Gordon Campbell on 90s retro proposals for our health system 28 Jul 2015
Related articles
- Minister launches SmartGate in Wellington Travel
- Brownlee Leads Aviation Mission To Shanghai News
- Sludge Report #192: The Naked Budget Columns
- Budget 2010 – Building the Recovery News
- Budget provides $321m for RS&T activities News
- Licensing To Cut Out Cowboy Advisers Migration
- Gordon Campbell: RWC fever, Obama's Supreme Court Columns
- Government Widens Drought Assistance News
- Young People Take Over Parliament News
- Actions For Young Driver Safety Get Green Light News
Gordon Campbell on the 1990s retro proposals for our health system
Reviews are under way that could transform the New Zealand health system into our very own version of the Eurozone, whereby DHBs that fail to meet their budgets will be treated like Greece, and punished accordingly. As we learned yesterday, the reviews propose that the democratically elected representation on DHBs should be reduced, such that community wishes will be able to be over-ridden by political appointees. In today’s revelations, the reviews also propose a return to the destructive competitive health model of the 1990s. Funding would flow to the best performers and be withheld from financially underperforming DHBs – and the door would be opened for private providers to cherry pick the most profitable bits of the service in regions that fail to meet their budgets.
So far, the details of the review process – led by former Treasury secretary Murray Horn – remain sketchy. What RNZ has obtained is a three page Health Ministry précis of a more comprehensive review. (That same precis has been sent to the chief executives of each of the country’s DHBs who, reportedly, have not yet seen the wider document.) The retro nature of the proposals is hardly an accident. Horn was a leading figure at Treasury during the 1980s and was Treasury Secretary during the National government’s health, welfare and labour reforms of the 1990s. Some of the worst aspects of those early 1990s health reforms look set to be re-introduced:
The review reveals the Ministry of Health would hand out funds to DHBs on achievement of planned milestones. If those targets were missed the money would be withheld, and would then go to other providers. Four pools of funding would also be created under the plan….
Those four pools of funding would be dispensed by central government according to its “milestone” priorities – which, as mentioned, will have been rendered immune to alteration by the communities affected, thanks to the proposed changes to DHB board representation revealed yesterday.
These extreme measures might be justified if health funding was running out of control. Certainly, the government spin machine works overtime to create the illusion of a rapacious health system gobbling up more and more funds. In fact, the health system has been systematically underfunded for the past five years, and the difficulty that some DHBs are having in meeting their budgets is a direct reflection of that reality. As I pointed out at the time of this year’s Budget:
Some $320 million of extra funding has been set aside in the coming year for DHBs. Yet according to the Association for Salaried Medical Specialists, the amount for spending on health services is…..actually $260 million below what’s required merely to maintain the status quo in the public health system, given (a) a projected population growth of over 2% (b) rising costs for new technology and pharmaceuticals and (c) rising salary costs, now that pay levels in public health have been allowed to fall substantially behind those in the private health sector.
So…. rather than an
adequate response to the healthcare needs of an ageing
population that is already suffering from large swathes
of unmet need, Budget 2015 offers a recipe for further
cutbacks by DHBs in the range and quality of the services
that they currently offer.
On paper, the
further cutbacks that the DHBs will now need to pursue will
have been compounded by the new services announced in the
Budget. These include $98 million more for elective surgery,
$12.4 million for extending a bowel cancer screening pilot (
but no national screening programme) and $76.1 million more
to hospices for better end-of-life care. ….In sum, this
still means that the 20 DHBs will be expected to meet their
new challenges from a shared pool of only $300 million in
new funding, or $15 million each. That is patently
insufficient at a time when – as mentioned – the public
health system is under extreme cost pressure, and when major
health needs in the community are already going unmet.
The underfunding of public health is quite deliberate, and is being ideologically driven:
There is no evidence that the cost of our health services is outpacing the country’s ability to pay for them. In fact, Vote Health has been declining as a proportion of GDP since 2010, and that ratio will decline further in the wake of this Budget. Meaning : We do not face an ever-expanding level of spending on Health needs. Instead, public health is receiving an ever-declining share of an expanding economy. In this year’s Budget, if the allocation for Vote Health’s operational funding had been allowed the same ratio of GDP that it enjoyed in 2009/10, there would have been an additional $1.2 billion in operational funding. See the evidence here and also here.
This is the real problem in the health sector: the chronic and systematic government underfunding of health, during a time of rising patient need. (Also: planning for an ageing population will be virtually impossible in the climate of short term, budget-driven competition that the Horn review is proposing.) The funding shortfall in the public health system is glaringly obvious to everyone who works in it and everyone who uses it. Unfortunately, all that the Horns of the world can do is (a) suggest ways to further tighten the funding screws, and (b) create a fresh raft of profit opportunities for health corporates. Hey, forget Greece as an analogy. This is more like one of those zombie movies where the undead from the 1980s and 1990s come lumbering back into view. It reviews. It cuts funding. It enables its own. It follows.
Song for Today
And in that same 1990s spirit, here’s a song for Murray Horn, and for the grand old crew at Treasury...
News
Hilary Timmins' Award-Winning UK Documentary Series To Inspire NZ Students
29 Jun 2020 Education
Dream Catchers, produced and directed by Hilary Timmins, celebrates the success stories of more than thirty inspirational New... more
New Zealand reaffirms support for Flight MH17 judicial process
7 Mar 2020 News
Ahead of the start of the criminal trial in the Netherlands on 9 March, Foreign Minister Winston Peters has reaffirmed the need to... more
Business
NZ Government's Economic package to fight COVID-19
17 Mar 2020 Business News
The Coalition Government has launched the most significant peace-time economic plan in modern New Zealand history to cushion the... more
NZ Government announces aviation relief package
19 Mar 2020 Business News
Transport Minister Phil Twyford today outlined the first tranche of the $600 million aviation sector relief package announced earlier... more
Living
Diversity was Key at New Zealand Trade Tasting in London
6 Jun 2022 Food & Wine
New Zealand Winegrowers Annual Trade Tasting was recently held in London, on Wednesday 4 May, in Lindley Hall.
It was the first... more
Kiwi author stuns Behind the Butterfly Gate
12 Jan 2022 Arts
Hidden behind the Butterfly Gate is where the secret has been kept for 76 years...
New Zealand writer Merryn Corcoran’s... more
Property
Fairer rules for tenants and landlords
17 Nov 2019 Property
17 NOVEMBER 2019
The Government has delivered on its promise to the over one million New Zealanders who now rent to make it fairer... more
New Zealand Government will not implement a Capital Gains Tax
17 Apr 2019 Property
The Coalition Government will not proceed with the Tax Working Group’s recommendation for a capital gains tax, Jacinda Ardern... more
Migration
Boosting border security with electronic travel authority – now over 500,000 issued
19 Nov 2019 Migration
19 NOVEMBER 2019
We’ve improved border security with the NZeTA, New Zealand Electronic Travel Authority, which helps us to... more
Christchurch reinstated as refugee settlement location
18 Aug 2018 Migration
18 AUGUST 2018
HON IAIN LEES-GALLOWAY
The announcement that Christchurch can once again be a settlement location for refugees... more
Travel
Gallipoli Anzac Day services cancelled
19 Mar 2020 Travel & Tourism
The New Zealand and Australian Governments have announced this year’s joint Anzac Day services at Gallipoli will be cancelled... more
New Zealanders advised not to travel overseas
19 Mar 2020 Travel & Tourism
New Zealanders advised not to travel overseas
more
Sport
The Skipper's Diary: Sir Richard Hadlee honouring his father and NZ's Forty-Niners
27 Oct 2019 Cricket
NZNewsUK London Editor Charlotte Everett spoke to Sir Richard Hadlee about why he’s chosen to publish his father’s... more
PREVIEW: All Blacks v England semi-final
26 Oct 2019 Rugby
The two most convincing quarterfinals winners are set to square off in a semifinal showdown for the ages when the All Blacks meet old... more
Columns
Gordon Campbell on the Gareth Morgan crusade
11 Nov 2016 Opinion
Gordon Campbell on the Gareth Morgan crusade
First published on Werewolf
The ghastly likes of Marine Le Pen in France and Geert ... more
Gordon Campbell on the US election outcome
10 Nov 2016 Opinion
Column - Gordon Campbell
Gordon Campbell on the US election outcome
Well um.. on the bright side, there (probably)... more
Kiwi Success
Congratulations to Loder Cup winner
26 Sep 2018 People
25 SEPTEMBER 2018
The Loder Cup, one of New Zealand’s oldest conservation awards, has been awarded to Robert McGowan for 2018... more
Appointments to New Zealand National Commission for UNESCO
16 Aug 2018 Appointments
16 AUGUST 2018Appointments to New Zealand National Commission for UNESCO
HON JENNY SALESA
Associate Education Minister Jenny Salesa is... more
Recruitment
Historic pay equity settlement for education support workers
14 Aug 2018 Recruitment
14 AUGUST 2018Historic pay equity settlement for education support workers
RT HON JACINDA ARDERN
HON CHRIS HIPKINS
Prime Minister
The... more
Historic pay equity settlement for education support workers
22 Aug 2018 Recruitment
14 AUGUST 2018Historic pay equity settlement for education support workers
RT HON JACINDA ARDERN
HON CHRIS HIPKINS
Prime Minister
The... more