Crisis everywhere in health system

Afew weeks ago, a car crashed at our front gate. For someone whose job is communicating, I was embarrassingly incoherent on the phone to 111. I dithered when they asked whether I needed ambulance, fire or police; luckily, they sent all three.

Living in a rural area, with a permanent population of fewer than 2000, I wasn’t sure how quickly the emergency services would respond. But I was hugely reassured.

The town siren was already sounding when I hung up the phone. First on the scene were the local volunteer fire brigade – who were there within minutes – quickly followed by police and ambulance. About 20 minutes later a rescue helicopter landed in our front paddock to take the driver to hospital.

It was an impressively well-oiled machine. Yet except for police, every one of the organisations that responded – fire, ambulance, rescue helicopter – is reliant to a greater or lesser extent on donations and or volunteers to maintain a level of service. Most are struggling to keep up with demand, as is the rest of our health system – whether it’s hospitals, mental health services, respite and palliative care, community and disability health services, midwifery, district health nurses, drug funding or our shrinking population of rural GPs, it seems like every part of the system is in crisis.

This week, the Government will announce farreaching changes to the health system; there will be winners and losers. It is inevitable that it will become a political football.

But something has to change. After Covid, I think we were all shocked to learn the country had only 200 ICU beds. Meanwhile, there seem to be horror stories every day: people waiting hours to be seen at A&E; stretchers lined up in corridors.

It’s not for lack of money; the Government throws $20 billion a year at the health sector – 20c in every dollar it spends. The bulk goes to district health boards, which seem to be struggling with mounting deficits, and whose elective surgery waiting lists have become bastions of false hope. Then there are those who never make it to the waiting list – people who are forced to live with debilitating pain because they are classified as not sick enough for surgery.

None of this is new; today is the third anniversary of my mother’s death from cancer. Her journey through the health system in the three years after her diagnosis was an eye-opener; so many people were wonderful, so many others were overworked, stressed and frustrated. And so many parts of the system seemed a little bit broken – like the bulging paper file that accompanied Mum from ward to ward.

When she was admitted to Hutt Hospital, they had to mail down a copy of the file. When I asked about iPads or laptops, the doctors and nurses laughed.

Recent Governments have shied away from root and branch reforms; they were mindful that constant change and restructuring in the 1980s and 1990s had left behind a shell-shocked and reformweary workforce.

But the case for change is becoming urgent.

It is inevitable that health reform will become a political football. But something has to change.