Patients first, not budgets

One must applaud the new Government for one of its new health targets, namely faster cancer treatment — that 90 per cent of patients receive cancer management within 31 days of the decision to treat.

The trick will be for GPs to get their patients to the point where they may be one of the 90 per cent of people to receive cancer management. Judging from a note I read, GPs obviously get told off by their hospital surgeon superiors should they dare advocate for their patient for speedier and more advanced assessment and treatment within the system.

One wonders if people are kept out of the public health system for as long as possible for cost or age reasons.

MRI scans, for example, are obviously expensive, yet able to detect an issue more accurately rather than blood tests and biopsies but screening a patient that way is probably expensive and therefore used as a last resort.

Patients possibly end up with depression and anxiety and other mental disorders on top of possible serious health conditions, which could worsen quickly while they wait to be seen and assessed by the public health system.

Perhaps an additional goal should be that 90 per cent of patients receive cancer treatment within 31 days of an initial assessment by their GP, the use of modern technology to be used first to diagnose the required treatment before other intrusive testing regimes, treatment not to be determined by ethnicity, age or cost.

One would suggest that by doing so, the patient is considered first and not hospital budgets — the cost benefit would be that people are treated quickly and earlier and not require expensive and long-term treatment in a hospital bed.

John Riddell, Massey.

public sector pushback

Kate MacNamara (NZ Herald, April 4) highlights the large number of new public service employees engaged late last year when the Government was already signalling its intention to cut costs.

Although there is some balance in a moderate reduction in the use of consultants and contractors, the continued expansion of public service employees is difficult to reconcile in light of the change of administration and its stated aims. In the immediate aftermath of the election, it also came to light that contracts were being finalised and signed to engage senior staff and long-term leases of office space signed and sealed for Three Waters administration despite the inevitable demise of the policy.

Are these examples of cynical politics on behalf of the defeated Government or a public service driven by self-interest in the best tradition of Yes Minister ? Or disregard for the best interests of taxpayers by both sectors of government?

George Williams, Whangamata¯ .

Blatant bureaucrats

The bureaucrats are alive and well and making any central or local government enactment of changes almost impossible.

Recent examples are continual hiring of civil servants at the back end of 2023: the Ministry of Social Development (405 fulltime employees), MBIE (365) and IRD (363), despite the coalition saying that the number of employees in the civil service needed to decrease; the Northland Transport Alliance continuing to decrease speed limits in that region, despite Simeon Brown giving instructions to the contrary; Auckland Transport still making all public transport announcements primarily in te reo despite Christopher Luxon saying that these will revert back to English first, and KiwiRail only cancelling the new ferry build contracts over two months after they were instructed to by Nicola Willis.

This blatant snubbing of policy by the bureaucrats has sunk governments in the

past. Hopefully this coalition is not another casualty.

John Roberts, Remuera.

grim picture

Setting policy on taxation and government fees can be complex, but on two points common sense and economic orthodoxy are completely aligned.

Firstly, good policy aims to incentivise behaviour with wider benefits for society, while discouraging actions with negative outcomes. Secondly, where practicable, those with greater means should pay as much or more than the less well-off.

Under the new charges levied on electric vehicles, however, the Herald reports EV owners will pay 23 per cent more per kilometre in road-user charges than the owner of a similar petrol vehicle pays in fuel excise duty; and drivers of older, cheaper plug-in hybrid vehicles with low-range batteries will pay the most.

It’s no wonder that new EV sales have plummeted from 27.2 per cent to 9.3 per cent of new car sales. That statistic paints a grim picture for our children and grandchildren, because these new vehicles — whether emissions-free or greenhouse gas emitting — will be on our roads for the next 15 to 20 years.

What’s next? Will this Government remove alcohol and tobacco excise tax, increase GST on fruit and vegetables, and make community service card holders pay higher prescription fees?

Stephen Bayldon, Mt Roskill.