Heather Roy's Diary – April 13 2006
Heather Roy's Diary – April 13
Massaging the Statistics - Amputating the List
Everybody is talking about the Hawke's Bay District Health Board's decision to reduce their waiting lists by axing 1,800 patients from them and sending them back to their family doctors. This sort of thing has happened before and is likely to happen again. However, there is something different about this occasion. The District Health Board is pointing the blame squarely at the Ministry of Health.
Health Minister Pete Hodgson, recently wrote to the following District Health Boards and threatened them with a downgrading of their status to the lowest grade - that of 'intensive monitoring' if they did not reduce their waiting lists:
* Hawke's Bay * Auckland * Waitemata * Waikato, Bay of Plenty * MidCentral * Capital and Coast (Wellington) * Canterbury
'Intensive monitoring' simply means that the Ministry of Health and Minister Pete Hodgson will keep a close eye on spending decisions. How this could achieve anything, other than slowing the decision-making process down, is hard to see.
To be fair to the Minister of Health I suspect he wanted to see the Boards increase their throughput and he may be unaware of the extent to which statistics are being massaged within his own Ministry. For example, when I highlighted the number of deaths on waiting lists just over a year ago the Ministry merged their 'exit from waiting lists' categories so that it is now impossible to access data on numbers of patients dying while on waiting lists.
But Mr Hodgson is new to Health and may be struggling to come to terms with his gigantic new portfolio. He has in fact inherited a lemon from his predecessor Annette King. She spent the last six years moving Boards to this position and has left Mr Hodgson holding the screaming baby.
What has happened in this case is that Ray Lind, Chief Operating Office of the Hawke's Bay District Health Board has sent a memo out to local health professionals saying:
"Ministry of Health guidelines state that no one should wait over six months for assessment after referral from their GP.
The reality is that in Hawkes Bay there are currently over 900 people who have waited over six months, and a further 877 people who are regarded as lower clinical priority who are unlikely to ever be seen in the current environment."
What he is actually saying is that the waiting list will be reduced by pretending the patients aren't there.
The latest development is that Minister Hodgson has come out swinging, essentially blaming the board for mis-management. What he is failing to tell New Zealanders is that every board in the country is in a similar position. Government has sanctioned and instructed boards to spend their money in certain areas and in so doing essentially pillaged the elective surgery pot of money. Boards have no choice under government guidelines but to send patients back to their GP if they cannot be assessed in six months. Yet the government refuses to accept that waiting lists are spiralling out of control.
One thing is certain - the problem will not go away, and is only likely to get worse.
Happy Birthday Plunket
In the year of its centenary Plunket has had a very bad week. They should have been celebrating the 25th anniversary of their highly successful car seat rental scheme on Monday and Plunketline's 12th birthday on Tuesday. Instead they spent the week in damage control mode trying desperately to make sense of the Ministry of Health's bizarre decision to award the Plunketline contract to McKesson's Healthline from 1 July.
Plunketline, despite many obstacles over its 12-year history, has provided a trusted, well-respected and high quality service to parents. Hundreds of thousands of parents with babies, toddlers and pre-schoolers have received high quality health advice from experienced Plunket Nurses at the end of the phone. I have heard little other than high praise from those who have used this service. 18 months ago I sounded a warning over the merger with Healthline, but this was the only viable option open to Plunket at the time if their service was to be retained. It is hard now not to conclude that Plunketline was set up to fail.
ACT fully supports Plunketline. Plunket has launched a petition, which can be found at www.plunket.org.nz. I encourage readers to send the Government a message by signing it.
The World's Most Expensive Escargot?
Yesterday, Conservation Minister Chris Carter approved the relocation of 250 Powelliphanta Augustus snails to a new home, so that Solid Energy can develop a coal mine on the West Coast.
Moving the endangered snails - by hand - will cost Solid Energy $120,000 per snail. There's no guarantee how many (if any) will survive. It's a prime example of why the RMA makes developing natural resources so difficult.
Because Solid Energy is a State Owned Enterprise, the $30 million cost of moving the snails comes out of the dividend government would normally receive. To put that cost in perspective, it's 30 years of Plunketline, 2307 hip replacements, (or a bag of Blitzem for every Kiwi)!