Prime Minister Christopher Luxon and Health Minister Simeon Brown.
Prime Minister Christopher Luxon and Health Minister Simeon Brown.
Opinion by Rob Campbell
Rob Campbell is a professional director and investor. He is chancellor at AUT, chair of Ara Ake, chair of NZ Rural Land and former chair of Te Whatu Ora.
The Government is funding a new two-year primary care training programme for up to 100 extra overseas-trained doctors.
Additional funding for primary healthcare is a good thing, even where it is a mix of previous funding decisions, reallocation of other health funding, and applying in areas where response will be less than immediate, uneven and uncertain.
But that is the reality we face for having allowed our publichealth system to degrade as far as we have.
Health service needs are now. Real-time, if you like.
But they build over decades, as does the ability to meet them. Even so, when announcements are about better availability of doctors, nurses and the services they provide, we must welcome them.
Many announcements these days have the opposite intent and outcome.
Around 1000 people turned out to The Strand in support of the Hikoi for Health, in protest of the downgrade of Whakatāne Hospital’s Obstetrics and Gynaecology department. Photo / Samantha Scown
There are, of course, reservations. These moves effectively put more funding into a system that has real structural problems. They are bandages rather than cures, badly needed but likely being oversold in terms of their real health impact.
We might also note that far from shifting away from a system that was criticised for being too centralised, these initiatives really stem from that central structure.
Some aspects are a little mysterious. Surely the announced “digital healthcare service” is not entirely “new” but at least builds on services already in place after lengthy and expensive development. This is certainly no new aspiration.
We might also be cautious about expanded GP funding, which is “performance based”.
Perhaps benign, but general practice performance is a complex matter that varies greatly between practices. It is not easily, or without great health and equity risk, translated into simple metrics.
This also highlights a glaring weakness. The proposals do not address the deep issues of equity in healthcare services.
We know that access and outcomes differ across income, ethnicity and location. Many people do not suffer any real health service deficit, often no more than inconvenience. Others simply forgo healthcare services because of affordability or other access issues.
A set of changes that is deliberately blind to this can only miss the mark.
I wonder what involvement the Iwi Māori Partnership Boards had in these priorities?
Under the legislation, they are entitled to it. Or the various clinical, professional and staff organisations. As per Te Mauri o Rongo/Health Charter.
To repeat, it is pleasing to see additional funding to the extent that it is genuinely new.
Rob Campbell, former chairman of Te Whatu Ora. Photo / Michael Craig
But throwing funds against a wall blindly and seeing what sticks is exactly what got us where we are in health services today.
In all of this, it is hard to avoid the conclusion that those in charge have decided “we have to do something” and have reached for the nearest levers they have.
The ones that have been in preparation for some time, that feed the old structures, and which avoid both the most pressing and the most complex issues.
