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Roy: Quality healthcare achievable for all NZers

Quality healthcare achievable for all NZers

Thursday 9 Dec 2004

Heather Roy - Speeches - Health

Speech to ACT Aoraki meeting; Benvenue Hotel; 16 Evans St, Timaru; Thursday December 9, 2004.

Good afternoon ladies and gentlemen.

I had some coverage recently in the Sunday Star-Times and in many of the major daily newspapers on the issue of deaths on the waiting lists. The Sunday Star-Times is, like me, concerned about the rapid rise of the death rate among people on hospital waiting lists. The issue has unsettled Health Minister Annette King who has responded in a very bad tempered way in radio interviews and in a recent speech to the Elective Services Forum.

So what I had done to upset the Minister? After more than six months of asking her parliamentary questions about numbers waiting for treatment I finally received figures which she says I have "falsely accused" her of hiding.

The first set of figures related to the total number of people on waiting lists. As at the end of August this year there were 110,000 people waiting to be seen by a hospital doctor for their First Specialist Assessment. In 1998, Ms King - then in Opposition - declared the waiting list of 96,000 patients as "criminal" and that "people would be dying on waiting lists". Five years later, under her ministership, Ms King's prediction is incorrect - things are much worse.

Since September 2000, 3,803 New Zealanders have died on Helen Clark's waiting lists - it has more than doubled over four years. Another 10,463 gave up languishing on the lists and went private. The number treated privately has more than trebled since 2001. A further 17,532 in the same time period were told they would not receive treatment unless their condition got worse - this figure has also doubled since 2001.

I am using the Health Ministry's own figures, although some reporters have been told by Annette King's spin doctors that I made them up. For the record, getting information from the Minister is like getting blood from a stone. My enquiries have been stonewalled and met with misleading responses. I have been complaining loudly and often about the Minister and the Health Ministry's evasiveness about statistics for two years.

Ms King insists that she is flabbergasted now only because the press is taking the issue seriously. In fact, this is part of a general pattern as to how Labour Ministers handle accusations of incompetence or dishonesty. They ignore the accusation for as long as possible, then they scoff at its accuracy, then they attack the character of the person making the accusation. Only as a last resort do they engage on the issue. I have progressed through the stages and I'm being attacked on the basis of my character.

Figures like these seem very dry and fail to tell the huge emotional and financial cost to the country and individual patients. But they come alive when we start talking about real cases. Let's take the case of Angie Webster. Fifteen-year-old Angie died of complications of the treatment of Wolf-Parkinson-White Syndrome, whilst on a waiting list for cardiac surgery. Wolf-Parkinson-White Syndrome causes an abnormal rhythm of the heart, but usually responds well to cardiac surgery. Those of you who are sports fans will remember that this ailment affected cricketer Sir Richard Hadlee.

What actually killed Angie was a toxic dose of a drug, flecainide, used to control an abnormal rhythm of the heart. But the cardiologist treating her was well aware that the treatment she was receiving was second rate. Unfortunately, the treatment of first choice, surgery, was unavailable.

Angie and her family were told she would have to wait 18 months for surgery. She died after waiting five months in the state system. An 18-month wait for a life-threatening condition in a 15-year-old is entirely unacceptable. And remember this is a condition that is fully reversible with treatment. The doctor was in the dock explaining himself to a disciplinary inquiry as is often the case but the failure here was clearly one of management. The best treatment wasn't available even though it wasn't that expensive - around $7,500. Instead, Angie's family paid nearly $5,000 to bury her.

The end result is that no one knows what's really happening, doctors are forced to use second line treatments, and Ministers evade responsibility whenever possible. Former US President Harry Truman had a sign on his desk that said "The Buck Stops Here", by which he meant that he did not evade responsibility. In the New Zealand health system, the buck sadly stops with the person who last saw the patient.

The figures I have shown you totally ignore another group, those who have failed to make the waiting lists at all.

My own feeling is that the Minister knows that the death rate figures I have released are genuine. They are, after all, her own department's figures. But it is becoming increasingly obvious she doesn't know why there has been a deterioration.

There is always a danger that people in power become divorced from the realities in society. With long periods in power, loss of contact becomes inevitable. However, the danger is always greater in health because of the culture in the Health Ministry, which is one of telling the Minister what they want to hear. This is in marked contrast to, for example, Treasury where they have long had a habit of giving advice to Ministers whether they like it or not. So we end up with a huge Ministry charged with delivering almost $10 billion worth of expenditure, and whose main priority is to avoid embarrassing the Minister.

What we have is a lack of intellectual honesty combined with a lack of political will to look to all the available options. When New Zealand's healthcare is ranked 41st in the World by the World Health Organisation there is clearly something wrong.

What New Zealand needs is a health system that delivers the best quality healthcare, in the best time, at the best cost. Kiwis must be allowed to take responsibility for their healthcare - both at a fundamental level (exercising and eating properly) and at a financial level. The way we have funded and provided services in the past is not sustainable into the future. Attitudes must change and those who can afford to take out private insurance should be encouraged to do so - the Government has a role to play here.

There are two things that could change the incentives overnight: choice and competition. We should be encouraging better co-operation between the public and private sectors in healthcare. And as I have already stated we should be encouraging greater uptake of private healthcare. All that is required is an open mind and the political will to make it happen. ACT has the political will to find what works and put it in place.


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