Government to drip feed health underfunding stories pre-budget

Former Health Minister Jonathan has finally spoken about what he knew about the building problems at Middlemore Hospital that seem to have suddenly emerged.

RNZ: Coleman says documents show he didn’t know about hospital rot

RNZ has been reporting on hospital buildings at Middlemore Hospital that are full of rot and potentially dangerous mould. There’s also asbestos present and raw sewage leaking into the walls.

Earlier today, National Party leader Simon Bridges told Morning Report Dr Coleman did not know about Middlemore’s building problems.

In a blog post this afternoon Dr Coleman said he had been reviewing a couple of “very pertinent” documents.

“It’s just not credible to say that Middlemore Building problems were widely known about and I would have known,” he wrote.

This claim that was made in late March to Morning Report by former Counties Manukau District Health Board chair Lee Mathias.

“Most people in Wellington knew of the situation Middlemore was in,” she said then.

She also said the state of the buildings was covered in board minutes that were publicly available. However, the DHB has blocked the release of these minutes to RNZ under the Official Information Act.

More withholding of information under the OIA.

But the Government seems intent on not withholding information about health underfunding heading into next month’s budget.

RNZ:  PM hints of further public underfunding revelations

The government is going to drip feed stories of public sector underfunding by the previous government in the run-up to next month’s Budget, Prime Minister Jacinda Ardern has indicated.

Ms Ardern is playing down expectations of a big spending budget next month saying her government did not realise how bad the under-investment in public services had been under National.

She said it was now clear National put budget surpluses ahead of the wellbeing of New Zealanders, and chronically short-changed public services.

“I’ve always said that from the beginning we thought it would be bad, we didn’t know it would be this bad.

“And the public is seeing just a snapshot of it now, the state of Middlemore Hospital I think is emblematic of what we’re seeing across the board.”

I get the feeling that the public were played during the election campaign, and are being played by politicians now – with DHBs possibly complicit.

Ardern:

“What we are flagging is that as we’ve gone through this process we’ve uncovered things we didn’t expect. We want to build more transparency around that as we lead up to Budget day.

“As ministers we have been engaging in this conversation for some time, we’ve decided it’s one we should be having with the public too.”

The public could have done with factual information on health and hospital funding long ago. This sort of waffle in an apparent attempt to manage pre-budget PR is crap. If Ardern has information she should just present it all now.  Instead she seems to be intent on playing a risky game. Not all information that is drip fed could look good for Labour.

So why did the Middlemore building story just start to emerge now? It sounds too serious and important to be used as political misinformation.

First DHB funded Sativex

A post from MZaNZ:

BREAKING NEWS: First Patient in NZ Successfully funded for Sativex by DHB

A woman who may have otherwise died from her regular severe seizures has been granted approval for medical marijuana funding.

Alisha Butt, 20, has the mentality of a toddler and is unable to speak.

Her seizures had presented a huge problem for specialists who were unable to adequately treat her, leading to the possibility she could end up in a coma from one and die.

But thanks to medicinal marijuana extract Sativex, Alisha is able to live a more comfortable life.

“Since being on Sativex for over 4 months, she has shown a great improvement,” mum Sushila Butt said.

“Her seizures have decreased immensely and now, after long last, Alisha has been able to enjoy a better quality of life without the disturbance of erratic and continuous prolonged seizures.”

A big relief to see a significant improvement.

Then, in September, Alisha was approved by the minister of Health to receive Sativex – which contains Cannabidiol with Tetrahydrocannabinol, or THC, the main psychoactive component of cannabis – but the family had to fund the $1000-a-month treatment themselves.

It wasn’t until January 22 that the Government agreed to fund the medicinal marijuana as a prescription.

“It’s completely covered now,” Sushila said. “It will be fully funded for my daughter.

A funding breakthrough. Until now Sativex wasn’t funded and was costing something like $1000 per month, too much for many parents.

Full post at MCaNZ:
http://mcadvocacynz.org/2016/01/28/breaking-news-first-patient-in-nz-successfully-funded-for-sativex/

DHB cost pressures

District Health Boards continue to be under pressure to keep within budgets, with increasing costs and increasing populations. Labour’s health spokesperson Annette King claims that the pressures are increasing.

Stuff reports: Every DHB facing ‘cost pressures’ of millions – Labour

Labour health spokeswoman Annette King says DHBs are chronically underfunded in real terms, and new Government figures prove it.

Nearly every District Health Board is facing significant financial strife, with new figures showing multi-million-dollar shortages in the funding needed to tread water.

Government figures, obtained by Labour, show each DHB is up against “population cost pressures” of between $1.3m and $39m, which could blow their budgets out.

The information was initially withheld by Treasury when it released background documents related to the budget, earlier this year.

Details are given of annual ‘cost pressures’ of up to $46 million (Canterbury).

DHBs have always struggled to keep within budget. We have the best health care ever and improving life expectancy, but it is expensive to maintain. An aging population means that the cost pressures will increase more.

It can be awful for individuals and their families if facing health problems, especially when life threatening.

Early this year I injured my shoulder and needed it checked out. ACC claimed that the problems were due to an old injury so wouldn’t cover it, so I had to pay $250 for the x-ray and scan. The injury came right after a while suggesting to me it was the recent injury that was the problem.

And a few months ago I had a health concern. I was booked in for a scan at the DHB, it took two weeks for them to give me an appointment three months later. I didn’t want to take the chance a delay might be too slow so went private, they responded within a day and gave me an appointment for two days later. That cost another $250-odd.

Two relatively minor (as it turned out) issues but they illustrate some of the limitations of our health coverage.

Out health system does many things very well but can’t cope with the costs and the needs.

The options are to continue operating the DHBs under severe cost pressure, or to increase their relative funding.

This means operating an overall budget deficit (which means increased borrowing, increased interest costs and increased debt levels), or increasing tax revenue, or shifting money from something else onto health.

It’s difficult transferring funds from something else onto health – superannuation is committed to, education is under cost pressure, there are pressures to spend more on transport and on climate change etc etc.

Some suggest investing more money into health prevention. This would cost more in the short term with the hope it will save money in the longer term.

Some suggest increasing tax – but usually people proposing that want increased tax for other people, not themselves.

Some suggest less tax so people can afford to pay for more of their own health care. But many people may not put their extra in-the-hand earnings aside for an unhealthy day.

Doing a country’s budgeting when people’s lives and livelihoods are at stake is demanding (in more ways than one) and very tricky.

It’s the Opposition’s job to push for better healthcare, and the easy way for them to do that is to suggest spending more money. And it’s the Governments job to try to be caring and prudent.

Hope for Alex Renton

Some hope for Alex Renton – or at least for his family, who have been watching over him in a coma for 57 days now.

Stuff reported recently: Family’s desperate quest for cannabis oil 

Nelson teen Alex Renton was hospitalised in early April after a serious seizure. He has been in an induced coma in Wellington’s intensive care unit since April 8.

Alex remains in ‘status epilepticus’, a kind of prolonged seizure.

With a recommendation from one of Alex’s neurologists, his family are now keen to try something new – a cannabinoid oil (CBD) extracted from marijuana that international research has endorsed as a treatment for seizures. But accessing the oil, even with the support of a neurologist, has proved nearly impossible.

This was covered on Seven Sharp tonight. They said the problem was inaction by the DHB, who need to submit a request to use CBD to the Ministry of Health.

They have also said that the DHB agreed today to submit a request to the Ministry of Health. Once they get that in it will be up to the Ministry and Peter Dunne as Associate Minister of Health as it’s his responsibility.

Cannabis oil isn’t guaranteed to be successful, one report was that it gave a 30% chance of improvement.  But for Alex and his family any chance is better than what they are having to endure at the moment.

Jaded encumbents need pushed

One of the most disappointing things about the campaign for me has been the negativity and defeatism of some incumbents. Current mayor Dave Cull is guilty – in forums he has said that pushing politicians is pointless and has also said there was no point in pursuing business related to oil/gas.

His political reluctance may be due to being overawed by Government ministers or not knowing how to go about it, but on oil/gas he seems conflicted, he opposes drilling so we can’t expect him to be enthusiastic about chasing business related to the industry.

There was more incumbent defeatism at a health forum on Thursday.

Health boards have little influence over the health of the population, and representatives who think they will change things fail to realise the Minister of Health is in charge, Southern District Health Board candidate Richard Thomson told a forum in Dunedin yesterday.

Those thinking that in Don Quixote fashion they would shake up the system soon discover if they do not do as they are told, the minister will simply do it anyway, the veteran health board member and former chairman said.

I commented on this at ODT online:

Bollocks. That is not the attitude that kept Neurology in Dunedin. People stood up and demanded. It worked. It doesn’t always work, but it will never work if you give up without trying.

It’s not easy, but people don’t vote for easy, they vote for people to do the hard stuff.

Council and the DHB need people who are prepared to do the hard work. That’s how you can succeed.

A Southern District Health Board candidate, John Chambers, also commented.

Like Pete George I was somewhat surprised by the cynicism and negativity in the comments made by Richard Thomson, a long standing board member. Around New Zealand and internationally there is ample evidence  that the members of health and hospital boards are very influential in steering the direction of health expenditure. That is why I am standing and, if elected, I intend to make a difference.

The DHB and council needs fresh enthusiastic determined people to push out or inspire and push jaded incumbents.