Police disappointed in scrapping of mental health pilot scheme

National’s spokesperson on the police, Chris Bishop, has uncovered the scrapping of a pilot project that would have added mental health expertise to front line policing.

The Government’s decision to axe a universally-supported pilot to improve the response to 111 mental health calls is nothing short of disgraceful, especially after Labour pledged to make mental health a priority, National’s Police spokesperson Chris Bishop says.

“It has been revealed that Labour has scrapped a pilot in which a mental health nurse would attend mental health incidents alongside police and paramedics to ensure that people in distress receive timely responses that are tailored to their needs.

“Police spend around 280 hours a day responding to mental health calls. They do a good job, but are not mental health professionals so having a mental health nurse deployed to incidents with police would make a real difference.

“The increasing demand on police to respond to mental health crises is set to continue. That’s why the National Government set aside $8 million for the pilot as part of our $100 million mental health package.

“Police Minister Stuart Nash confirmed in answers to written questions the day of the Police Estimates hearing that the pilot would be canned, yet Police Commissioner Mike Bush told the hearing that police were very hopeful it would continue – in front of Mr Nash.

“Mr Nash has admitted that police are dealing with more and more mental health cases. The pilot would have eased pressure on police and improved the quality of the response for those experiencing mental distress.

RNZ: Police disappointed after mental health pilot dropped

Police officers are upset a proposal to improve 111 callouts has been dumped and mental health advocates hope it may yet be salvaged.

The former National government last year announced an $8 million pilot scheme where mental health workers would attend crisis calls along with police and ambulance staff.

The trial was due to start in September, but police headquarters said the new government had “re-allocated” the funding and so the pilot had been dropped.

Police Association president Chris Cahill said the decision was “disappointing” and officers needed practical support “sooner rather than later”.

“It’s all good to have inquiries and to have think-tanks, but people need help now. They’re crying out for it.”

Front-line officers were overwhelmed by the sheer volume of calls relating to mental health, he said.

“Police aren’t the best equipped to do this. It needs to be people in mental health services who look after them. It’s a medical issue, not a policing issue.”

Health Minister fobbed off queries.

Health Minister David Clark turned down an interview request, but in a statement said the proposal “was never fully developed” and it appeared National had cobbled it together in a hurry.

He expected the government’s mental health inquiry, announced in January, would include advice on how to improve the emergency response, he said.

How long will that take? What if that inquiry recommends the pilot project or something similar? Labour said there was a mental health crisis, but they are not acting like it is a pressing problem now.

The Mental Health Foundation…

…had been supportive of the scheme and its chief executive Shaun Robinson said it was a shame to see it fall by the wayside.

“The police have unfortunately been left to be the mental health service of last resort.”

Mr Robinson said he would be keeping a close eye on the inquiry’s findings and was hopeful it would come up with a similar or even better idea.

“We would really hope to see that there’s something significant in the crisis response area,” he said.

“It may be a short-term loss for a longer-term gain.”

Fiona Howard, from Mental Health Advocacy and Peer Support in Christchurch…

…also hoped the inquiry would report back with a similar project.

She said she empathised with police frustration, but understood the government’s approach to first assess the entire mental health system.

“What I hope is that we can sort of pause – even though I know it’s hard to wait – to make sure that we get all the results from that inquiry in to make sure all parts of our system that are under stress get the resourcing and new initiatives they need.”

Reporting back with a similar project, and then implementing it, will take some time. Scrapping the pilot scheme seems very strange.

Calls for more funding for cochlear implants fall on deaf ears, reduced instead

The Government has cancelled funding for cochlear implants after a successful campaign last year pushed the previous Government to give a funding boost.

Further campaigns this year have fallen on deaf ears in the new Government.

Minister of Health David Clark has refused to comment.

A cochlear implant is an electronic device that provide sound signals to the brain when inner ear nerves that usually do this are damaged.

July last year: Kiwi woman urgently needing cochlear implant not even on waiting list and feeling ignored

In March, 1 NEWS told how the 22-year-old would be completely deaf, if she didn’t have a cochlear implant.

Now, with just weeks before her hearing deteriorates completely, she’s learned that she isn’t even on a waiting list for the surgery.

She says she is “depressed, angry and upset” by the news.

Now almost 25,000 people have signed a petition calling on the Government to step in.

A petition signed by 26,000 people was presented to Parliament in August. Later that month (during the election campaign): Cochlear funding boost music to ears of deaf Kiwi adults

Another 60 adults will once again be able to hear thanks to a boost in funding for cochlear implants.

Health Minister Dr Jonathan Coleman this morning announced an extra $6.5 million would be spent on providing cochlear implants for adults.

There are currently 224 adults on the waiting list for a funded cochlear implant.

Up until now there has been funding for only 40 a year but in 2017/18 there will be money available for 100 people to have the life-changing procedure.

The money, taken from another part of the health system, would take the Cochlear Implant Programme’s total funding to $14.93m, Coleman said.

“The investment will also increase the capacity within the system and cover the additional audiology and rehabilitation time required to support such a massive uplift.”

Levin surf lifesaver Danielle Mackay, 22, has been waiting for a publicly-funded implant for more than three years and will now finally get one.

In January this year – Deaf device: ‘A lot of people don’t want to wait’

Profoundly deaf people are bypassing a waiting list and paying to get their first Cochlear implant because they can’t bear to wait several years before they get their hearing back.

More funding for the cochlear implants – which can change the life of a deaf person – is needed, say advocates.

Dr Baber said about a third of the people who came in wanting an implant were turned away after being assessed.

Mr Baber supported the call for more public funding for Cochlear implants.

“They are considered the third most cost-effective high-tech medical intervention there is.”

Yesterday Stuff reported Government’s ‘shocking’ $6.5 million funding cut to cochlear implants

The Government has quietly cancelled extra funding for cochlear implants, despite a successful campaign for publicly-funded devices for every Kiwi who needed one.

Levin surf lifesaver Danielle McKay spearheaded the campaign after she waited three years for the surgery. She said the decision to slash the $6.5million funding boost was “shocking” and “disappointing.”

Health Minister David Clark refused to comment on the cut. But a spokesman confirmed that extra funding was not extended in this year’s Budget.

National Party spokesman for health Michael Woodhouse:

“It’s a callous and disgraceful decision which is going to see people lose their hearing when they don’t need to,” Woodhouse said. “We boosted the number of funded cochlear implants for adults and sped up access to implants for children.”

“This Government doesn’t see saving the hearing of hundreds of New Zealanders as a priority and those hundreds of New Zealanders and their families will be bitterly disappointed.

“Let’s not forget this Government has claimed for years there was a health crisis and now they’re in Government they’re cutting funding.

“It’s a disgrace.”

There are many demands on the health system and on Government funding, and it isn’t possible to fund everything, but cutting back on funding is difficult to defend – so Clark has chosen to not try to defend it.

Discussion on this at Reddit. Is not continuing a funding boost a funding cut?

 

Quietly scrapped national health targets, no replacement yet

Health Minister David Clark has decided to quietly scrap national health targets, without debate, without evidence, and without anything yet but a vague promise to replace them with.

There is nothing in the Beehive media releases, but yesterday National claimed Government axes National Health Targets

The Government’s quiet shelving of National Health Targets is bad news for Southland says local MP, Sarah Dowie.

“It is outrageous that the Government has done away with the targets which include a set of six major indicators, which measured DHB’s throughput in surgeries, cancer treatment, Emergency Department waiting times and childhood immunisations, as well as B4 School checks and help for smokers to quit.

“Just as they scrapped National Standards within education, they have done away the Health Targets that ensure public reporting of DHB’s performance with no plan of how to effectively manage and monitor the healthcare of New Zealanders.

“Minister Clark needs to realise that you cannot effectively operate healthcare systems on anecdotal evidence.”

Simon Bridges (RNZ): Ditching health targets is ‘absolutely outrageous’

The targets were put in place by the former National-led government in 2009.

They focussed on six areas: increased immunisation, faster cancer treatment, shorter stays in emergency departments, improved access to elective surgery, helping smokers to quit and raising healthy kids.

Mr Bridges said it was absolutely outrageous that the government had canned the targets.

He said it was a prime area where the government could be held to account.

“Over time dropping the targets, losing the accountability will mean more illnesses and more fatalities in our health system that could have been prevented.”

The Health Minister’s office…

…said the old targets would not be published, and new targets were being developed.

Meaning the old targets are being scrapped,

Acting Prime Minister Winston Peters…

…said National had the wrong end of the stick.

“They are not correct in saying we’ve dropped health targets, we just think those health targets were such a miserable failure that we have to find something that works and that is better, and that’s what we are working on at the moment.”

Peters proves himself incorrect in the same sentence.

Stuff:  How’s your DHB doing? Govt does away with National Health Targets

Public reporting of District Health Boards’ (DHB) performance of procedures including elective surgeries, cancer treatment times and Emergency Department wait times, has been axed.

It also appears a new project to publicly measure elective surgery referrals and rejections has also been quietly shelved, with the Ministry of Health failing to release updated figures since the election.

Health Minister David Clark said the targets created “perverse incentives”, particularly in relation to surgery – but the Opposition said there was no evidence to suggest that’s true.

And while there has been no announcement, the National Patient Flow project – which measured the number of patients being turned away from the operating table – has not released any updated figures since September last year. That project was launched following intense political pressure from Labour, over surgical unmet need.

Clark has given an assurance that more surgeries would be performed, but there was currently no public measure of that.

Just trust Clark’s word, with no numbers?

“As minister, I’m concerned about the perverse incentives that exist under the existing targets, whereby we’ve had what were traditionally cheaper surgeries performed in more expensive environments and so not spending the health dollar as wisely as it could be spent,” he said.

Clark, who has also implemented a complete review of the health sector, said the current system wasn’t “fit for purpose”.

Nationals health spokesperson Michael Woodhouse asked Minister Clark about it in Parliament yesterday.

8. Hon MICHAEL WOODHOUSE (National) to the Minister of Health: Why does the Government intend to dispense with the national health targets?

Hon Dr DAVID CLARK (Minister of Health): The previous Government’s health target data has not been published since August 2017. I want a health system that has honest and transparent reporting.

Woodhouse complained that his question ‘why’ wasn’t answered, but I think it is established under Speaker Mallard in Parliament that avoiding answering is an obvious answer of not disputing what was asked.

Hon Michael Woodhouse: Does he stand by his statement that the targets create “perverse incentives”; if so, what is his definition of “perverse incentive”?

Hon Dr DAVID CLARK: A good example of a perverse incentive is to recall what happened toward the end of the previous Government’s tenure, when the overall statistics showed that the number of electives was going up, yet in centres like Northland, Auckland, Counties Manukau, Bay of Plenty, and Waikato, if Avastin injections and skin lesion removals were taken out of those pumped-up statistics, the actual number of surgeries was dropping. Despite a growing population, the actual number of surgeries was dropping. That Government should hang its head in shame. That is the result of nine years of underfunding.

Hon Michael Woodhouse: Given that, is it his view that eye procedures designed to save the sight of patients with macular degeneration, or skin procedures aimed at improving the prognosis of cancer patients, are not worthy of undertaking or counting?

Hon Dr DAVID CLARK: We know that skin lesion removals can be performed for roughly half the price in a primary care setting as compared to being performed in a hospital setting. So it doesn’t take a rocket scientist to work out that if you can afford to perform twice as many surgeries, more lives will be saved.

Hon Michael Woodhouse: Is it appropriate to describe the saving of more than 700 lives a year by implementing targets to improve emergency department waiting times, as reported in the New Zealand Medical Journal last year, as a perverse incentive?

Hon Dr DAVID CLARK: I don’t think anyone is saying that about that target. We will continue to monitor a range of measures, dozens of measures, through the Ministry of Health, and the district health boards will be held to account for improved performance.

Hon Michael Woodhouse: What possible benefit to New Zealanders can come from the dispensing with of publicly stated targets that improve surgery throughput, reduce waiting times, improve health, and quite literally save lives?

Hon Dr DAVID CLARK: I disagree with the member’s characterisation. What we know is that that set of targets was driving a set of behaviours which may have led to the public health dollar being more poorly spent, with health consequences for New Zealanders. By defending a set of targets with perverse outcomes in it, the actual fact is that that member and his former Government may well have been driving poorer health outcomes for New Zealanders.

Audrey Young points out Labour ditches national health targets with no debate on their value

At no point during the election campaign last year did Labour or its coalition partner campaign to get rid of national health targets.

So the decision Health Minister David Clark to drop national health targets came like a bolt.

In fact for the past six years Labour and Jacinda Ardern in particular have insisted there is value in having specific targets in the area of child poverty in order to measure progress.

Ardern won that argument. There has been wide buy-in to that argument, which makes Clark’s decision when it comes to public health the more bizarre.

It was a decision that did not go to Cabinet – and should have.

The least that the new Government could have done was come up with its own priorities or have some new form of accountability in place before ditching the targets.

Quietly dropping the targets without saying so and without debate is a concern, especially when there is nothing in place yet to replace them.

Dominion Post editorial: Trust me, I know what I’m doing

Health Minister David Clark is scrapping National Health Targets that publicly address district health boards’ success or failure in achieving, among other things, reasonable treatment times, numbers getting surgery, waiting times in emergency departments, and immunisations.

Incredibly, the National Patient Flow project, which monitors the number of people turned away from surgery, and which Labour supported while in opposition, also appears to have been sidelined.

In making these changes, he has criticised the “perverse incentives” created by the previous monitoring regime. Also, Labour has intimated that the DHBs and the previous National government padded the statistics with easier procedures, that they gamed the system. Trouble is, there’s no evidence. Just a “vibe”, it seems.

No evidence, just Clark thinking he knows best. That’s a concern, especially in health.

This Government has set aside an extra $31.5 million for elective surgery; Clark insists that will mean more operations and that the performance of the Ministry of Health in delivering those will be monitored.

But we just won’t have the regular, public updates to help verify that.

What we do have is the minister’s assurances that more operations will be done, at lower cost, with more beneficial outcomes.

He appears to be asking us to simply trust him.

Trust a politician? If things don’t go according to plan politicians are notorious for hiding bad news.

Clark had better hope that there is a perceptible improvement or he could come under fire in the future.

Significant pay settlement for mental health workers

Community and institutional mental health care has been deficient ever since mental hospitals were mostly emptied several decades ago.

Last year when 55,000  aged and disability residential care, and home and community support services workers, were awarded a long overdue pay increase (from the bare minimum to something relatively reasonable) there was a notable exclusion of 5,000 mental health care workers.

Yesterday the Minister of Health David Clark announced that this would be rectified.


Pay equity settlement for mental health and addiction support workers

Health Minister Dr David Clark is pleased to announce an estimated 5,000 mental health and addiction support workers will soon receive the same pay rates as care and support workers.

In an agreement with unions and employers, the Government will extend the Care and Support Workers (Pay Equity) Settlement Act to include mental health and addiction support workers.

Nearly half will get an increase of more than $3 per hour which means full-time workers will be paid approximately an extra $120 a week before tax.  One-in-five workers will get an increase of more than $5 per hour or around an extra $200 for a 40-hour week.

The new pay scale reflects workers’ qualifications and experience. It will be back-dated to 1 July 2017.

“This agreement puts right a problem created by the previous Government, which deliberately excluded mental health and addiction workers from the Care and Support Workers settlement. These workers often support New Zealanders when they are most vulnerable and they deserve a fair go. This Government has delivered that,” says Dr Clark.

“Ensuring our mental health and addiction workers are paid what they deserve will help deliver a robust workforce,” says Dr Clark.

The $173.5 million settlement extension will be implemented over a five-year term and funded through an increase to Vote Health.


This will go some way towards improving mental health care in institutions, community houses and the community generally.

Mental health issues impact on many things, including general health, education, workplace productivity, crime, prison overcrowding and rehabilitation.

Paying workers more will help get more and better care for people with mental health issues and their families.

This costs a bit but it should be money well spent.

Nurses reject large pay offer, Government says no more available

Nurses have rejected a half billion dollar pay offer. In response Health Minister David Clark says there is no more money available to “fix nine years of underfunding in one pay round”.

They have been offered a 9% increase but are seeking 15% – that’s a huge adjustment given the low rate of inflation and pay rises over the past decade.

Nurses’ Union:

NZNO seeking urgent mediation

The latest revised DHB MECA offer has been strongly rejected by NZNO members. However, Industrial Services Manager Cee Payne says that as nursing and midwifery is an essential service, mediation or facilitation will begin with urgency. NZNO remains committed to working with DHBs to find a resolution to this impasse and avoid strike action.

“The immediate staffing crisis as a result of the past decade of underfunding of DHBs has taken a heavy toll on nurses and their ability to provide safe patient care.

“Whilst the revised offer was substantially improved, compared to the previous one on pay for some members, members have rejected this. There may be concern about the variability of the offered pay increases.

“The revised DHB MECA offer on pay equity fails to specify how and when outcomes will be implemented. This has created uncertainty for members,” she said.

What is curious is why the NZNO aare taking such strong action seeking such a large settlement now that Labour are leading the Government, but did relatively little over “the past decade of underfunding”.

The Government response:

Minister disappointed nurses reject $500m offer

Health Minister Dr David Clark says he is disappointed that nurses have voted against the District Health Boards’ half-billion dollar offer, the largest made to nurses in more than a decade.

“Nurses are a vital part of our health workforce and clearly feel they have been undervalued over the last nine years. Their frustration is understandable. This offer goes a long way to address their pay and staffing concerns, but you cannot fix nine years of underfunding in one pay round.

“The deal that’s been rejected today is the largest nurses and midwives have been offered since their historic pay jolt 14 years ago under the last Labour-led government.

…the Government has to balance pay demands across the public sector. We have gone as far as we can in terms of extra Government money but hopefully the offer can be reconfigured in a way nurses are happy with.

It seems that nurses have a habit of pushing for pay jolts when Labour is in charge of the finances.

Perhaps they do deserve to be paid substantially more, but this puts the Government in an awkward position.

They are already making a large offer. If they give nurses a big catch-up then it’s likely teachers will be asking for something similar, mental health workers are also trying to get (deserved) increases. The police may then want to maintain parity.

This will substantially increase government spending, and could put pressure on non-government workers who will be left relatively worse off.

Everyone wants to be paid more, but no one wants to be taxed more, or pay higher mortgage and interest rates, or to pay higher prices for goods forced up by wage induced inflation.

Business confidence is wavering at the moment. Uncertainty over the cost of wages won’t help.

This is a very challenging environment for the Government.

Consensus government or an awful mess?

It’s certainly been a messy week for the Government. Is it a sign of a bigger, awful mess?

Prime Minister Jacinda Ardern tried to paper over some of this weeks cracks by claiming it was consensus government in action, but there were worrying suggestions it was the opposite – both Labour and NZ First ministers look like they are pushing their own agendas with poor or non-existent communication between them.

There are worrying signs of a lack of overall leadership, and this is at a very tricky time, with Ardern distracted by having a baby and due to go on maternity leave as soon as her baby is born (actually as soon as she goes into Labour and goes into hospital).

The big unknown is whether things will spiral more out of control with Winston Peters in charge.

The media have observed this weeks mess and many have commented on it.

Stacey Kirk (Stuff): Three ring circus with one ringmaster at the centre – buckle in for a wild ride

Consensus government in action, or a bloody awful mess?

It’s difficult to characterise the past week as anything but the latter and Prime Minister Jacinda Ardern may be worried about whether she’ll have a Government to come back to when she returns from maternity leave.

Her MPs don’t exactly make it easy for her.

And if this week has illustrated anything it’s what lies at the beating heart of any coalition-related controversy – Deputy Prime Minister Winston Peters has been at the centre of everything.

I don’t think he has. He had nothing to do with the David Clark revelations. And nothing to do with the Green uprising over granting water bottling rights.

And nothing to do with Stuart Nash telling a parliamentary committee he didn’t bother reading advice on what effect increasing poluice numbers might have, and would have ignored the advice if he had read it.

Peters  wasn’t directly involved in Kelvin Davis announcing a new prison that will rely on double bunking to cater for growing prisoner numbers – and Davis went as far as saying they could resort to mattresses on the floor. Peters didn’t directly cause that brain fart, but Labour are limited in becoming more lenient on imprisonment when they require NZ First votes to do any law changes.

But Peters dumped Little in a big mess over 3 strikes.

It began with a hastily-arranged press conference by Justice Minister Andrew Little, to reveal that his grand plan to repeal the three strikes legislation had been shot out of the sky.

He’d spent the previous week giving interviews about his plans to take it to Cabinet and push forward – the only issue was, he did not have the numbers to do so. More embarrassingly for Little, Peters decided to wait until the 11th hour to let him know.

Total humiliation  awaits any member of Cabinet who threatens to step outside the bounds of MMP and attempt a “first past the post”-style power play to get ahead of public opinion – that’s what Little got and really, he should have expected it.

That was in part self inflicted, but Peters played Little then dumped on him big time.

Never one to play second fiddle, Peters also took a starring role in a different drama. Days out from assuming the seat at the head of the Cabinet table was the moment he chose to file papers in the High Court, suing the Government and top officials over their handling of his private superannuation details.

Ardern’s assertions rang out more as pleas, that his actions were a totally private matter. Presiding over a Cabinet that may be liable for an eventual payout to Peters is awkward at best, and a clear conflict at worst – a matter that is most certainly in the public interest.

Peters’ court action looks debatable, but he has made Ardern look weak – or more accurately, Ardern has made herself look weak, just as she is about to hand over most of her power to Peters.

Meanwhile, as sources across multiple polls have suggested NZ First has well and truly settled below the 5 per cent MMP threshold, Shane Jones has pulled out the megaphone to tear strips off Fonterra. A total overstep many might say, of a Minister of the Crown. However, Ardern is adamant these comments were made in a private capacity, despite Jones as good as repeating them in the House.

This again makes Ardern look weak if not impotent in her own Government.

And she is now sidelined, leaving Peters and Jones to take on board this week’s signals and likely do as they please to raise their profile, putting the government at risk.

And Labour’s ministers look increasingly arrogant, uncoordinated and messy.

The Government looks like a bunch of headless chooks, with the fox about to take over the hen house.

 

Suggestions Health Minister tried to gag hospital staff

A week that began with Prime Minister Jacinda Ardern announced she would be staying away from Parliament as the birth of her child nears has become very messy for the Government, with Winston Peters and Shane Jones throwing bombs into the political fray, Minister Eugenie Sage under fire from Green members for doing her job, and a run of bad looks from labour ministers.

And here’s another, from Newshub: David Clark accused of silencing DHB staff over Middlemore

Newshub has obtained a voicemail and emails which suggest the Health Minister tried to gag senior staff talking publicly about the state of embattled Middlemore Hospital.

In one case he even appeared to promise a board member, who he’d sacked, another job if they shut up.

“I notice more and more getting reported that is really not helping at all, and I’m hopeful that there won’t be much more commentary,” Health Minister David Clark said in a voicemail to District Health Board chair Rabin Rabindran.

“My fear is that if you and I keep commenting, the story keeps ticking along. I’d rather not have distraction about who said what when.”

However Mr Clark denies this, saying he was “absolutely not” trying to stop board members from speaking out.

“There were a lot of conversations happening through the media and that meant there wasn’t clear communication about what was going on, and that’s unhelpful,” he told Newshub.

The voicemail was left on April 18th, two weeks after he sacked Mr Rabindran. In the same voicemail, Mr Clark offered him a new job.

“I would consider you for further appointments because I think that sends a message.”

If Clark and other Ministers under fire survive the term voters may consider sending them a message.

There is a growing impression that the Government is either out of it’s depth, or over the top arrogant. Possible both.

Nation: Health Minister David Clark

On Newshub Nation this morning: Budget 2018 pledged around $4 billion to fix the ailing health system. We ask Health Minister David Clark if that’s enough, and what areas are going to take priority.

Unusually Newshub hasn’t tweeted an excerpts of the interview as it happened.

Clark came across ok. he acknowledged that past Governments had dome their best to provide good health services, and New Zealand had one of the best and in some ways cheapest health services in the world, but was due a comprehensive review to try to determine the most cost effective ways of delivering.

Hence the Government are doing a review. And Clark deferred most questions to be being subject to the review. And he repeated several times that he wouldn’t say what might happen in pay negotiations (he is not directly involved) nor with future budgets.

So he competently didn’t really say much about what might change in providing health services.

There was little of value in this interview. Maybe next year, or the year after, Clark will be able to explain how he will improve health services.

Major review of health system

This one is called a Review but it seems to be similar to the scores of working groups and committees and inquiries set up by the Government.

A major health Review, to be chaired by Heather Simpson, senior staffer for Helen Clark when she was Prime minister and also in when working for the UN, and I think also assisting the current prime Minister’s office, will report back by January 2020.

That is unlikely to leave enough time to make any major changes prior to the election, but will likely provide for a  basis for Labour-Green campaign policy.


Major review of health system launched

Health Minister Dr David Clark has announced a wide-ranging review designed to future-proof our health and disability services.

“New Zealanders are generally well served by our health services, particularly when they are seriously unwell or injured. Overall we are living longer and healthier lives – but we also face major challenges,” says David Clark.

“The Review of the New Zealand Health and Disability Sector will be wide-ranging and firmly focused on a fairer future. It will look at the way we structure, resource and deliver health services – not just for the next few years but for decades to come.

“We need to face up to the fact that our health system does not deliver equally well for all. We know our Māori and Pacific peoples have worse health outcomes and shorter lives. That is something we simply cannot accept.

“We also need to get real about the impact of a growing and aging population, and the increase in chronic diseases like cancer and diabetes. Those issues in turn create pressure on services and the health workforce that need to be addressed for the long term sustainability of our public health service.

“The Review will include a strong focus on primary and community based care. We want to make sure people get the health care they need to stay well. Early intervention and prevention work can also help take pressure off our hospitals and specialist services.

“People rightly have high expectations of our public health service. As Health Minister I want to ensure we can meet those expectations now and into the future,” says David Clark.

The Review will be chaired by Heather Simpson, who is perhaps best known as Chief of Staff to Helen Clark from 1999-2008 but also has a background in health economics. The Review will provide an interim report by the end of July 2019 and a final report by 31 January 2020.

 

The review would culminate in a report to Government, including recommendations, on:

  • How the health system can improve accessibility and outcomes for all populations
  • Whether the health system promotes the right balance between availability of services,
    (particularly tertiary services) population density and proximity
  • Whether the current system is well-placed to deal with environmental challenges such as climate
    change, antibiotic resistance and technological advances
  • Whether there are changes that can be made to the health system that would make it fairer,
    more equitable and effective
  • How the technological and global healthcare context is evolving, what opportunities and risks
    this rapidly-evolving context presents, and whether there are changes that would support the
    health system to adapt effectively given the rapid changes underway.

In examining the points above, the review would consider the following:

  • Demographic impacts – what the predicted population changes are, their potential impacts
    upon service demand, workforce availability and risks that may need to be managed
  • The international landscape – what New Zealand might learn from examining where health
    systems are heading internationally and what the impacts are, including input from relevant
    international organisations such as the OECD, World Health Organisation and the
    Commonwealth Fund
  • Decisions around distribution of healthcare resources, capacity of the health system to deliver
    care and clinical effectiveness (quality and safety) – e.g. how does the current geographic
    distribution of services help or hinder the system as a whole
  • Funding – how financial resources applied to health funding could be altered to provide
    greater flexibility in allocation, better transparency of return on investment, better support
    innovation in service mix/design and investment in key enablers, and reduce inequities
    through targeting those in need
  • Investment practices – providing a nation-wide view of how much infrastructure will be
    needed, over what timeframe and the balance to be struck across service provision and
    delivery
  • Ways to support the increasing priority of the role primary care and prevention has within the
    wider heath service
  • Potential opportunities and risks associated with rapidly emerging technological advances and
    the implications for, including but not limited to, clinical tools and settings, communication and
    transport
  • Institutional arrangements – roles and responsibilities, funding, accountability and delivery
    arrangements.

[DRAFT] Health and Disability Review Terms of Reference.pdf

More from Minister of Health on GP fees promise

Minister of Health David Clark was pushed again today on the apparent decision to not fulfil an election promise to reduce GP fees by 1 July this year.

5. Hon MICHAEL WOODHOUSE (National) to the Minister of Health: Is it his intention to reduce GP fees for all New Zealanders by $10 per visit by 1 July 2018?

Hon Dr DAVID CLARK (Minister of Health): Last year, more than half a million New Zealanders couldn’t afford to visit the GP to get the care they needed. I’m not about to announce Budget details today, but what I can say is that the Government is committed to increasing the number of people that can afford to visit the doctor in the upcoming Budget.

Hon Michael Woodhouse: I raise a point of order, Mr Speaker. Largely thanks to the curtailment of the question, it was very specific—it specified a reduction and a date—and I don’t think the question was addressed.

Mr SPEAKER: And the question was addressed.

Hon Michael Woodhouse: Does he stand by his comments that Labour having to prioritise coalition commitments with the New Zealand First and Green parties is the reason the policy cannot be implemented from 1 July?

Hon Dr DAVID CLARK: Coalition priorities will be delivered, and I’m not going to comment further on what will be announced on Budget day.

Hon Michael Woodhouse: Why, then, did he answer an oral question seeking assurance on Labour’s GP fees policy on 16 November, nearly a month after coalition agreements were signed, “That member refers to specific aspects of our policy as announced, and we intend to deliver on it.”?

Hon Dr DAVID CLARK: We do intend to deliver more affordable care at the level of GP visits. Under the last Government, GP visits went up 44 percent and there was underfunding in the health sector. We are determined to make access to primary care more affordable.

Hon Michael Woodhouse: When he told Morning Report, yesterday, that the Government “needed to prioritise the things that had been promised.”, was he telling New Zealanders the Government saw free tertiary fees for rich families and winter heating payments for retired millionaires as a higher priority than reducing the financial burden of GP visits on low-income households?

Hon Dr DAVID CLARK: No.

Hon Michael Woodhouse: Well, then, in that case, isn’t the Minister really telling New Zealanders that despite the strong and improving economy the Government inherited, he overpromised, can’t count, and therefore can’t deliver on the pledges he made in Opposition.

Hon Dr DAVID CLARK: No.

The transcript referred to from 16 November 2017 is:

Dr Shane Reti: When he said at question time on Tuesday that more people would be able to access affordable primary healthcare, what specific health outcomes will that access deliver?

Hon Dr DAVID CLARK: We know that when people can access primary care we have more prevention in the system, and that lowers their personal experience of sickness but also lowers cost in the health system.

Dr Shane Reti: What assurances can he give that by 1 July next year he will deliver GP visits that will cost the patient no more than $2 and $8 within the $250 million he promised in Labour’s election policy?

Hon Dr DAVID CLARK: That member refers to specific aspects of our policy as announced, and we intend to deliver on it.

Jacinda Ardern promised on this policy before the election, and Labour now claim they have had to take into account demands of other parties in Government with them. But Clark repeated the commitment as Minister of Health after the coalition and confidence and supply agreements had been made.