The Right Prescription For Healthcare
The Right Prescription For Healthcare
Tuesday, 6 June 2006
Articles - Health
Strikes by junior doctors and reports of women waiting up to a year for mammograms will leave many Kiwis suffering from more than deja vu. The latest symptoms of our ailing health system require more than a sticking plaster solution, and with so few health professionals asked to treat so many people, almost every family is somehow affected.
It could be your mother waiting for treatment, or your sister, or your son. Behind the awful statistics are real people, with families, jobs and lives put on hold until they get the attention they need.
180,000 people are waiting - equivalent to the entire population of Hamilton. About half of those are waiting to see a specialist. The others have been assessed as needing treatment and are waiting to either have a date booked, or for that date to arrive.
What's holding us back? It's certainly not a shortage of ideas.
The Hutt District Health Board is investigating offering financial assistance for people who "go private" for their operations. In the United States, Massachusetts has just made health insurance compulsory, either through government-owned Medicaid or a private insurer.
The Minister of Health's chosen course of action has been to blame health workers for the waiting list crisis. District Health Boards, hospital management, surgeons and general practitioners - government will blame everyone but themselves.
Healing the health system requires more than buildings, bureaucracy and campaigns against particular diseases like Meningococcal B. Above all, it needs people.
The reinvention of Government's "Health Workforce Advisory Committee" as an "action committee" only reinforces its four years of failure. General practitioners not only have to deal with the red tape that holds all small businesses back, but also grapple with the added bureaucracy of Labour's Primary Health Organisations.
There is no shortage of measures New Zealand could take; it's the political will our government lacks.
We don't need to tear up the health system and start over. Our doctors, nurses and other health professionals do a difficult job extremely well. With health budgets increasing at over $1billion a year, we don't even need a huge cash injection.
Firstly, Government needs to accept that demand for healthcare outstrips supply. Pretending the waiting lists don't exist, or that there isn't a problem, won't help a single patient. Then we need to work out how to fulfil the demand for treatment.
That's where we have to consider the private sector. A recent high profile case told us that surgery at the private Ascot Hospital is less than half the price of surgery in Auckland Hospital. A night in Ascot's intensive care is almost $3000 cheaper than in a public hospital.
Yet Government has built a wall between the public and private sectors, insisting that the public sector be used. The result is less choice, longer waiting lists and poorer outcomes for patients.
Government's role is to provide the framework, and some of the funding; ensuring that healthcare should be available for everyone, easy to access and affordable.
With New Zealand's growing, aging population, and an increase in expensive treatments, we need to face the fact that government cannot meet all the demand themselves. We should consider using the public health system for emergency surgery with the private sector handling more elective cases, and examine what incentives we can give people who take care of their own health needs.
Everyone knows that our health system is in critical condition. Annette King, the former Health Minister, tried to manage expectations by telling us that New Zealand couldn't expect a first world health system like Australia, the US and the UK. Pete Hodgson hides behind his DHBs and managers, mixing the figures and amputating the waiting lists.
The best medicine for our health system would be for government to tear down the walls they've built and join an open and honest debate about what role the private sector can play in making people well and encouraging people to look after themselves. Labour can no longer afford to wallow in denial while thousands are waiting for treatment, but need to summon up their political courage and examine all the ideas in search of the right prescription.