Hospitals told to consider delaying surgery for older and overweight people

Health care investigations, treatment and surgery have always had to be prioritised and limited do to demand outstripping resources, but this will raise a few eyebrows: Hospitals urged to consider putting off some surgery

Hospitals are being told to consider putting off surgery for seriously overweight people and those over 70 unless it is urgent.

A memo from the Ministry of Health to district health boards has outlined how they should manage getting normal services up and running again with the risk of Covid-19 still looming.

It said deferring treatment should be considered for people over 70, those with a body mass index over 40, or those with other conditions including heart, lung or kidney disease.

That is because if they contracted Covid-19 they had a higher risk of death.

But if they urgently need treatment, they should get it, the memo said.

I don’t know why people who are at higher risk from Covid are being put on a lower priority. At this stage the risks of anyone getting Covid look very low.

There has to be prioritising as they crank up normal health care again, there always is, but putting people down the list due to the (low) possibility of catching a specific virus looks dicey to me.

Why not include influenza as well? Anyone with a greater chance than normal of having any sort of lung or heart problems?

Low uptake on fees-free scheme, could be scaled back

In 2017 Labour campaigned on there being a number of crises that needed urgent attention after ‘nine years of neglect’. It was surprising that one of the first policies they piled money into was something that seemed less urgent than housing, homelessness, poverty, mental health – they rushed in a tertiary education free fees scheme so that it would be in place by the start of 2018.

It turns out that the uptake hasn’t been anywhere near as high as predicted, so the scheme won’t cost as much as was budgeted. But the Government also seems to be considering scaling back the scheme to divert  budgeted money to more urgent needs (the so-called crises remain largely unaddressed).

Stuff:  Low enrolments sees $200m clawed back from fees-free scheme

The Government is stripping nearly $200 million from its controversial fees-free policy, after the number of people taking up the offer of a year of free tertiary education was below expectations.

Although he denied disappointment with the policy, Finance Minister Grant Robertson appeared to leave the door open to cancelling an extension of the scheme to further years of free education in 2021.

At a speech to the Wellington Chamber of Commerce in Parliament on Tuesday, Robertson said that as part of the upcoming Budget, the Government had identified around $1 billion of the lowest priority initiatives to cancel.

As part of this, $197m allocated for a year of tertiary education was being redirected to changes being made in the vocational education reforms.

Of course if they don’t have to spend everything the budgeted for for fees-free that money will be able to be used elsewhere (if they don’t want to cut government expenditure).

But what is apparent here is that a scheme rushed through as a high priority in 2017 now seems to be regarded as ‘lowest priority’.

Robertson denied the move was an acknowledgement of problems with the policy. The policy assumed a significant uplift in enrolments, which had not materialised. Robertson put this down to the strong labour market which made job opportunities good.

“When you get a period of time when you have employment being very, very low, that traditionally coincides with lower enrolments, in particular in polytechs,” Robertson told reporters, adding that people still had the option of taking up the policy if they chose.

Robertson maintained that it still remained Labour Party policy to extend the scheme for a second and eventually a third year of free education, but appeared to open the door to that happening.

“We’ll take a look at the extensions nearer the time, but I still believe the principle of making sure that people can carry on with study at university or apprenticeships  or work place training is really, really important.”

The plan for a second year of free education did not take place until the next term of Government so there was “plenty of time between now and then to make that call”.

So Robertson certainly seems uncommitted to expanding the scheme as planned.

Robertson’s pre-budget speech to the Wellington Chamber of Commerce:  Wellbeing Budget to tackle long-term challenges

Small party priorities post election

Small party (and Green) leaders were asked in a The Nation debate what their priority policy would be in post election negotiations.

Summary:

  • United Future: Flexi-Super
  • Maori Party: Whanau Ora
  • Mana Party: the elimination of child poverty within the first five years
  • Act Party: economic growth
  • Conservative Party: binding referenda
  • NZ First: non-committal
  • Green Party: expect to have a very comprehensive coalition agreement that meets a whole range of objectives

    Details:

United Future

Right, I wanna talk about relationships in MMP, and I’m coming to Mr Dunne. I want to know that if you get into a confidence-in-supply agreement with the next government, what would be the one thing you would be pushing for in return?

Dunne: I think probably top of our list would be to make progress on our flexi-super proposal, which would see people being able to take a reduced rate of super from the earlier age of 60 or an enhanced rate if they deferred to 70, and with the standard age remaining 65. I think that would be the one thing we’d wanna push most strongly.

That’s a repeat of last election.Dunne negotiated a discussion paper on Flexi-Super with National after the 2011 election and that which was released last year but National are luke-warm on doing anything on it

UnitedFuture’s plan which would allow people to take a reduced rate of New Zealand superannuation from the age of 60, or an enhanced rate if they deferred uptake until 70. The rationale was to give people more choice over retirement income and to recognise that for some people 60 was the age to leave the paid workforce, but that they were currently unable to do so for financial reasons.

Māori Party

Te Ururoa, you say that you could go with either Labour or National, so what would be your top priority as a policy to get?

Flavell: …the major platform that the Maori party has always been on about is final order. We say that if we’re able to consolidate, not only just social—the MSD-

So you would be pushing that if you were with the next government, you’d be pushing to keep–?

Flavell: It’s an absolute must from our perspective that final order will be at the centre of our platform, our policy. It is right now, and it will be.

‘Final order’ is a mistake in the transcript, it should read ‘Whānau Ora’ which is the Māori Party’s flagship policy.

Whānau-ora: restoring the essence of who we are; putting the vibrant traditions from our people at the heart of our whānau

Whānau Ora begins with you. Whānau is the heart of our people, it is the foundation on which our country thrives. It is about reaffirming a sense of self-belief.

Mana Party

All right. Mr Harawira, Mr Cunliffe says that you’re not gonna be part of his government. But you say he’ll pick up the phone if he needs you. So if he rings and says, ‘Hone, I’m offering you confidence in supply, that’s it, no ministers’, what do you want from him?

Do you think he has the vision to lead this country?

Harawira: What I know is this – if the polls keep trending the way that John Armstrong of the NZ Herald says and hit 5% even before the campaign starts for Internet Mana, I’m guaranteed to get a call on the night of September the 20th. And if he asks us, is there one policy, if there’s one thing that we would want to see changed, it would be this – the elimination of child poverty within the first five years.

The ‘elimination of child poverty’ seems idealistic, especially when it is usually a statistical figure based on families below the median income and on that basis there will always be some ‘in poverty’ – below the arbitrary line.

I can’t find a reference to the five year target on the Mana website but they have a range of policy points addressing “economic justice’, for example:

Work towards implementing a Universal Basic Income where everyone in Aotearoa aged 18 and over would receive a minimum, liveable, tax free income after which progressive tax would kick in. This would eliminate the huge costs involved in administering the current shame and blame WINZ system, and do much to end poverty and address growing inequality.

Act Party

Jamie Whyte, if you had a confidence and supply agreement, what would you be after as your top priority policy?

Whyte: Well, almost all problems, practical problems, are remedied by becoming wealthier. And so economic growth is by far our priority. And so the policies that we’ve been promoting on – cutting taxes and reducing the regulatory burden, which would promote economic growth, those would be our priorities in a negotiation with the National party.

That’s straightforward.

Short to medium term goals should include reducing the level of government expenditure below 28 per cent of GDP and lowering the top tax rate to 24 cents.  ACT’s Regulatory Responsibility Bill should be passed.

Conservative Party

Mr Craig, your policies are almost the same as NZ First. You’re the doppelganger in this room, so why would people vote for you when we’ve got the real thing right here.

What would be your top policy that you’d be after?

Craig: We’ve said publicly that we think governments should not be able to ignore overwhelming vote in referenda. The anti-smacking law, tough on law and order, reducing the MPs, all right quite rightly should have been implemented by government, because there is a point at which people need to know they control this nation. It’s their country.

Craig has already stated a bottom line on binding referenda.

ON OUR WATCH REFERENDUMS WILL BE BINDING

At the heart of the democratic system is the principle of the citizens initiated referendum. It’s when a single issue is thought to be so important, all voters are asked to make their opinion heard.

No specifics are given on exactly what this would entail, Conservative ‘Issues’ or policies are brief and vague.

New Zealand First

Mr Peters, your bottom lines or things that you really don’t wanna budge on are no foreign land sales, no race-based parties, buy-back assets and keep the super age at 65. You’re gonna be on the cross-benches, aren’t you, with that list?

Peters talked about a range of policies but was typically evasive and vague.

Peters: Your assumption is that at six weeks out from the election, we’re gonna make decisions now and tell the public, ‘Forget about you, doesn’t matter what happens in six weeks’. Behind close room deals. Now, I’m gonna leave it to the public to decide who’s gonna be standing there at the election, and it won’t include some parties standing here right now.

Many alluded to but no bottom lines revealed before the election.

Green Party

All right, let’s go to Metiria Turei there. (asked about working with NZ First)

Turei: The Green party in government will be a very large part of that government, and we will have significant influence. We will expect to have a very comprehensive coalition agreement that meets a whole range of objectives – a cleaner environment, a fairer society and a smarter economy. And we will have—we won’t settle like other parties might for a single achievement. We want to see our whole plan, our whole agenda being rolled out.

Turei wasn’t asked specifically about a priority but her answer was more befitting of a medium sized party with potentially a significant influence in a coalition.

Greens are excluded from major party debates despite the chances of them getting half the votes of Labour, and they could be a quarter to a third of a left wing coalition so could reasonably expect to include a number of their key policies in negotiations.

Source: TV3 The Nation – Debate: Multi-party election campaign debate