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Relief for public health in sight but a lot more needed

17 May 2018
Some Budget relief for public health in sight but a lot more needed

“The Government’s health budget revealed today offers some relief to the cash-strapped public health system but clearly much more will be required to reverse years of under-resourcing,” says Lyndon Keene, Director of Policy and Research at the Association of Salaried Medical Specialists (ASMS).

“It’s a positive first step, however, and senior doctors and dentists will particularly welcome the Government’s acknowledgement of the burden they and other health professionals have been carrying during years of under-funding, workforce shortages, and increased workloads.”

New Zealand Doctor magazine reports on its website ( that Finance Minister Grant Robertson addressed health professionals directly, saying: “You have carried the burden of a system that was unable to cope with the demands it faced. Thank you for your service and your dedication.” (

“This is really important recognition for public hospital specialists, who have been doing everything possible to hold the health system together in the face of considerable resourcing challenges, and often at the detriment of their own health,” says Mr Keene.

He says Vote Health appears to have received sufficient funding in the Budget to at least maintain existing levels of service, but there is still a long way to go to address the longstanding funding shortfalls.

Vote Health operational spending has increased by $833 million, which is less than the Council of Trade Unions and ASMS estimated was needed in a pre-Budget analysis, due to a lowered CPI forecast (1.5%) and average wage increase of 2.7%. However, the overall effect of the Budget is that Vote Health will be $16.9 billion, which is about $80 million more than needed to cover costs and population increases.

“It’s difficult at this stage to assess how district health boards have fared under the Budget. On the figures available they appear to have received sufficient funding to maintain their current levels of service, but we need to analyse the figures further to fully understand the implications. It means that the current pressures facing hospital staff will continue this year, however.

“The Government has allocated an additional $750 million for DHB capital spending, which is good news indeed, but again a lot more will be required given the run-down state of our hospitals and the need for major rebuilding work.”
A pre-Budget analysis by the Council of Trade Unions and ASMS estimated what funding the health sector needed: target="_blank"> It also outlined some of the pressures on the public health system, including:

• 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.

“Senior doctors will welcome the Government’s recognition of the burden they’ve been carrying in recent years – the challenge now is to make meaningful headway on relieving these pressures for the benefit of clinical staff and their patients.

“There remains a huge backlog of funding cuts to be addressed over the coming years.”


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