Cost cuts are causing pain in health care
OPINION: The 24/7 news churn means that events often get reported in isolation when arguably, they’re better seen as part of a pattern.
For instance, the public health system has lately experienced a cluster of events symptomatic of a wider malaise.
Someone in Canterbury is needing to wait a year for surgery. A 72-year-old in Auckland has been in agony with bones scraping together while waiting for a knee replacement. Someone with an infected open wound had to wait seven hours in a hospital A & E ward. Someone else died because of an incorrectly inserted breathing tube.
Surely, these are signs of a system under profound stress.
Not at all, Health Minister Dr Shane Reti claimed while defending the $105 million in further cost reductions that the government is imposing on the public health system.
“None of these cost-saving measures,” Reti said, “will impact the level of care patients receive.”
Health New Zealand chief executive Margie Apa chimed in that the savings drive was “reducing the overspend, not making cuts.”
Few New Zealanders will be feeling receptive to such messages.
Meanwhile, and out on the hospital front lines, overtime has been frozen and contract renewals are being deferred.
This frugality will raise the risk of New Zealand losing more of its trained specialists and nursing staff to more stable and better-paid employment conditions overseas.
Previously, because of reduced capacity linked to understaffing, some urgent healthcare was being contracted out to private health providers, leading to cost overruns. Reportedly, contracting out will also now be discouraged.
To state the obvious, forcing a new round of funding austerity onto the public health system looks short-sighted.
Our population is ageing, rapidly. The number of New Zealanders aged 65-plus is sharply increasing, leading to greater complexities in patient care. More patients are presenting with chronic and multiple illnesses, thus generating additional cost pressures across the entire health system.
Already, there are calls for the government (a) to subsidise a wider range of expensive drug treatments for conditions that afflict a minority of patients,
(b) to fund the capital building needs of a crowded hospital sector, and (c) to fund the purchase of the big-budget equipment required for modern diagnosis and treatment.
Similar pressures are being replicated in the nursing workforce. Nurses are the front-line carers in hospitals, and in aged care facilities and other long term care institutions.
Yet many internationally trained nurses able and willing to work here are being prevented from doing so –sometimes because the jobs promised to them by immigration agents do not exist, and sometimes because of the funding constraints in public health.
In addition, nurses provide expert support in primary care settings and increasingly, in home care situations. Despite these snowballing health needs, the government appears determined to impose a hiring freeze and funding cuts across the health system – seemingly, in order to deliver tax cuts likely to further undermine the government’s ability to meet such needs in future.
In sum, the government’s promise that its public service cuts will not affect front line services looks less and less credible, and the political impact is already evident in the polls.