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Posts Tagged ‘health’

Cuts to public services- more misleading from Key

Posted by Grant Robertson on November 2nd, 2011

A very interesting story in the Manawatu Standard today where John Key is accused of misleading the New Zealand public. The accusation does not come from a Labour politician, it comes from a health professional.

A leading injury rehabilitation specialist has lashed out at comments made by Prime Minister John Key, saying he has misled the public over cuts made to the health system. Rehabilitation medicine consultant physician Jurriaan de Groot said he was left outraged at a statement made by Mr Key in a televised leaders debate that only administrative jobs had been cut from the public health service.

This is the mythology that the National Party have tried to create. The fact is that they have no idea whether the jobs that have gone in the core public service or the wider state sector are frontline, back office or any other term. They are just the result of indiscriminate cuts. In this case services delivered for rehabilitation.

Dr de Groot said the slashing of MidCentral District Health Board’s rehabilitative Star Unit from 12 beds to eight, proved Mr Key was “wrong at best, deliberately misleading at worst”. “It certainly wasn’t just administrative services that were cut from there, the hospital lost a valuable resource expertise and they’ll never get it back.”

Throughout the health sector cuts in funding have caused lost services. This was the result of $10 million being taken from a budget. In other places its been mental health or youth health or public health.

I am really glad a medical professional has called out the misleading from the government on the real impact of cuts to services. Many have been scared as to what will happen to them when they speak out. Good on Dr De Groot.

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Filed under: health, public services
10 Comments

Improving ACC #1

Posted by Chris Hipkins on May 23rd, 2011

Over the weekend I blogged about Nick Smith’s manufactured crisis in ACC. National’s agenda is pretty transparent. They’re trying to soften up public support for our excellent accident prevention, compensation and rehabilitation scheme as they prepare to privatise it. Labour will strongly oppose National’s plan to carve up ACC and hand it over to the private insurance industry.

But we’ll also be looking at how we can improve the scheme that we have now, because although we think the system overall is a sound one, we agree that it could be even better. Over the past few months I’ve been meeting with a wide range of ACC stakeholders, from claimants and their advocates through to medical providers and medical assessors.

One of the issues that I’ve become increasingly concerned about is the lack of independence in the specialist medical assessor process. It’s pretty clear to me that ACC have some “tame” medical assessors who are giving them the result that ACC wants, rather than the one that is in the claimant’s best interests.

In some cases, these assessors are working almost exclusively for ACC, making them reluctant to bite the hand that feeds. I’ve also met with specialists who have been all but ‘black listed’ by ACC because they haven’t been willing to give them the assessment results that they want.

So the question I’ve been contemplating is whether we need a bit more independence in the ACC medical assessment process. Should specialist assessors be required to be ‘current practitioners’ in the field they are assessing? Should there be a limit on the proportion of a specialist’s work that can be ACC assessments? Should claimants be given more ‘choice’ over who they go to for specialist assessments?

I’m interested in your views and your stories. Like I said above, I think ACC is a very good system and I’d hate to see it carved up as National want to, but that doesn’t mean I’m not willing to debate how it can be constructively improved.

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Filed under: ACC, health
9 Comments

Why would the Minister of Health not want a debate?

Posted by Grant Robertson on May 13th, 2011

Not too long after I became Health Spokesperson the Association of Salaried Medical Specialists (the senior doctors union) invited me to participate in a debate with Health Minister Tony Ryall at their annual conference. They were getting in early as the conference is not til November, but they rightly reasoned that if they locked us in now they would ensure we were there in the election campaign.

I was a bit disappointed then, when I got the message this week that the debate was off. I will let ASMS tell the rest of the story

At its February meeting, recognising that it is election year and that the Conference will be held in the penultimate week of the election campaign, the Executive resolved to invite the Minister of Health Tony Ryall and recently appointed new Opposition (Labour) health spokesperson Grant Robertson MP to participate in a debate on the ‘future direction of the health system and the role of senior doctors in it.’ However, while Mr Robertson accepted the invitation, Mr Ryall did not, instead stating his availability to speak in a separate stand-alone session at Conference but not participate in the proposed debate.

Now, I know can be a little bit scarey, but I would have taken it easy, honestly.

So, Tony, here it is for the record, your chance to re-consider, and let’s have a debate. After all that is what elections are all about.

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Filed under: Elections, health
12 Comments

The role of public health

Posted by Chris Hipkins on August 19th, 2010

My good friend Dr Ayesha Verrall has written a really interesting post over at Policy Progress on the appropriate role for the public health system. Ayesha argues that the public health system exists not just to care for the sick, we should also view health as an investment and as a social determinant.

In terms of investment we need to see the value of a healthy population and workforce. Health is a public good and we should see the benefits of health care to our wider society that are far wider than simply ameliorating suffering. Health as a social determinant  looks at the linkages between health and other factors such as socio-economc status, social isolation and so forth.

Ayesha advocates a greater focus on preventative health care, but also points out how this can challenge the agreed role of the state:

“…different approaches to health care may prioritise treatment on the basis of need (the most sick), or treatment based on ability to benefit (often less sick) through to prevention (not sick at all). In extending the scope of the health system to prevention, one intervenes in the lives of the healthy. Those the subject of preventive medicine aren’t sick, don’t feel sick and may not agree with authorities that it is worth their while participating. As progressives seek to do more through preventive medicine, we test the boundaries of the agreed role of the state. The benefits of intervention may take generations to materialise and – when they do they appear as statistical phenomena – represent decreasing rates of disease, rather than individuals who can point to concrete services creating improvement in their lives.”

The last Labour government increased the focus on preventative health care, but many of the steps we took have been reversed by the new National-led administration. I strongly believe that we’re far better off investing in programmes that keep us healthy rather than focusing on putting more ambulances at the bottom of the cliff. But as Ayesha points out, we have to carefully consider where the appropriate role of the state starts and ends.

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Filed under: health, public services
5 Comments

Government Department Performance

Posted by Grant Robertson on June 8th, 2010

This morning’s Dom Post has an interesting piece previewing the Trans-Tasman ranking of government agencies.

I am somewhat sceptical of these kinds of rankings. An awful lot depends on who the panelists were who picked them. But it is interesting nonetheless.

Some of it certainly correlates with my experiences. I would lay a fair bet that Peter Hughes from MSD may well be awarded their best Chief Executive. He is a class act, who is responsive and innovative. Another agency that I think is in fact underrated is DOC. I think Al Morrison has had them running pretty well lately.

On the downside I think Education’s position reflects a Ministry really struggling with a Minister who confounds them at every turn. When I was in the PMs office we used to award a Ministry each week who put forward the most impenetrable language in a Cabinet paper. Education, ironically, often took out the award. But that was before Karen Sewell took over, and I think she has been good.

Health is definitely facing challenging times. The placement of the National Health Board inside the Ministry with Tony Ryall’s hand-p[icked guy Murray Horn running it is definitely causing confusion and unclear lines of accountability. Whoever takes over from Stephen McKernan has to accept an interfering Minister and a “fox in the hen-house.”

In any case good on TransTasman for being interested in how Ministries and Departments are being run. Its important for all of the public services we use every day.

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Filed under: public services
29 Comments

A nation of couch potatoes?

Posted by Chris Hipkins on July 17th, 2009

Worrying new data released by the OECD this week shows one in four New Zealanders are overweight. All of us pay for the health-related costs of that. Obesity is one of the major health risks facing New Zealanders, but National has taken a knife to initiatives to combat this growing problem.

So far the Government has cut funding to the Obesity Action Coalition, is threatening to remove Fruit in Schools, has dumped reducing obesity as a health target and has cut nearly $5 million from the diabetes ‘Lets get Checked’ budget. They’ve pulled the plug on healthy food in schools, cut budgets for Mission On and Push Play, and no doubt there is more to come.

Without appropriate intervention it has been estimated there could be up to 180,000 New Zealanders living with Type 2 Diabetes by 2011. One dollar spent on preventing obesity is repaid many times over in the long-run. So what is the appropriate role for the state? Should we focus on preventative measures or simply wait until people become dependent on the ‘nanny state’ for their healthcare?

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Filed under: health
31 Comments

So What if Workers Die

Posted by Trevor Mallard on July 14th, 2009

NOHSAC (National Occupational Health and Safety Advisory Committee) is to be abolished.

So what I here the voices cry. Well because it is a small useful group doing good work helping set priorities for research and commissioning some that is designed to reduce what has been a shocking record when compared to like nations.

It was set up in 2003 and gave independent academic and evidence based  advice to the Minister of Labour.

In my brief term I found the work they did in the area of occupational illness fascinating – it certainly raised some real issues around the health/ACC interface/boundary that we need to look at seriously at some stage – both for our long term health as well as for equity reasons.

At the same time the Nact government has taken the slasher to health and safety training both in institutions and workplaces.

What does not surprise me is that neither Kate Wilkinson nor Anne Tolley had the backbone to issue a media statement announcing the cuts or thanking people for a lot of mainly voluntary work well done.

It is like they just don’t care if more working people die.

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Filed under: Budget, national
7 Comments