The unenviable health dilemma

Most of the time I have little to do, touch wood, with our health system. However, a couple of recent incidents involving friends and family have reacquainted me. My entirely unscientific view is that while we are lucky to have a public health system rather than an insurance-based private system, we could do much better.

Funding bureaucracy dominates the lives of many patients, not always with the best outcome. Social workers are run off their feet. Nurses, who haven’t had a decent pay rise in ages, recently rejected a paltry two per cent pay offer.

It has also been revealed that necessary spending on infrastructure has been delayed by a number of district health boards because they were under such pressure from the previous government to show an operating surplus.

Even though the Labour Party pledged $8 billion to health during the election campaign, Health Minister David Clark thinks that won’t be enough. It is estimated that $14 billion will be needed over the next 10 years for infrastructure alone.

Jacinda Ardern has found health finances are even worse than she expected. She identified $10 billion worth of capital expenditure needed whereas the previous government set aside just $600 million.

The word ‘crisis’ is now being used in the health sector. So how on earth did we get to this point?

The previous National government would rightly argue that it spent billions on health. Spending increased under its watch, but was it enough to meet rising demand? With failing infrastructure and frustrated salary workers who haven’t had a raise of ages, I would say no.

David Clark reckons National deliberately ‘sweated’ public assets and kept DHB funding low in order to help promote the private health system. Get more people using private health and that puts less stress on public health.

So what’s the solution? Ask most health professionals and they would suggest a substantial investment in infrastructure and pay rises for hospital staff, especially nurses and those at the bottom. But given about 60 per cent of health expenditure is for salaried staff, that is a considerable cost, even though I suspect most voters would support it.

And that is the problem for this Government. They may want nurses and others to be paid fairly, but where is the money coming from? During the election campaign, Ardern and Grant Robertson were at pains to point out they wouldn’t touch the corporate tax rate or John Key’s 2008 tax cuts for the wealthy.

This reticence to change the wealth distribution might have helped them get elected but now they either have to find the money elsewhere or disappoint underpaid nurses, many of whom would have voted for them.

So that’s the unenviable health dilemma that this Government faces over the next three years. But if they can invest in public health, get our DHBs and their staff onside and get the system out of crisis, then thousands of New Zealanders will show their appreciation at the ballot box.

A well-funded and efficient health system would make lattes at Astoria, Russian spies and incompetent supervision of Labour Party camps pale into insignificance in the minds of most voters.

And though we need to increase health funding, let’s also remember that it’s not only about money.

As the three lovely Kenepuru nurses who sang happy birthday at the foot of the hospital bed to my sick relative recently reminded me, happy patients recover more quickly and happy staff make hospitals run far more smoothly.