Red Alert

Posts Tagged ‘Health Select Committee’

Subsidised Private Healthcare

Posted by Iain Lees-Galloway on June 22nd, 2010

Peter Dunne and Southern Cross Healthcare want the Government to subsidise private health insurance.

Superficially, the argument that incentivising the use of private healthcare (specifically elective surgery) in the hope that it will reduce the burden on the public system and cut waiting lists makes sense.

But, like so many ‘common sense’ policies, a closer look at the details reveals more than a few fishhooks. To me, there are two principal problems with this policy: Workforce capacity and acuity.

The fact is that most surgeons working in the private sector also work in the public sector. There isn’t a bunch of bored private sector surgeons sitting around awaiting a flood of subsidised patients to come through the door. Until that changes, sending more patients to private surgical hospitals will simply draw resources away from public hospitals, exacerbating the situation for those who cannot afford health insurance. That will increase health inequalities, a concern expressed yesterday by health economist Robin Gauld.

Then there is the problem of complicated surgeries. Private hospitals only take the most straightforward cases. That is not meant to be a disparaging comment, it’s just a fact that private hospitals are not set up to deal with additional complications that may arise from other conditions the patient may have – it’s not their core role.

So, many people (particularly older people) with insurance will still need to use the public sector in order to get the additional care required to get them safely through the surgery.

Australia has strong incentives for those earning over $100,000 to take out private health insurance. This was a topic of discussion on the recent Health Select Committee visit to Australia. One of their ministry officials told the committee that many people who take out insurance will still often use public hospitals precisely because of the additional care that is available. His personal view was that the effective relief on the public system is negligible.

There is a role for the private sector in health care. But if there is money to spend in the health system, there are more cost-effective and future-focussed places to put it than private surgical hospitals.


Ryall won’t answer the obvious question

Posted by Iain Lees-Galloway on June 16th, 2010

Tony Ryall appeared before the health select committee this morning to answer questions on the health budget.

I put it to him that the fact that DHBs are cutting frontline services tells us that the small increase in the health budget is not enough to cover the cost of maintaining current services.

So I asked him if he thought that reducing the supply of health services would reduce the demand. (ie if you take the service away, will the community suddenly no longer require it?).

He completely avoided the question instead choosing to talk about his pet projects. When I attempted to get him back on track, the chairman, Paul Hutchinson, shut me down.

Put simply, health services for those who need them are not a priority to this Government.  National’s priority is tax cuts for those who don’t need them. No wonder the Minister is so evasive.


Westminster Delegation – Day 2 Part 1

Posted by Iain Lees-Galloway on June 24th, 2009

If I covered every aspect of day two this would be an excruciatingly long post so here’s a quick run down of the itinerary and a bit of detail on a couple of things. Carol Beaumont will also post on her highlights.

We met with three MPs to discuss current issues in UK politics. We then had a presentation on community cohesion and urban regeneration. Next was a visit to MP Betty Williams’ office followed by a reception and lunch at the House of Lords hosted by Lord Speaker Rt Hon Baroness Hayman. After lunch was a briefing on pay and allowances and standards in public life, then a meeting with Rt Hon Kevin Barron, Chair of the UK Health Select Committee. The day ended with a briefing on UK security and counter terrorism.

Expenses and allowances dominated almost every conversation (the record for not discussing it was 40 minutes at the counter terrorism briefing). As one MP put it in our first session – “there is no political scene at the moment. We are absolutely paralysed by the expenses issues.” Whilst there are many examples of inappropriate claims, there is a bit of a media beat up going on too. Notorious claims like the moat and the duck house, for instance, were never actually paid out. But change does need to happen.

Interestingly, those changes look as though the UK system will start to look very similar to our own system. Use of the second home allowance will be more restricted (as ours is to hotel bills, rent or mortgage interest) in fact possibly so restricted that it will be impossible for MPs to cover all of their costs if they rent or purchase a home near Westminster, which is perhaps going a bit far.

Employment of staff is quite different here. Staff are employed directly by MPs who draw on an allowance pool to fund their staffing costs. It is more flexible in that MPs can decide how many staff they want and what they will pay them (within a set allowance cap) but also more open to abuse or at least the appearance of abuse than our system of set staffing numbers who are employed by parliamentary services. The MPs here were interested in our system, but a bit reluctant to make the change although I expect they will end up having to do it anyway.

As you might imagine the Health Select Committee meeting was a highlight for me. What I found particularly interesting is that the Government MP chairing the committee had no problem whatsoever using the committee to thoroughly scrutinise, criticise and make recommendations to the executive of his own Government in a way that is not quite so apparent in our system. He is proposing a comprehensive select committee inquiry into Social Care (more or less what we think of as Aged Care) to create a document that can inform the policies or any future Government over the next twenty years.

The UK Health Committee recently came to NZ (we met them briefly) to study PHARMAC, Alcohol policy and issues, Patient Safety and ACC. Basically as far as I can tell most of the health issues we are dealing with, the UK is grappling with too. That includes my particular interest at the moment, Tobacco Displays.

Right, time to stop. This is getting too long and I need my breakfast.