Speech: Hon Ken Shirley: Towards Consensus
Speech: Hon Ken Shirley 'Towards Concensus In Health Care Policy
Thursday 8th Jul 1999 Ken Shirley Speech -- Health
Towards Concencus In Health Care Policy
Firstly may I congratulate all associated with organising Health Care 99 and take this opportunity to welcome my parliamentary colleagues to my home town of Tauranga.
Health is perhaps the most contentious of all public policy arenas and all too often politicians dwell on and highlight negative specifics, forgetting to recognise the marvellous advances that have occurred and the pathways of continuing improvement.
We all tend to forget that open-heart surgery was only made possible in the 1960's, largely as a result of technological breakthroughs in anaesthetics. Prior to this time the common by-pass operation did not occur and people suffered and died early.
Equally the incredible advancements in joint replacements has given mobility to people who were formerly confined to wheelchairs. I am one of the grateful recipients of this marvellous technology having undergone athroscopic debridement in both knees, here in Tauranga last Friday. Five years ago I would still have been in hospital and would have been on crutches for a further month, whereas tonight I am capable of dancing an Irish jig.
Since 1969 Government spending on health care has more than trebled in real terms, from $2.041 billion to $6.264 billion in 1998. Health is the second biggest item of public expenditure after welfare and it exceeds the annual export earnings of our pastoral sector.
This increase is largely driven by accelerating technological advances leading to the increasing demand for a wider range of more expensive services. An aging population further compounds the situation with the average person over the age of 75 consuming 10 times more publicly funded health services per year than the average teenager. Population projections tell us that we will experience a 6-fold increase in the number of people over the age of 80 by 2020. We also know that the ratio of those in the workforce to those in retirement will halve in that time period.
We have created artificial barriers with our health care system between primary health care and secondary health care on the one hand and between public and private provision on the other. Primary personal health care is substantially delivered by the private sector by GP's and pharmacists, even though the government provides the bulk of the funding.
With secondary hospital care a dual system has emerged. Those without health insurance languish on waiting lists, and those with it pay twice.
Many people believe that private health insurance is simply a means of funding optional extras (additional comfort and choice). Others see it as a means of providing a desirable alternative to public funding and provision. In practice it is both, providing 'top up' funding for additional services as well as displacing the need for public funding.
While the public health hospital system is failing to keep up with the needs of New Zealanders, the private health insurance market is retrenching because of the uncertainty of State provision and deficiency of pricing information. Insurers are unable to set the service and price bounds of their premiums. What we have is 'gap' insurance with more and more New Zealanders falling into the 'gap'. With premiums for private health insurance rising rapidly, fewer people can afford this choice. In 1991 51% of New Zealanders were covered by health insurance whereas in 1997 this had fallen to 37%.
We must restore confidence in the health sector.
? All New Zealanders must have access to high quality health and medical services. ? We must place greater emphasis on preventative health care, thereby reducing the need for intervention in illness. ? All New Zealanders must accept more responsibility for their own lifestyle choices that influence health eg adequate exercise, non smoking, diet. ? The artificial barrier between primary and secondary health care should be reduced allowing for more integrated care options. ? The private sector should be encouraged to invest in both the provision of health care facilities and services. A climate of commercial neutrality should exist between the private and public provision of those services.
Partnership Between Public and Private Hospitals
ACT's key objective is to give consumers choice and to get the public and private sectors working together in the task of providing the best health care for all New Zealanders at the most affordable price.
Pacific Health Limited 's initiatives in the Bay of Plenty to integrate the public and private provision of hospital health services must be applauded and encouraged.
The saving of $1 million through the sharing of a state-of-the-art CT scanner between the public and private sector to ensure the optimum use of expensive but under-used technology is a first step in the right direction particularly when the $1 million saved can be used to improve services in other areas of health care.
I also applaud the Tauranga based Venturo Project providing urological services. A two-year waiting list was eliminated in six months by the public purchase of private services. A project has now commenced providing orthopaedic services with similar potential.
The extensive use of private hospitals by ACC in the last two years has demonstrated that treatment can be more timely and efficient allowing people to return to the workforce earlier than previously possible. These outcomes are highlighted by the fact that for the year ending 30th June 1998, ACC chose to purchase 86% of its 26,730 elective surgical services from private hospitals.
These examples of improved efficiencies are models for the rest of the country. We must avoid the hang-ups and rhetoric between public and private provision and concentrate on guaranteeing better access for all New Zealanders to quality and affordable health care when they need it.. ENDS The ACT Media Unit today launched its new media release template. Speaking at the launch, Caucus Press Secretary Trish Sherson said, "It's pretty sharp, isn't it?", before the bubbly got the better of her and she passed out.
ACT Leader Richard Prebble said the template marked a new era in New Zealand politics.
"Independent commentators agree that this thing is the best of its kind in the world. Sources inside the PM's office have revealed to me that they think it might just win the election for the centre-right.
"In fact my own Labour party contacts tell me that Helen Clark's office admit that they are dog tucker unless they take their things back to the drawing board too.
"No responsible commentator would make rash predictions in this unstable political environment. However, I would not be surprised if the parties follow ACT's bold initiative."
Other ACT MPs were not available for comment.