electioneering. Win government, get that untapped taxation, make bold decisions, and pass it under urgency. Too bad if some people don't like it- I don't think many of us liked the tobacco tax break and cancelling the fair pay process.
Wairau hospital Emergency Department in Blenheim serving 50,000 people is in crisis, three staff short of the eleven needed. Sometimes there is no doctor there. The staff were on the news last night. It has been an ongoing situation. The manager says they will be doing something about it…. what has been a long term problem has to have doctors going onto national television to get even a promise.
I attended a Grey Power meeting in the Kaikoura electorate where Blenheim and the Wairau hospital are, and took notes. The second question related to wait times for diagnosis and treatment. The National MP answered that he favoured extending the private Churchill Trust and pushed the case for private medicine. The ACT candidate also pushed for a greater private sector involvement (less red tape).
There seems to be an agenda here. Run down the state, and fix the mess by privatisation. The Labour man had the answer. Let the State provide fully funded health care and we won't even need a private system. My notes after the ACT man's answer reads "How do poor people access private?"
The Right see policy planks in simple black and white terms. Private – good. Public – bad.
Private is good because it means government don't have to pay. Public is bad because it means government do have to pay.
And the more government has to pay, the less there is for their voters who don't need public assistance.
Simple as that.
As simple and as wrong as that.
Listening to the current political debates, I believe that we as a nation, as a society, as citizens, need to once again become aware of, and supportive of, the social contract that binds us all, incorporating fairness, empathy, justice, compassion and mutual respect.
This election is surely not demonstrating a lot of that.
Hipkins IIRC at least mentioned the social contract in a leaders' debate on TV.
Heh, like the American system?
What fans of private health fail to acknowledge is that any provision of services by private providers is dependent on a robust public system.
When that complication or infection occurs then it's off to the public system for that to be treated.
I will believe private health acolytes a little more when there is a private ambulance service.
"then it's off to the public system for that to be treated."
That's true of the Churchill Trust mentioned above. They are also picking up work from the public sector such as supplied to a family member for medical services which the public hospital would/could not do. I bet the cost for his treatment was greater than the public system would have supplied.
I spent a night next door there after a public system operation because the hospital beds were full. Maybe some usefulness there but I bet the cost was greater.
We've had a fair bit to do with the health system over the last few years, partner had an abdominal wall reconstruction, then as she came right I had a run in with a cancer. We're both very much on the mend now. Generally the care we received was very good, in my case it was hard to keep up with once the ball got rolling, in my partners, they moved mountains. But we've seen a few things.
We've got a private walk in / semi ED at the medical centre in Queenstown, no in patient functionality but it takes the load off the public ED at Lakes, where people can afford it . It's helped by Lakes requiring payment up front from patients who don't qualify for free treatment (large fraction) and the Medical Centre is slightly cheaper. For enrolled patients the QMC walk in is bloody fantastic, but pricey. A large proportion on the patients at Lakes ED are people who either can't afford the Medical Centre, or who aren't enrolled.
Which makes wonder, how much will the load on EDs around the county be reduced by making access to GPs easier and cheaper. I'm picking that this is where the gains are to be made. Just got to ensure that the '3 free visits' are put to good use and not gamed on trivialities.
We have a wonderful walk-in GP clinic in my burgh. Adjacent to the ED, it's a one stop community health hub.
And then we have the arses who wait until closing time and then present because ED is free.
https://www.wrhn.org.nz/wam
That's an impressive organisation. Really interesting seeing how other places work with different communities.
How solid is the charitable trust model, are they able to derive enough funding from fees or do they need outside funding from donations or funding drives? And how do they get on for recruitment and retention of staff. The normal, booked consultation fees are very reasonable compared to Queenstown, but the walk in fees are only slightly less. What sort of delay is there for appointments, here you might get an appointment with a doctor same day, but your regular doctor could be weeks.
Interesting idea having the medical centre / GP adjacent and kinda integrated with the Hospital and ED. Is there integration / cross over of staff as well, or two seperate operations?
Our local ED deals with those arses with a long wait until not so early hours on a not that comfortable seat. Also there's a distinction between people who can't pay and those that won't.
Well said. NZ Public health service –> Two tier public/private –> ???
I don't think the US healthcare system is a good model for your argument.
It appears to operate entirely on a user-pays (or rather insurer pays) model. It is *not* backed by a robust public health network.
Wealthy people with complex conditions – which, in NZ would be treated in the public health system – are treated by the private healthcare model in the US.
My comment about the US system was a response to;
"The National MP answered that he favoured extending the private Churchill Trust and pushed the case for private medicine. The ACT candidate also pushed for a greater private sector involvement (less red tape)."
We must resist any move towards health budget going to
profit seekersprivate providors. In fact we need to rethink the amount spent now and wind it back.Anyone with a pulse realises the Americans have one of the most inefficient health systems when you consider dollars spent and services delivered.
But you then went on (next sentence) to say that a private health system is dependent on a robust public heath one. Which, AFAIK is not the case in the US.
The US standard of health care, for those who can pay, is literally world-leading.
Yes, it is expensive (don't travel there without health cover). But you really do get what you pay for.
From personal experience, private won't do all surgery.
Private does where the profit margins are highest and the insurance risks are lowest. And where the amortized cost of machinery pays off ok.
State has to pick up the rest.
As far as I'm aware.
Indeed. A relation's FIL needed joint replacement surgery but was knocked backed by the public system. After a lifetime riding high on the hog he was too big, too unwell, and apparently unable or unwilling to do the work required to satisfy the surgeon so off he trotted to another, private, provider. They obliged him but things didn't go well, he was transferred and spent a fortnight or so in a public CCU, another month in a public hospital, and died a couple of months after going home. But the surgeon got paid.
Also picking up the pieces from medical tourism gone wrong.
https://www.rnz.co.nz/life/wellbeing/nzer-whose-weight-loss-surgery-went-wrong-in-turkey-can-t-get-refund
What private does very well, is pick up the routine minor to medium level surgery, that is either impossible to get in the public health system, or is unbearably delayed.
The situation in Health has been grim for a decade now. This government has made a bad situation worse.
Pay round after pay round successive Health Minister's have baulked at nurse to patient ratios.
"All political parties must urgently commit to legally enforceable and culturally safe nurse-to-patient ratios for the sake of patient safety, NZNO says.
Labour leader Chris Hipkins today said Labour was open to introducing mandates for minimum staffing levels. "
https://www.nzno.org.nz/about_us/media_releases/artmid/4731/articleid/7304/all-parties-must-commit-to-nurse-to-patient-ratios-for-patient-safety
Listening to a finance professor from the UK who summed it up in 2 words 'grow up'.
Same issue there as here which he summarised as '…you can want a scandanavian welfare, health and education system, this isnt compatible with a US based tax system….'.
The piper has to be paid, theres no free lunch.
Hospital nurses are awesome and the NZ Nurses Organisation does awesome work!
They have to use data obtained under the Official Information Act, analyse it, and make it work hard.
https://www.scoop.co.nz/stories/GE2610/S00053/starship-oncology-ward-short-staffed-85-of-all-shifts-in-august.htm [data are also presented in graph and table formats]
Sadly, these big issues are not limited to the oncology ward at Starship Children’s Hospital.
https://www.scoop.co.nz/stories/GE2610/S00062/te-whatu-ora-must-fully-staff-vital-starship-childrens-hospital-wards.htm
Among other things, the above problems show that National’s targets are bogus and misleading the public. For example, Ian Powell has debunked National’s target-approach to Health NZ many times.
Though tax economists may complain, the real magic to me is hypothecating Labour's CGT to dealing with our growing health bill.
Treasury modelling suggests healthcare and pension costs will continue to increase as New Zealand's population ages, and laready is. (Binning et al., 2026)
The alternatives include higher income taxes, greater reliance on GST, borrowing, spending cuts, new tax bases or some combination of them.
Each option has trade-offs.
Higher income taxes can make the tax system more progressive, but may affect incentives to work or invest.
GST provides a broad and reliable tax base, but consumes a larger proportion of the income of lower-income households.
Borrowing can spread costs over time, but increases debt and leaves future taxpayers to service it.
Spending cuts may reduce expenditure but can also mean fewer or lower-quality public services.
Other tax bases, such as environmental or wealth taxes, could diversify government revenue but bring their own political and practical difficulties.
Each choice also distributes the burden differently. Higher income tax places more of it on workers. Higher GST spreads more of it across consumers. Borrowing shifts part of the cost onto future taxpayers. A capital gains tax places more of it on owners of appreciating assets.
There is no option in which the cost disappears.
That creates an intergenerational issue as New Zealand's population ages. So Labour is facing it squarely.
If increasing health and retirement costs are met primarily through taxes on wages, a greater proportion of the burden falls on the working population.
If governments borrow instead, some of that burden is transferred to taxpayers in the future.
A CGT shifts some of it towards people whose assets have increased in value.
None of those choices is automatically fair.
National's answer is to meet health pressures through existing revenue, economic growth, savings and spending restraint.
Labour argues some of the future cost should instead be met by taxing gains from residential investment and commercial property.
“Labour argues some of the future cost should instead be met by taxing gains from residential investment and commercial property.”
Which pre-supposes that there will be sustained capital growth in these areas. Not something I actually want to see.
Property rises in future will be gradual, unlike last 20 years.
I think Labour are providing gradual permanent funding, just like petrol tax to transport.
I can't help but wonder which party is going to commit suicide in the future by removing fuel tax and make RUC universal.
And that has to happen.
I think its been well-signalled that change is on the horizon towards RUC – from this government.
Of course, a pesky election got in the way 🤣
aj
Of course, fuel tax penalizes the greatest polluters. If you drive an inefficient, gas-guzzling car, with low mileage to the gallon (sorry, kilometerage to the litre doesn't have the same ring) – you pay for the privilege. That's not the case for RUC.
That doesn't mean a carbon charge can't be added to fossil fuels in the future. The roading levy on petrol was a rather crude and sideways way of punishing gas guzzling polluters. There's also plenty of scope for RUC to differentiate between smaller and larger cars to encourage a move to smaller, especially in cities. Combine that with time of use charging and some good changes might be possible to our love of cars, and love of big cars.
The full RUC change starts late 2027, rolls a couple of years.
So, for those who missed the news last night about the Emergency Department at Wairau hospital here is the RNZ report.
It will be interesting to see how much this costs the local National MP, Stuart Smith. In 1999, the forced sale of local publicly owned and profitable power generation cost National so much that the Marlborough end of the Kaikoura electorate voted Labour for candidate and Party, so much anathema was it to the locals.
Now we have a hospital in a small town in a large province being the unwelcome recipient of national news reportage- unwelcome to residents who as patients are seen as now in danger and who rely on a local hospital when the nearest hospital is over a 100 km away over a range of hills or across the seas of the Cook Strait- unwelcome for the two local Coalition MPs, Smith and NZF's Arbuckle who will bear the brunt of this failure of a vital health service.
https://www.rnz.co.nz/news/health/2020930/patients-in-danger-from-understaffed-emergency-department-doctors-say?