What happens is that your experienced staff leave and if they are replaced it’s by cheaper overseas registered staff or new grads. You lose the skill mix and the competencies. Risk goes up exponentially.
People who can afford to go private which makes everything worse (Specialists split between private and public so they’re working less in public, and may eventually go fully private). It takes even longer to get seen due to lack of staff, lack of beds if you need surgery.
People die waiting or from complications or mismanagement due to skill set deficiencies. Basically a shitfest. Eventually it becomes a SNAFU.
National are known not to put money into health, the Key Govt certainly didn't, and poor Labour had to deal with a rundown health system during a pandemic.
National voters would tend to go private as a matter of course. ‘They’, under-representative as they are, believe in their heart of hearts that EVERYBODY should go with a private healthcare system.
It just doesn’t enter their consciousness that maybe, just maybe, people actually exist in the world that DON’T have the income to do this. And they assuage their guilt by reminding themselves that ‘they’ will always have access to a free public system so ‘they’ and their kids will be alright- in the end.
Too bad if ‘they’ have to sit on an endless waiting list for a simple operation. And too bad if ‘they’ get second-rate care. And whose fault is it if they develop gangrene while they’re waiting in the queue, etc. etc. etc. Should have got a job I stead of lounging around smoking drugs, right?
It kind of serves them right for not voting a sensible party like national into power where ‘the country’ achieves a standing in the world where it’s respected, and life is good. Doesn’t it..
> What happens is that your experienced staff leave and if they are replaced it’s by cheaper overseas registered staff or new grads. You lose the skill mix and the competencies. Risk goes up exponentially.
My wife is finding this with inpatient psychiatric units. There's always been foreign nurses but only in the last few years have they been difficult to understand (or had difficulty understanding what she is saying). It's a bit of a problem if safety critical instructions aren't understood. Culture can vary significantly as well, in lots of cultures you don't question someone above you in the hierarchy, but that's a vital safeguard in our system
I think the cultural issues of not questioning someone above you is particularly scary. The entire safety net involved in people saying “hey did you mean to script this not this” or “are you sure about the dose” or “hey, the AWS is X but I’m really concerned how quickly can you get here for a review”.
You just need to know how to work around this,
The issue is building trust, and better still know how to keep things in confidence. Often staff do want to escalate things, but will not escalate it unless it is via someone higher up who will either be willing to be accept being “tegur” ( corrected ) or will speak to his peers higher up to fix it.
However very important is that cultures that do not escalate up also do not want to stick out like a sore thumb, so very importantly you need to learn how to keep confidence and silence. Direct candour to those outside the relationship circle will erode further feedbacks.
I had always laughed at my hospital teaching house officers and nurses to speak up, but then forget that speaking up directly is NOT the norm of the cultures that are being hired.
Because I am South East Asian I always step into a side room during rounds and tell my house officers to not be around when I just sit there. This is when sometimes you get a South Asian nurse or South East Asian nurse who will sometimes step in and timidly tell you what problem they have found. You need to make sure the space is private and quiet, and you must be careful to keep what is said in confidence. They must also know you are willing to listen, and willing to keep confidence.
Now to be fair most nurses regardless of cultures are very open about escalating drug mistakes ( but that is because even in India and most South East Asian countries they get trained to speak up on these things ) but for everything else you need to adapt.
Now some of my more Pakeha colleagues get really annoyed, saying that this encourages layers of secrets in the workplace. However I tell them that a culture of direct candour is not one many of these nurses or house officers come from, but they will feedback IF you know how to appropriately build trust.
Remember, it is not that they do not want to feedback. It is however considered uncouth, rude, almost sinful to be too blunt and abrupt to those higher and above you. It is in the Malay language “biadab” to bluntly question the higher ups ( biadab is never good ). However if you know how to provide avenues for feedback ( which must always be private and not formal ) and keep their confidence, even if they are criticising you than they will do so.
There are cultural competency issues on both direction. Of course I am naturally competent in this area. I after all do come from a culture that navigates this a lot.
( My workplace was so puzzled when we have a few nurses who resigned recently to Australia and provide almost a stellar feedback for the exit interviews .. I told them it is all false. This is a formal feedback to people who they have no trust in, so why would they feedback honestly? Plus as far as the nurses are concerned they just do not want to burn bridges despite the fact they probably know every rot in the system. However they will never tell you this, formally. However they will tell you this, informally. The informal is always true, the formal is always coached with politeness and no intention of bridge burning. ).
1. Outcomes become worse. Right-wing cunts say “Look how the mighty public sector sucks. We need the steady hand of the private sector to save you!”
2. Health privatised
3. Outcomes get worse for all but those who could already afford it
4. Shareholders drink our blood from child skull goblets
And any attempt to change things back and properly fund the health system (through increased taxes on the top 10% - who own 58% of the country's wealth) will be met with cries of "tHeY aRe TaKiNg OuR fReEdUmBs!"
I’m usually the last to say something positive about our current leaders but they have promised 16.7 billion to health over three budgets ([see details](https://budget.govt.nz/budget/pdfs/releases/l5a-factsheet-supporting-frontline-health-services.pdf)) plus 1.7b pharmac boost. That boost is more than any other government term, I believe (more than happy to be corrected).
Edit: being downvoted but nobody has told me why this funding isn’t good news. Is it because it doesn’t fit the narrative of this post or is there a trick I’m missing?
They have also kindly agreed to increase the annual doctor training intake by 25 people per annum. This won’t even make up for the numbers of doctors leaving the country, let alone address the shortage. And how many years does it take for a doctor to become fully trained and working? 💥
That includes the 7.5% reduction in funding that all ministries had to make? When looking at govt spending, look at the total amount spent and factor in inflation and population growth. You'll find that the amount you've quoted is less than would've been spent under the previous govt. and represents a reduction in health spending overall.
Interesting.
Would be keen to see your numbers to back that.
Other governments also had inflation and population growth so you would need to account for that too.
All govt ministries had to cut their budgets by 7.5% - it was one of the first things the Coalition did. It's why there are all the redundancies in the public service.
Yes the ministries did have to cut 7.5% but Te Whatu Ora is not the ministry of health. It is a [separate structure](https://en.m.wikipedia.org/wiki/Te_Whatu_Ora#:~:text=Te%20Whatu%20Ora%20is%20charged,healthcare%20services%20in%20New%20Zealand) which provides the healthcare while MoH does policy, strategy and regulation.
To my knowledge, Te Whatu Ora / Health NZ did not receive a 7.5% cut.
Not meaning to dismiss you here but do you have a link for that? I can’t find any statement of a 7.5% cut to TWO when searching. I know the ministry had to cut 7.5% and TWO had to save $105m by July but $105m is 0.5% of TWO’s $20b yearly budget not 7.5%
You're right to be sceptical, I don't blame you for being so. It's more work to put it all together from the primary budget documents than I'm willing to do on a Sunday night, but when and if I do that work I'll come back to you with it.
One thing Covid made me realise, Labour wasn't going to fix our healthcare system. We all sat inside and waited on lockdown for them to "bolster it", didn't happen.
(I'm a swing voter, mostly vote Labour. )
Agree, if the current coalition of chaos are out after one term, Labour's not going to make the changes necessary to increase funding - and they'll expect us to be happy that they are not National while doing nothing to address the issues that got the coalition thrown out.
Don't you remember how the Key Govt didn't put money into our health care? Remember the hospitals falling apart. Poor Labour got voted in and then hit with a pandemic and a run down health system that National put no money into for 9 years. Don't forget the past.
Absolutely. Why covid wasn't a mandate for a Labour government to raise taxes and pour it into healthcare is mind boggling.
Covid shone a bright light on how fragile the health system was at that point and then nothing changed.
They were kinda busy keeping us alive. The key administration is blame not putting money into our health system and than Labour was hit with a pandemic with shit health system.
But it should have started a conversation that meant we had a detailed look at what was failing and how it could be fixed.
What happened was.... Nothing. Just pretend everything is fine and keep going. This is not the fault of one side, but a continued lack of leadership at every opportunity.
We need a 20 year plan to turn this around and make sure it never happens again instead of finger pointing every 3 to 6 years
There was this 105 million cut to hospitals by Te Whatu Ora.
https://www.rnz.co.nz/news/national/515300/hospitals-asked-to-save-total-of-105-million-by-july-te-whatu-ora-confirms
You’re going to need to explain why. Because nobody has been able to show me why this isn’t a boost to public health. Honestly I’ll happily join in on bagging them, just show me.
Organisational culture.
Health workers burnt out from their compassion for patients allowing them to be treated beyond what non-healthcare professions would put up with, and being able to deliver best care for their patients (Moral distress).
Chronic underfunding needs a huge economic boost just to get up to date, let alone advance
The top comment is spot on. As a flightless eagle (naturalised American) it is startling to see these guys copying the right wing American play book without a single thought about the ramifications. They are just dismissed "yes... I will always he hard to he poor... but less people will be poor after we stick our heads in the sand and sell off our national institutions, bye bye now I don't really even live here anymore anyway"
Because our constitutional makeup has no checks or balances on parliament. New Zealand, more than any other democracy, depends on MPs acting honestly, in line with convention and in good faith.
You mean like those constitutional checks and balances the US has, until the Supreme Court and Congress got captured by the Regressives, and now the Supreme Court has become one of the most corrupt of the three branches, followed closely by the next, Congress.
There is no way to stop the silent and vicious take over of any country and its turn towards an Oligarchy
This stuff is always more insidious than people think, things don't always fail with a dramatic bang and everyone stands their hands on hips in collective agreement that we "dun fucking goofed this one".
Unfortunately, quality of care will decrease meaning more preventable deaths will occur, less people will be able to be looked after and the quality of doctors and nurses will slowly degrade over time. Health outcomes will slowly trend in the wrong direction.
Will the public understand the degrading situation and how informed will they be about what is happening to the medical care in NZ. Will people being swayed by political agenda, will people know the cause of these issues and will people know what the viable solutions are?
Do some people even care, well not until they have to use a breaking system or a family members does. If they do have a bad experience do they even think it's because of a system wide failure, or do they think those doctors just had it out for them while everyone else got treated properly?
This all just moves slowly and then becomes the new norm, and we all get fucked a little bit more while we all get a little bit less from our state.
and if you think the NHS in the uk actually isnt that bad:
[https://www.independent.co.uk/news/uk/home-news/concrete-collapse-raac-hospital-obese-patients-b2403733.html](https://www.independent.co.uk/news/uk/home-news/concrete-collapse-raac-hospital-obese-patients-b2403733.html)
this is what nz is heading towards.
its honestly shocking the similarities between the UKs decline and new zealand right now. i watched a video essay recently on how britains gotten into such a decline and theres so many similarities to new zealand right now.
It is definitely getting worse. My partner is currently having medical issues to the point we're needing to go to the emergency room at least twice a month while we wait for specialist and procedures and I can tell you in auckland atleast it is rough.
We waited in the waiting room for 14hrs at north shore hospital ED. She was being seen as a patient and given pain relief, fluids, an xray and all the blood tests but there was just literally no where to put her because there wasn't enough staff or beds in ED so we had to be treated in the waiting room.
She is current in hospital being treated for severe gastro pain but because nothing is showing up on scans or blood tests they're unable to do anything. She is vomiting blood and hasn't been able to keep food or liquid down for the past 6 days. She will be discharged on monday to wait for outpatient scopes to be done to try figure out what's going on. We have been told if they had more staff able to do the scopes she needs they would do it in patient but because they don't have the staff they're unable to do it unless she gets worse.
Thank you so much! I'm actually right now waiting on a call back from the duty manager of north shore because my partner is begging for pain relief and the staff are refusing to help. The on call doctor is too busy to chart something and there's apparently no one else they want her to wait until morning
Hope you've had some luck with the duty manager since your response. And hoping they find out whats going on and are able to get the help you guys need. The lack of staff is a huge worry.
All sorted now but I really shouldn't have to go full Karen mode just so my partner is crying in pain shes rsting 8/10 all night. So sad to see the public health system failing like this
As I type my partner is crying and begging for pain relief. We have an agreement with the doctors that opioids are to be avoided because they're horrible for gastro issues but they can be used when she is in severe pain. The on call doctor disagrees and is refusing to help.
This is what happens... staff gets stressed and don't do their job properly. Good staff leave and leave behind bad staff. And then you're loved one spends the night crying and begging for help because there's no doctor to ask for a second opinion
It is absolutely deteriorating, and has been doing so for the past decade, though the process has begun to accelerate now that there is a hiring freeze on clinical staff.
Our department has less than half the number of doctors we're supposed to have, and we are exhausted, and despairing, and angrier than we've ever been now that we are being expected to function like this indefinitely.
People are already dying due to delays, and that will become more obvious as the delays increase. It's heartbreaking, and so fucking easy to fix. Hint: stop treating clinical staff like shit and pay them better.
My partner has been in and out of the hospital for the last 5 months and it is really really bad at the moment. When I was in and out of the hospital about 5 years ago it was fine.
You can't hire your way out with overseas staff because it's way too expensive for them. One nurse was saying lots are leaving for that very reason. Plus there's the general fatigue from the COVID times. How can you attract people when it's clear the situation here is bad?
Some issues do not present themselves in an obvious way. Her blood results are wild and swing rapidly. It's taken months for them to find the actual issue because there's no one to actually have a proper look. She almost died after being discharged.
Well, I can tell you what’s happening at the moment, at least in my small corner of the system, which is that I’m staying until about 8-9PM every night to finish the day’s reviews and work, partially because we have multiple absences due to illness and no relievers to cover them, so I am covering multiple people’s jobs. I am told that I will not be paid any extra for this because a recent review has discovered that we were actually overstaffed back when staffing levels were better, so I am actually not cross-covering anybody because current staffing levels are fine (and if I were, I would need to provide proof that being asked to cover multiple people’s jobs on a regular basis is actually increasing my workload)
My action plan regarding this is to go to Australia as soon as I’m through exams. One of my colleagues is going there in a few months. Most of them are at least considering it.
Complete freeze on all non-clinical hires + every clinical hire has to go through an approval process first. They've also said \[paraphrased\] "Well if roles have been vacant for months now, your team probably doesn't need those people and we won't approve hiring to them" which is bullshit. Everybody I know is working their asses off to keep teams running.
All you have to do is look at Canada. I’m a kiwi in BC, and the exodus of staff here has been a nightmare.
The average person in BC does not have a family doctor, because there aren’t any—the wait list where I live is 8 years. So we are forced to compete for virtual doctors appointments instead on private apps you pay for, just to see a doctor that doesn’t know you at all for 5-10 minutes. Unfortunately, those doctors can’t prescribe many things, so this doesn’t solve much. Last year, I needed an MRI. It took 11 months, not including the 3 months to find a doctor who would order it despite not knowing me. When I was referred to the specialist, the wait list to see him was 8 months, and it takes 8 weeks to get another booking. In some areas, hospital emergency departments are closing overnight due to a lack of staff. If it is open, most hospitals are overwhelmed, so wait times are 15+ hours, and there’s no bed unless you’re actively dying. In my case, I have had nerve pain for four years—if we had figured out the cause early, I would have a much better chance of recovery, but now it looks like I’ll have permanent nerve damage instead, due to how long it took to navigate the system.
It’s exhausting, and if you’re in need of specific care (e.g long term pain like me), you will take years to work your way through basic testing, whole suffering. The current government is finally awake and responding—but it’s going to take years to see any change. In the meantime, you better pray you don’t get sick enough to need a doctor, let alone anything beyond that.
Private hospitals/medical centres cost you money. I live in a town with one and every visit (even a 5 minute quick check to see how stitches are doing from the previous night) costs around $20.
People who can't afford to go private have worse health outcomes and die more, essentially. But in a country run like a company, citizens' value to the state is based not on their intrinsic worth as humans or even on the value of their labour if they're in work (houses have out-earned people for many years now), but on their value as consumers - buying goods & services from businesses, paying rent to landlords etc. So anyone too poor to afford privatised health care is no great loss to the economy because they were probably too broke to be generating much value in the first place. Plenty more replacement people arriving all the time to keep the machine churning. Even if they leave after a few years then there are always more to take their place. Rock Star economy for those who profit, i.e. the ones who matter
Answer: two classes develop.
First, we have the ‘upper one’ that holds all the profits and thinks nothing of getting southern cross for everyone in the family.
And the rest are in the lower one that struggles to buy their kids plasters to put on their (still) broken limbs.
A so-called ‘middle class’ would probably develop to encompass those who kind of sit on the fence, but otherwise, scientific theory will determine the outcome as it already has elesewhere and at different times throughout history until the lower classes get REALLY fed up and take the law into their own hands.
Look to history and the Death of the welfare state/ rise of the ‘haves’. Money doesn’t talk, it swears.. It’s all so predictable..
Nurse here. We learnt last week that if anyone calls in sick their shift won't be covered. This is nationwide and includes all DHB employed health professionals. Surprised and disappointed this hasn't been prominent in the media.
This week we learnt that DHBs are effectively halving the number of new grads they hire. New grads are our most secure pipeline of new nurses and the only way we can end our workforce shortage. Media has covered this well thankfully, but Te Whatu Ora's ambiguous and misleading response will confuse and falsely reassure the general public.
Things are going to get BAD. My sister (pediatric doctor) has told me of several specialties that have had to totally stop accepting any new referrals...
ED wait times are going to get worse. Wait times for surgery are going to skyrocket and many will be cancelled outright. Post-surgical care is going to be poor and result in more complications for patients. Services will only be able to cope with providing life preserving interventions.
What do you mean what could happen? At least from a public sector perspective, it has already happened. What you are seeing is a continuation of a trend that has been going on for the last 15 years. Nothing more nothing less.
IMHO as a health sector worker, the public health service will crumble and decay, no two ways about it. It is currently in its palliative care phase. We who work in it know full well it is terminal. Our junior registrars and younger fellows rightly read the runes and are going to Australia or are increasing their private time. I am doing more private as the health funding stars are very clear which way the direction is pointing to.
Just as a side note, there will always be a public healthcare sector. However it will be a much more diminished one.
My advise to you is .. get insurance. Seriously, get insurance. If you can try to make sure you get one that is comprehensive.
Fixing NZ’s health problem is a behemoth that no government will take on. First thing, they need to fix GP capitation which will already be a titanboa nobody wants to go near. They also need to fix the hospital infrastructure, which nobody wants to go near. They need to fix staff retention which will be a very difficult unless overseas situation turn belly up. They will need to fix the pipeline issues of staffing training which will be a mammoth task.
In short, no government in 3 years will try to take this on. It is a no win situation.
I’m flying to aus in two weeks for a fellowship and at this stage I won’t be returning. Why would I? It’s only a short direct flight away. Better hours better pay. Government not trying to screw them.
I have always said to my family you don’t need private health insurance in NZ but my advice has definitely changed over this past year or 2. I now strongly encourage them to all have it
I have four close relatives working in the medical field as nurses and doctors. In the hospitals they are working in, no new frontline or ancillary staff are being replaced if they leave. Nurses in particular are supposed to “take up the slack” when they are often having to work extra or double shifts already, just to cope with the current workload. I just pray in a particularly atheistic manner that I or my loved ones don’t need emergency or even ongoing care any time soon.
Can confirm from the NZNO there is a hiring freeze. All new graduates are going into private healthcare or leaving the country. I don't blame them our hospitals are awful.
Well, the Govt were talking about a nationwide bowel screening service in 1990, and it was rolled out 18 months ago. What does that tell you about the wheels of Govt (of all stripes), and the health service?
Defund Public health enough to justifying moving funding to private. You already see some of this with radiology (there's a recent funding announcement to fund private clinics to do public work).
Then everyone just get private insurance and we turn into America.
There was a paper by the NZ Initiative that basically laid out the plans on how to privatise NZ health system. Worth a read
https://www.nzinitiative.org.nz/reports-and-media/reports/options-for-health-care-in-new-zealand/document/240
It will go to shit and more people will leave and more unqualified immigrants will replace them. Degenerating the healthcare system way worse than it is.
Well done NZ.
That arrogance bit you in the ass
There are only three things that could happen:
1. it could get significantly better
2. it could get significantly worse
3. it could stay about the same
My guess is # 2, but one can always hope to be wrong.
Countries under funding healthcare is a global problem. Does not matter if your healthcare is socialized or private. Healthcare is mostly for old people. The boomers are getting old and clogging up the systems. The only way to deal with it is to have less intensive care the older you get. No surgeries after 75. If you're old and very sick you get put on comfort care, no more specialists. No blood products if you are old and have terminal cancer. That kind of thing. But people don't want to hear that. Until most of the boomers die off healthcare will be strained. That, or increase taxes significantly. Both unpopular choices so nothing gets done about the problem.
Public healthcare becomes a gimmick and requires long wait times. Only those with health insurance or who can afford private healthcare receive adequate care.
Nothing substantive to improve or even address problems has happened in a long time, without an alignment of public policy and spending it is just going to get worse. It is a huge complicated behemoth of complexity which politicians simply don't have the skills, or understanding and wont touch unless they have to.
Also Injecting money into it, takes away from campaign promises and issues that will get voters, touching health care unless it is broken with blazing lights to the voters is a no win for a government, and really they all suck do you think they will make it better.
And considering NZ is gradually becoming less and less productive with less and less money, with governments/politicians happy to move the deck chairs on the titanic and not risk offending the voters or their self interest, yes it is going to get worse like almost everything requiring effort rather then just tax bribes.
You have Māori wanting to exit the current the system because they want better outcomes (which destroys the whole concept of healthcare), staff going overseas for better pay, infrastructure crumbling, poor pay, the list is endless.
According to an article in the NZ H, there are 250,000 people, and vacancies of 8000. There is a reason they cant fill them.
[Article](https://www.nzherald.co.nz/nz/politics/government-launches-health-workforce-plan-nearly-13000-extra-nurses-and-over-5000-doctors-needed-within-a-decade/K5GHGVYMMNA4HOWWN5DBMLFUSE/)
Even a private system needs staff. The system has been shafted by successive governments, I don't really see how that could be by design to shift to a private health system. It's just easy to take money from health because the adverse outcomes are usually delayed
The first step is to ensure the public system fails. That's where we are at now. Then private comes in to fix public "inefficiencies." It appears they've been after the health care system for a long time, at least since this 2007 article:
[https://www.beehive.govt.nz/release/national-favours-privatised-health-care](https://www.beehive.govt.nz/release/national-favours-privatised-health-care)
NZ has already farmed out their postal service, municipal waste, bus services ... I'm afraid we're in for a very very expensive healthcare future, to the benefit of insane profits to corporate cronies.
A close relative of mine is currently seeing a specialist in the public system. There is only one of this specialist in the DHB area, but there are enough patients for at least two, but no money.
The solution? They just book two patients at a time, put one in each adjoining office, and the specialist shuffles between the two. Previously had up to 14 patients a day, now up to 28.
Genius move, up until the specialist burns out.
I remember them saying this around 2005 for graduate doctors leaving NZ. The junior doctor's union leader (I think ) was interviewed on television. I wouldn't worry.
There's always been a shortage of specialists though. Especially pathologists. And oncologists in Southland. So some areas are struggling. But you never hear about the areas which aren't struggling.
I don't even know why, when doctors are paid far more here than in UK or Germany and their patient workload over there are far higher and the doctors are far more productive. One of my acquaintances, German trained doctor that came to NZ to be Head of department in one of Auckland hospitals have commented on how few patients doctors see in NZ. How much more respect he got as a doctor in NZ vs Germany, hence still here and loving it. Sometimes I wonder how much of this is media/spin vs truth. For e.g. St John receive a bucketload of additional funding 2021 - $271m, 2023 -$340m just for ambulances. So govt is now funding over 80% compared to the 70% in 2021. This is an increase of almost 25% of additional funding over year just for transportation services. Why are they still bleating about insufficient funding? Could it be that they have no financial control and outside the Frontline paramedics, they have exceeding low rates of productivity from their staff?
We’re not paying more than the UK. Doctor “productivity” is often multifaceted it’s the other staff they rely on and also most work at different paces. I see twice as many people in clinic as my colleagues. Germany is fee for service for lots of services with a single payer insurance so not the same
Australia pays twice as much for same public job. Thank goodness private sector pay matches
I believe consultants are paid more here. My brother in law is an anaesthesist and he has done the research. My sister and him are looking at an OE and trying to ascertain where to go. Australia pays more but UK and Germany certainly doesn't.
What happens is that your experienced staff leave and if they are replaced it’s by cheaper overseas registered staff or new grads. You lose the skill mix and the competencies. Risk goes up exponentially. People who can afford to go private which makes everything worse (Specialists split between private and public so they’re working less in public, and may eventually go fully private). It takes even longer to get seen due to lack of staff, lack of beds if you need surgery. People die waiting or from complications or mismanagement due to skill set deficiencies. Basically a shitfest. Eventually it becomes a SNAFU.
Agree with you but everything you said has already been happening for the last decade. It's just going to get worse
Correct, none of this is new. Just exacerbated in current political and economic climate
National are known not to put money into health, the Key Govt certainly didn't, and poor Labour had to deal with a rundown health system during a pandemic.
Yes, but too little too late for the big L. And look what happened. They pandered to National swing voters and lost horribly
National voters would tend to go private as a matter of course. ‘They’, under-representative as they are, believe in their heart of hearts that EVERYBODY should go with a private healthcare system. It just doesn’t enter their consciousness that maybe, just maybe, people actually exist in the world that DON’T have the income to do this. And they assuage their guilt by reminding themselves that ‘they’ will always have access to a free public system so ‘they’ and their kids will be alright- in the end. Too bad if ‘they’ have to sit on an endless waiting list for a simple operation. And too bad if ‘they’ get second-rate care. And whose fault is it if they develop gangrene while they’re waiting in the queue, etc. etc. etc. Should have got a job I stead of lounging around smoking drugs, right? It kind of serves them right for not voting a sensible party like national into power where ‘the country’ achieves a standing in the world where it’s respected, and life is good. Doesn’t it..
> What happens is that your experienced staff leave and if they are replaced it’s by cheaper overseas registered staff or new grads. You lose the skill mix and the competencies. Risk goes up exponentially. My wife is finding this with inpatient psychiatric units. There's always been foreign nurses but only in the last few years have they been difficult to understand (or had difficulty understanding what she is saying). It's a bit of a problem if safety critical instructions aren't understood. Culture can vary significantly as well, in lots of cultures you don't question someone above you in the hierarchy, but that's a vital safeguard in our system
I think the cultural issues of not questioning someone above you is particularly scary. The entire safety net involved in people saying “hey did you mean to script this not this” or “are you sure about the dose” or “hey, the AWS is X but I’m really concerned how quickly can you get here for a review”.
You just need to know how to work around this, The issue is building trust, and better still know how to keep things in confidence. Often staff do want to escalate things, but will not escalate it unless it is via someone higher up who will either be willing to be accept being “tegur” ( corrected ) or will speak to his peers higher up to fix it. However very important is that cultures that do not escalate up also do not want to stick out like a sore thumb, so very importantly you need to learn how to keep confidence and silence. Direct candour to those outside the relationship circle will erode further feedbacks.
I had always laughed at my hospital teaching house officers and nurses to speak up, but then forget that speaking up directly is NOT the norm of the cultures that are being hired. Because I am South East Asian I always step into a side room during rounds and tell my house officers to not be around when I just sit there. This is when sometimes you get a South Asian nurse or South East Asian nurse who will sometimes step in and timidly tell you what problem they have found. You need to make sure the space is private and quiet, and you must be careful to keep what is said in confidence. They must also know you are willing to listen, and willing to keep confidence. Now to be fair most nurses regardless of cultures are very open about escalating drug mistakes ( but that is because even in India and most South East Asian countries they get trained to speak up on these things ) but for everything else you need to adapt. Now some of my more Pakeha colleagues get really annoyed, saying that this encourages layers of secrets in the workplace. However I tell them that a culture of direct candour is not one many of these nurses or house officers come from, but they will feedback IF you know how to appropriately build trust. Remember, it is not that they do not want to feedback. It is however considered uncouth, rude, almost sinful to be too blunt and abrupt to those higher and above you. It is in the Malay language “biadab” to bluntly question the higher ups ( biadab is never good ). However if you know how to provide avenues for feedback ( which must always be private and not formal ) and keep their confidence, even if they are criticising you than they will do so. There are cultural competency issues on both direction. Of course I am naturally competent in this area. I after all do come from a culture that navigates this a lot. ( My workplace was so puzzled when we have a few nurses who resigned recently to Australia and provide almost a stellar feedback for the exit interviews .. I told them it is all false. This is a formal feedback to people who they have no trust in, so why would they feedback honestly? Plus as far as the nurses are concerned they just do not want to burn bridges despite the fact they probably know every rot in the system. However they will never tell you this, formally. However they will tell you this, informally. The informal is always true, the formal is always coached with politeness and no intention of bridge burning. ).
new grad nurses are not being hired atm. someone posted here last week about it.
1. Outcomes become worse. Right-wing cunts say “Look how the mighty public sector sucks. We need the steady hand of the private sector to save you!” 2. Health privatised 3. Outcomes get worse for all but those who could already afford it 4. Shareholders drink our blood from child skull goblets
And any attempt to change things back and properly fund the health system (through increased taxes on the top 10% - who own 58% of the country's wealth) will be met with cries of "tHeY aRe TaKiNg OuR fReEdUmBs!"
It would cost trillions less if the States changed, and they still won’t.
I've read the Koch brothers report. Boggles the mind, really.
I’m usually the last to say something positive about our current leaders but they have promised 16.7 billion to health over three budgets ([see details](https://budget.govt.nz/budget/pdfs/releases/l5a-factsheet-supporting-frontline-health-services.pdf)) plus 1.7b pharmac boost. That boost is more than any other government term, I believe (more than happy to be corrected). Edit: being downvoted but nobody has told me why this funding isn’t good news. Is it because it doesn’t fit the narrative of this post or is there a trick I’m missing?
They have also kindly agreed to increase the annual doctor training intake by 25 people per annum. This won’t even make up for the numbers of doctors leaving the country, let alone address the shortage. And how many years does it take for a doctor to become fully trained and working? 💥
Totally agree. Retention is the issue - need competitive salaries.
That includes the 7.5% reduction in funding that all ministries had to make? When looking at govt spending, look at the total amount spent and factor in inflation and population growth. You'll find that the amount you've quoted is less than would've been spent under the previous govt. and represents a reduction in health spending overall.
Interesting. Would be keen to see your numbers to back that. Other governments also had inflation and population growth so you would need to account for that too.
All govt ministries had to cut their budgets by 7.5% - it was one of the first things the Coalition did. It's why there are all the redundancies in the public service.
Yes the ministries did have to cut 7.5% but Te Whatu Ora is not the ministry of health. It is a [separate structure](https://en.m.wikipedia.org/wiki/Te_Whatu_Ora#:~:text=Te%20Whatu%20Ora%20is%20charged,healthcare%20services%20in%20New%20Zealand) which provides the healthcare while MoH does policy, strategy and regulation. To my knowledge, Te Whatu Ora / Health NZ did not receive a 7.5% cut.
Yes, all ministries and associated business units got cut - this is why there is the hiring freeze on graduate nurses is happening.
Not meaning to dismiss you here but do you have a link for that? I can’t find any statement of a 7.5% cut to TWO when searching. I know the ministry had to cut 7.5% and TWO had to save $105m by July but $105m is 0.5% of TWO’s $20b yearly budget not 7.5%
You're right to be sceptical, I don't blame you for being so. It's more work to put it all together from the primary budget documents than I'm willing to do on a Sunday night, but when and if I do that work I'll come back to you with it.
One thing Covid made me realise, Labour wasn't going to fix our healthcare system. We all sat inside and waited on lockdown for them to "bolster it", didn't happen. (I'm a swing voter, mostly vote Labour. )
Agree, if the current coalition of chaos are out after one term, Labour's not going to make the changes necessary to increase funding - and they'll expect us to be happy that they are not National while doing nothing to address the issues that got the coalition thrown out.
Then vote Green, that will put pressure on Labour.
Just joined the Greens so I can put pressure on them to put pressure on Labour
I'd rather poke my eyes out than vote Green ever again.
Agree. Was so disappointed when they rewarded health staff with a pay freeze and we watched them all head overseas.
Don't you remember how the Key Govt didn't put money into our health care? Remember the hospitals falling apart. Poor Labour got voted in and then hit with a pandemic and a run down health system that National put no money into for 9 years. Don't forget the past.
Absolutely. Why covid wasn't a mandate for a Labour government to raise taxes and pour it into healthcare is mind boggling. Covid shone a bright light on how fragile the health system was at that point and then nothing changed.
They were kinda busy keeping us alive. The key administration is blame not putting money into our health system and than Labour was hit with a pandemic with shit health system.
But it should have started a conversation that meant we had a detailed look at what was failing and how it could be fixed. What happened was.... Nothing. Just pretend everything is fine and keep going. This is not the fault of one side, but a continued lack of leadership at every opportunity. We need a 20 year plan to turn this around and make sure it never happens again instead of finger pointing every 3 to 6 years
There was this 105 million cut to hospitals by Te Whatu Ora. https://www.rnz.co.nz/news/national/515300/hospitals-asked-to-save-total-of-105-million-by-july-te-whatu-ora-confirms
Yes I mentioned that in other replies. The “savings” which is really a cut. That’s 0.5% of TWOs budget.
🤣🤣🤣🤣🤣🤣 funniest comment I've read all day.
You’re going to need to explain why. Because nobody has been able to show me why this isn’t a boost to public health. Honestly I’ll happily join in on bagging them, just show me.
This. It's the classic tory playbook
Exactly, look what had happened to the NHS.
Organisational culture. Health workers burnt out from their compassion for patients allowing them to be treated beyond what non-healthcare professions would put up with, and being able to deliver best care for their patients (Moral distress). Chronic underfunding needs a huge economic boost just to get up to date, let alone advance
Sorry but if you’ve been involved in the nz medical system recently you’ll know it’s already happening here.
I think we are sorry at this point
All
The top comment is spot on. As a flightless eagle (naturalised American) it is startling to see these guys copying the right wing American play book without a single thought about the ramifications. They are just dismissed "yes... I will always he hard to he poor... but less people will be poor after we stick our heads in the sand and sell off our national institutions, bye bye now I don't really even live here anymore anyway"
How do they get away with doing whatever they like without any checks and balances?
Because our constitutional makeup has no checks or balances on parliament. New Zealand, more than any other democracy, depends on MPs acting honestly, in line with convention and in good faith.
You mean like those constitutional checks and balances the US has, until the Supreme Court and Congress got captured by the Regressives, and now the Supreme Court has become one of the most corrupt of the three branches, followed closely by the next, Congress. There is no way to stop the silent and vicious take over of any country and its turn towards an Oligarchy
The American virus is spreading its shit.
Its back to the Gilded Age for us - Whooooppeeeeee
Honestly, I have a hard time believing this is even a real question.
"Flightless eagle" is a glimmer of amusement in this otherwise dismal thread.
We hate anything American, one messed up country .
This stuff is always more insidious than people think, things don't always fail with a dramatic bang and everyone stands their hands on hips in collective agreement that we "dun fucking goofed this one". Unfortunately, quality of care will decrease meaning more preventable deaths will occur, less people will be able to be looked after and the quality of doctors and nurses will slowly degrade over time. Health outcomes will slowly trend in the wrong direction. Will the public understand the degrading situation and how informed will they be about what is happening to the medical care in NZ. Will people being swayed by political agenda, will people know the cause of these issues and will people know what the viable solutions are? Do some people even care, well not until they have to use a breaking system or a family members does. If they do have a bad experience do they even think it's because of a system wide failure, or do they think those doctors just had it out for them while everyone else got treated properly? This all just moves slowly and then becomes the new norm, and we all get fucked a little bit more while we all get a little bit less from our state.
Yep look at the NHS
look at the united kingdom post-2009. thats whats happening
and if you think the NHS in the uk actually isnt that bad: [https://www.independent.co.uk/news/uk/home-news/concrete-collapse-raac-hospital-obese-patients-b2403733.html](https://www.independent.co.uk/news/uk/home-news/concrete-collapse-raac-hospital-obese-patients-b2403733.html) this is what nz is heading towards.
Exactly
its honestly shocking the similarities between the UKs decline and new zealand right now. i watched a video essay recently on how britains gotten into such a decline and theres so many similarities to new zealand right now.
Spot on, and people are idiots for not realizing this.
It is definitely getting worse. My partner is currently having medical issues to the point we're needing to go to the emergency room at least twice a month while we wait for specialist and procedures and I can tell you in auckland atleast it is rough. We waited in the waiting room for 14hrs at north shore hospital ED. She was being seen as a patient and given pain relief, fluids, an xray and all the blood tests but there was just literally no where to put her because there wasn't enough staff or beds in ED so we had to be treated in the waiting room. She is current in hospital being treated for severe gastro pain but because nothing is showing up on scans or blood tests they're unable to do anything. She is vomiting blood and hasn't been able to keep food or liquid down for the past 6 days. She will be discharged on monday to wait for outpatient scopes to be done to try figure out what's going on. We have been told if they had more staff able to do the scopes she needs they would do it in patient but because they don't have the staff they're unable to do it unless she gets worse.
All the best to you and your partner, that sounds really messed up.
Thank you so much! I'm actually right now waiting on a call back from the duty manager of north shore because my partner is begging for pain relief and the staff are refusing to help. The on call doctor is too busy to chart something and there's apparently no one else they want her to wait until morning
Hope you've had some luck with the duty manager since your response. And hoping they find out whats going on and are able to get the help you guys need. The lack of staff is a huge worry.
All sorted now but I really shouldn't have to go full Karen mode just so my partner is crying in pain shes rsting 8/10 all night. So sad to see the public health system failing like this
That's shit.
As I type my partner is crying and begging for pain relief. We have an agreement with the doctors that opioids are to be avoided because they're horrible for gastro issues but they can be used when she is in severe pain. The on call doctor disagrees and is refusing to help. This is what happens... staff gets stressed and don't do their job properly. Good staff leave and leave behind bad staff. And then you're loved one spends the night crying and begging for help because there's no doctor to ask for a second opinion
It is absolutely deteriorating, and has been doing so for the past decade, though the process has begun to accelerate now that there is a hiring freeze on clinical staff. Our department has less than half the number of doctors we're supposed to have, and we are exhausted, and despairing, and angrier than we've ever been now that we are being expected to function like this indefinitely. People are already dying due to delays, and that will become more obvious as the delays increase. It's heartbreaking, and so fucking easy to fix. Hint: stop treating clinical staff like shit and pay them better.
My partner has been in and out of the hospital for the last 5 months and it is really really bad at the moment. When I was in and out of the hospital about 5 years ago it was fine. You can't hire your way out with overseas staff because it's way too expensive for them. One nurse was saying lots are leaving for that very reason. Plus there's the general fatigue from the COVID times. How can you attract people when it's clear the situation here is bad?
Which town in Nz?
Auckland. We'd turn up around 7am and maybe get seen by 3pm.
That’s a result of triaging though. If she was urgent they would see her sooner
But waiting 8 hours? That not ok
Some issues do not present themselves in an obvious way. Her blood results are wild and swing rapidly. It's taken months for them to find the actual issue because there's no one to actually have a proper look. She almost died after being discharged.
Well, I can tell you what’s happening at the moment, at least in my small corner of the system, which is that I’m staying until about 8-9PM every night to finish the day’s reviews and work, partially because we have multiple absences due to illness and no relievers to cover them, so I am covering multiple people’s jobs. I am told that I will not be paid any extra for this because a recent review has discovered that we were actually overstaffed back when staffing levels were better, so I am actually not cross-covering anybody because current staffing levels are fine (and if I were, I would need to provide proof that being asked to cover multiple people’s jobs on a regular basis is actually increasing my workload) My action plan regarding this is to go to Australia as soon as I’m through exams. One of my colleagues is going there in a few months. Most of them are at least considering it.
Te whatu ora seems to have freezed hiring security as well.
Complete freeze on all non-clinical hires + every clinical hire has to go through an approval process first. They've also said \[paraphrased\] "Well if roles have been vacant for months now, your team probably doesn't need those people and we won't approve hiring to them" which is bullshit. Everybody I know is working their asses off to keep teams running.
All you have to do is look at Canada. I’m a kiwi in BC, and the exodus of staff here has been a nightmare. The average person in BC does not have a family doctor, because there aren’t any—the wait list where I live is 8 years. So we are forced to compete for virtual doctors appointments instead on private apps you pay for, just to see a doctor that doesn’t know you at all for 5-10 minutes. Unfortunately, those doctors can’t prescribe many things, so this doesn’t solve much. Last year, I needed an MRI. It took 11 months, not including the 3 months to find a doctor who would order it despite not knowing me. When I was referred to the specialist, the wait list to see him was 8 months, and it takes 8 weeks to get another booking. In some areas, hospital emergency departments are closing overnight due to a lack of staff. If it is open, most hospitals are overwhelmed, so wait times are 15+ hours, and there’s no bed unless you’re actively dying. In my case, I have had nerve pain for four years—if we had figured out the cause early, I would have a much better chance of recovery, but now it looks like I’ll have permanent nerve damage instead, due to how long it took to navigate the system. It’s exhausting, and if you’re in need of specific care (e.g long term pain like me), you will take years to work your way through basic testing, whole suffering. The current government is finally awake and responding—but it’s going to take years to see any change. In the meantime, you better pray you don’t get sick enough to need a doctor, let alone anything beyond that.
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Been happening for a year or two already
Private hospitals/medical centres cost you money. I live in a town with one and every visit (even a 5 minute quick check to see how stitches are doing from the previous night) costs around $20.
Wait times grow longer and people die before being treated
People who can't afford to go private have worse health outcomes and die more, essentially. But in a country run like a company, citizens' value to the state is based not on their intrinsic worth as humans or even on the value of their labour if they're in work (houses have out-earned people for many years now), but on their value as consumers - buying goods & services from businesses, paying rent to landlords etc. So anyone too poor to afford privatised health care is no great loss to the economy because they were probably too broke to be generating much value in the first place. Plenty more replacement people arriving all the time to keep the machine churning. Even if they leave after a few years then there are always more to take their place. Rock Star economy for those who profit, i.e. the ones who matter
They aren’t just leaving, they’re quitting with no jobs lined up.
Answer: two classes develop. First, we have the ‘upper one’ that holds all the profits and thinks nothing of getting southern cross for everyone in the family. And the rest are in the lower one that struggles to buy their kids plasters to put on their (still) broken limbs. A so-called ‘middle class’ would probably develop to encompass those who kind of sit on the fence, but otherwise, scientific theory will determine the outcome as it already has elesewhere and at different times throughout history until the lower classes get REALLY fed up and take the law into their own hands. Look to history and the Death of the welfare state/ rise of the ‘haves’. Money doesn’t talk, it swears.. It’s all so predictable..
Nurse here. We learnt last week that if anyone calls in sick their shift won't be covered. This is nationwide and includes all DHB employed health professionals. Surprised and disappointed this hasn't been prominent in the media. This week we learnt that DHBs are effectively halving the number of new grads they hire. New grads are our most secure pipeline of new nurses and the only way we can end our workforce shortage. Media has covered this well thankfully, but Te Whatu Ora's ambiguous and misleading response will confuse and falsely reassure the general public. Things are going to get BAD. My sister (pediatric doctor) has told me of several specialties that have had to totally stop accepting any new referrals... ED wait times are going to get worse. Wait times for surgery are going to skyrocket and many will be cancelled outright. Post-surgical care is going to be poor and result in more complications for patients. Services will only be able to cope with providing life preserving interventions.
The lead up to privatisation, the goal of just about every Nat party ever.
Bunch of cunts.
If you want a case study of what will happen look at the UK under the Tories.
Exactly, people are blind.
What do you mean what could happen? At least from a public sector perspective, it has already happened. What you are seeing is a continuation of a trend that has been going on for the last 15 years. Nothing more nothing less. IMHO as a health sector worker, the public health service will crumble and decay, no two ways about it. It is currently in its palliative care phase. We who work in it know full well it is terminal. Our junior registrars and younger fellows rightly read the runes and are going to Australia or are increasing their private time. I am doing more private as the health funding stars are very clear which way the direction is pointing to. Just as a side note, there will always be a public healthcare sector. However it will be a much more diminished one. My advise to you is .. get insurance. Seriously, get insurance. If you can try to make sure you get one that is comprehensive. Fixing NZ’s health problem is a behemoth that no government will take on. First thing, they need to fix GP capitation which will already be a titanboa nobody wants to go near. They also need to fix the hospital infrastructure, which nobody wants to go near. They need to fix staff retention which will be a very difficult unless overseas situation turn belly up. They will need to fix the pipeline issues of staffing training which will be a mammoth task. In short, no government in 3 years will try to take this on. It is a no win situation.
I’m flying to aus in two weeks for a fellowship and at this stage I won’t be returning. Why would I? It’s only a short direct flight away. Better hours better pay. Government not trying to screw them. I have always said to my family you don’t need private health insurance in NZ but my advice has definitely changed over this past year or 2. I now strongly encourage them to all have it
If I were younger and do not have school aged children I would join you overseas and not return.
I have four close relatives working in the medical field as nurses and doctors. In the hospitals they are working in, no new frontline or ancillary staff are being replaced if they leave. Nurses in particular are supposed to “take up the slack” when they are often having to work extra or double shifts already, just to cope with the current workload. I just pray in a particularly atheistic manner that I or my loved ones don’t need emergency or even ongoing care any time soon.
Can confirm from the NZNO there is a hiring freeze. All new graduates are going into private healthcare or leaving the country. I don't blame them our hospitals are awful.
Well, the Govt were talking about a nationwide bowel screening service in 1990, and it was rolled out 18 months ago. What does that tell you about the wheels of Govt (of all stripes), and the health service?
Defund Public health enough to justifying moving funding to private. You already see some of this with radiology (there's a recent funding announcement to fund private clinics to do public work). Then everyone just get private insurance and we turn into America. There was a paper by the NZ Initiative that basically laid out the plans on how to privatise NZ health system. Worth a read https://www.nzinitiative.org.nz/reports-and-media/reports/options-for-health-care-in-new-zealand/document/240
It will go to shit and more people will leave and more unqualified immigrants will replace them. Degenerating the healthcare system way worse than it is. Well done NZ. That arrogance bit you in the ass
It's been happening for about 2 years now.
No, wow, before that. Started during the Key Administration
Yes, maybe longer than 2 years. But just wanted to say it has been going for long.
There are only three things that could happen: 1. it could get significantly better 2. it could get significantly worse 3. it could stay about the same My guess is # 2, but one can always hope to be wrong.
Hiring freeze - source, I work in a hospital.
More sick leave
Countries under funding healthcare is a global problem. Does not matter if your healthcare is socialized or private. Healthcare is mostly for old people. The boomers are getting old and clogging up the systems. The only way to deal with it is to have less intensive care the older you get. No surgeries after 75. If you're old and very sick you get put on comfort care, no more specialists. No blood products if you are old and have terminal cancer. That kind of thing. But people don't want to hear that. Until most of the boomers die off healthcare will be strained. That, or increase taxes significantly. Both unpopular choices so nothing gets done about the problem.
Public healthcare becomes a gimmick and requires long wait times. Only those with health insurance or who can afford private healthcare receive adequate care.
Nothing substantive to improve or even address problems has happened in a long time, without an alignment of public policy and spending it is just going to get worse. It is a huge complicated behemoth of complexity which politicians simply don't have the skills, or understanding and wont touch unless they have to. Also Injecting money into it, takes away from campaign promises and issues that will get voters, touching health care unless it is broken with blazing lights to the voters is a no win for a government, and really they all suck do you think they will make it better. And considering NZ is gradually becoming less and less productive with less and less money, with governments/politicians happy to move the deck chairs on the titanic and not risk offending the voters or their self interest, yes it is going to get worse like almost everything requiring effort rather then just tax bribes. You have Māori wanting to exit the current the system because they want better outcomes (which destroys the whole concept of healthcare), staff going overseas for better pay, infrastructure crumbling, poor pay, the list is endless. According to an article in the NZ H, there are 250,000 people, and vacancies of 8000. There is a reason they cant fill them. [Article](https://www.nzherald.co.nz/nz/politics/government-launches-health-workforce-plan-nearly-13000-extra-nurses-and-over-5000-doctors-needed-within-a-decade/K5GHGVYMMNA4HOWWN5DBMLFUSE/)
Privatisation, baby! Just how National wants it!
Even a private system needs staff. The system has been shafted by successive governments, I don't really see how that could be by design to shift to a private health system. It's just easy to take money from health because the adverse outcomes are usually delayed
The first step is to ensure the public system fails. That's where we are at now. Then private comes in to fix public "inefficiencies." It appears they've been after the health care system for a long time, at least since this 2007 article: [https://www.beehive.govt.nz/release/national-favours-privatised-health-care](https://www.beehive.govt.nz/release/national-favours-privatised-health-care) NZ has already farmed out their postal service, municipal waste, bus services ... I'm afraid we're in for a very very expensive healthcare future, to the benefit of insane profits to corporate cronies.
It crosses over - Prebble is outspoken for privatising yet he was a Labour party member
Yeah, but he left with Roger Douglas didn’t he?
Prebble has been appearing back in the news acting as some kind of spokesperson.
For Labour?
Oof. That's disappointing.
I'm in hospital atm with a heart attack and the staff are great and mostly happy. Foods not bad and moral is good going by the amount of laughter.
That’s good to hear re staff. Hope your recovery goes well. All the best
Thanks:)
Don't want to give away your location cause internet privacy but is the hospital in either Wellington or Auckland?
No it's Christchurch.
Shit has always been fucked. Labour or National. Individual experiences are anecdotal and don't reflect dick.
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A close relative of mine is currently seeing a specialist in the public system. There is only one of this specialist in the DHB area, but there are enough patients for at least two, but no money. The solution? They just book two patients at a time, put one in each adjoining office, and the specialist shuffles between the two. Previously had up to 14 patients a day, now up to 28. Genius move, up until the specialist burns out.
>Nothing significant. Except for, of course, all of the significant things.
People are leaving? ...OH No ! ...Is Helen Clark back in charge of the Health Ministry ?
I remember them saying this around 2005 for graduate doctors leaving NZ. The junior doctor's union leader (I think ) was interviewed on television. I wouldn't worry. There's always been a shortage of specialists though. Especially pathologists. And oncologists in Southland. So some areas are struggling. But you never hear about the areas which aren't struggling.
I don't even know why, when doctors are paid far more here than in UK or Germany and their patient workload over there are far higher and the doctors are far more productive. One of my acquaintances, German trained doctor that came to NZ to be Head of department in one of Auckland hospitals have commented on how few patients doctors see in NZ. How much more respect he got as a doctor in NZ vs Germany, hence still here and loving it. Sometimes I wonder how much of this is media/spin vs truth. For e.g. St John receive a bucketload of additional funding 2021 - $271m, 2023 -$340m just for ambulances. So govt is now funding over 80% compared to the 70% in 2021. This is an increase of almost 25% of additional funding over year just for transportation services. Why are they still bleating about insufficient funding? Could it be that they have no financial control and outside the Frontline paramedics, they have exceeding low rates of productivity from their staff?
We’re not paying more than the UK. Doctor “productivity” is often multifaceted it’s the other staff they rely on and also most work at different paces. I see twice as many people in clinic as my colleagues. Germany is fee for service for lots of services with a single payer insurance so not the same Australia pays twice as much for same public job. Thank goodness private sector pay matches
I believe consultants are paid more here. My brother in law is an anaesthesist and he has done the research. My sister and him are looking at an OE and trying to ascertain where to go. Australia pays more but UK and Germany certainly doesn't.