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ASSM: Fingers crossed for the budget

Fingers crossed for the budget our public hospitals desperately need, say senior doctors

“Public hospital specialists are desperately hoping the first Budget from the new coalition government will make a real difference to waiting lists, high levels of unmet health needs and the increasingly bare cupboards,” says Lyndon Keene, Director of Policy and Research at the Association of Salaried Medical Specialists (ASMS).

The Council of Trade Unions and ASMS have released a joint analysis of the levels of funding required in Thursday’s Budget to maintain public health services at both their existing levels and to improve services further.

CTU Policy Director/Economist Bill Rosenberg and Lyndon Keene estimate the Health vote’s operational expenses need to rise by around $805 million (or 5%) simply to maintain the level of health service we already have. That figure climbs to $1,021 million (or 6.3%) when a number of the Government’s election commitments and additional costs such as pay equity for mental health and addiction care workers are taken into account. The full joint CTU-ASMS analysis is available at

“These are big sums of money but they’re required in order to recover from some of the excessive belt-tightening that’s happened in the past nine years, which has placed the public health system under real pressure,” says Lyndon Keene.

“More people are going to hospital than ever before, and they’re sicker. Then there are others who are struggling to get the hospital care their doctors say they need – they’re either getting bumped off waiting lists or facing long waits.”

Examples of the pressures on the health system include:
• A big increase in the number of people discharged from public hospitals since 2009/10 – a rise of 16.3% compared with estimated population growth of 10.2%.
• A 9% increase in hospital outpatient visits, including to emergency departments and nurse-led clinics, over the same period.
• Patients arriving at hospital sicker than in previous years – and that’s expected to rise as the 2018 winter starts to bite.
• The rise in acute hospital patients points to poor access to primary health services, including GP visits and prescriptions.
• The need for mental health services continues to outstrip the growth in resources.
• About half of all public hospital specialists who took part in a peer-reviewed survey of ASMS member report symptoms of burnout, described as ‘a state of vital exhaustion’.
• New Zealand has the sixth lowest number of specialists per population in 33 OECD countries. We’ve also been ranked among the worst out of 11 comparable countries for waiting times for elective surgery, to see a specialist, and for treatment after diagnosis.

These are described in more detail in the joint CTU-ASMS analysis.

Mr Keene says ASMS research shows that senior doctors and dentists, like other health professionals, have shouldered much of the pressures on the system, and this has taken a toll.

“It’s imperative the Government makes a very real commitment on Thursday to improving the situation in public health so that communities have access to high quality publicly-funded health care, and so that public hospital specialists don’t have to provide care and treatment at the expense of their own health.”
ASMS has also published a paper calling for capital charges on DHBs to be abolished: (

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