Election 2020: National's health policy - more money for Pharmac, elective surgery guarantees

"Primary care navigators" would be put in every general practice to spend extra time talking to patients to ensure they get the care needed, under a new National health policy that would also establish new dedicated Pharmac funds.

National health spokesman Dr Shane Reti has announced a number of policies as part of a health package, including:

• $20 million over four years for a new Pharmac rare disorder fund. National had already pledged $200m over four years for a dedicated cancer drug fund.

• Fund "primary care navigator" roles in every general practice. Based on a United Kingdom model, such people would support doctors by allowing more time to talk to patients and follow-up appointments and referrals and do home visits.

• Ensure every person accepted for elective surgery actually gets that procedure within four months of the decision to treat. (DHBs are currently expected to provide such treatment within four months of a person being accepted, but some have had delays.)

• Reintroduce public reporting of updated national health targets, scrapped by Labour and which monitor DHB performance including cancer treatment times, elective surgeries and ED wait times.

• Start a request for proposal process to establish a medical school focused on retaining GPs in rural areas.

After an overarching review of the health system, the Labour Government indicated it could slash the number of DHBs next term, but National appears to have ruled that out - its policy document stating that DHBs "are an essential component of New Zealand's health system", but should surrender some planning and funding services "to a regional level".

Reti said the total health package would cost about $800m over four years.

"Even before Covid-19's emergence we were seeing cracks in our health system. Access to quality healthcare has slid backwards under Labour. Waiting times are increasing and the number of elective surgeries has decreased."

Other policies announced today include setting up a dedicated border protection agency, making DHBs report against a new Maori health strategy and "passing all health legislation through an inequality filter", increasing funding for cochlear implants from 40 to 100.

A new cancer agency has also been pledged, with associated cancer treatment targets.

National also says it will fully roll out the national bowel cancer screening programme within its first year in Government (11 of 20 DHBs currently have screening and the ministry estimates the rest will have it by December next year).

National has previously announced $5m a year to test more women for gynaecological cancer and fund more access to clinical trials. It would also establish a surgical mesh register.

The suite of policy did not cover mental health - that will be announced in the coming days.

Reti said funding primary care navigator roles would make a big difference to helping treat people early in their illness, and lessening pressure on hospitals.

"The United Kingdom has piloted the use of primary care navigators with positive outcomes. National will make sure every general practice in New Zealand has a government-funded primary care navigator.

"They will provide counselling, interface with government agencies, follow-up appointments and referrals, do home visits and implement primary care health plans collaborated with each general practice."

Setting up dedicated funds within Pharmac's budget would be a huge departure from a model that allows the drug-buying agency to operate independently from political influence. Clinicians and patients in some areas of health, such as diabetes, often struggle to get as much media attention and resulting political pressure for more funding.

However, Reti said on top of the dedicated cancer and rare disorder funds, National would also increase Pharmac funding at the same rate as increases in the health budget, adding about $35m each year.

"The sad reality is that most New Zealand families will be affected by cancer. All New Zealanders should have the ability to access potentially life-saving drugs."

The rare disorders fund would "ensure that people suffering from rare diseases aren't overlooked".

National's policy statement states that if a DHB can't provide a promised elective surgery within four months, "they will be required to source an alternative provider".

Its maternity policy includes guaranteeing three days postnatal stay for mothers and their babies (what mothers are currently entitled to, but it's sometimes ignored by under-pressure services), and re-establishing birthing units at Lumsden and Wanaka.

The party has already announced an "investing in the first 1000 days" policy including a $3000 entitlement for expectant mothers, to be used to spend on services for their baby, with those with higher needs getting up to $6000. The package includes better funding for pre and post-birth GP visits; allows parents to both take paid parental leave at the same time; and would establish a "national centre for child development" at a university to drive research.

An extra $30m a year would go into childhood oral health under National, including paediatric and school dental services.

National's obesity policy doesn't include any direct regulation or limits on junk food or the marketing of it - the party has promised to refresh the 2015 childhood obesity plan and expand a "daily mile" exercise programme to all schools.

The announcement contrasts with Labour, which is yet to announce any major health policy this campaign. Instead, the party's website lists actions taken last term, including the Covid-19 response, a funding boost for Pharmac and elective procedures.

One recent flashpoint has been the resignation of Canterbury DHB's chief executive and board members, amidst pressure on the board to rein in deficits. That's caused staff protests and worries over service cuts, but Health Minister Chris Hipkins has insisted DHBs must get back into the black - and those consistently over budget shouldn't be rewarded.

National's health policy document promises to "set clear expectations for DHBs to live within their means by way of accountability agreements with board chairs".