Truth hurts us all

Keeping people out of hospital, with an emphasis on preventative care, should be the country's prime goal if it ever hopes to effectively use its health budget.
So says Geoff Simmons, co-author with Gareth Morgan of Health Cheque - the truth about New Zealand's public health system.
Mr Simmons was the guest speaker at a forum organised by the Whanganui Regional Primary Health Organisation for primary and secondary medical leaders.
He said devolving the District Health Board system to free up much-needed resources should be a key objective, but more important was preventative care.
"Trying to balance local accountability with creating an efficient national health system is not easy," he said. "But the major issue is that people see their hospital as a proxy for their local health service. The reality is that is not the case. The best health care tends to be that which keeps people out of hospital. Things such as Plunket and pre-natal care are a great investment in terms of health spending. But this is the stuff that tends to get cut as we struggle to keep our hospitals operating on the same scale."
Mr Simmons said a lot of the debate was around people being unwilling to travel for their care and although that should be minimised as much as possible, "don't people still want the best care"?
He said: "If that means travelling to a major centre, then that's the price to pay. We're a small country with only so many health dollars to go around."
Mr Simmons said people had to realise that the expense of maintaining specialist units, such as the paediatric oncology unit at Wellington Hospital "is worth it but we can't have these units everywhere".
Mr Simmons said the obesity debate, a topic touched on in the book, was another that needed urgent attention.
"For some people bariatric surgery will be the only answer because some people have issues that can't be controlled through diet and exercise.
"But we did some numbers and found it would take all of the surgeons in this country to be retrained in bariatric surgery to deal with the diabetes epidemic that's coming.
"So bariatric surgery is not going to be the answer - end of story. We've only got until 2020 when they expect the numbers of diabetics in New Zealand to double."
Mr Simmons said that the country needed to ration its health care more openly.
"There are groups in our society who miss out because those that shout the loudest get the health care.
"And we need to look at delivering health services more efficiently to free up money that we can do a lot more of the preventative work with."
He said as far as politicians were concerned, the Government was elected on an "anti-nanny state" agenda and as a result had struggled to engage in talking about preventative measures.
"A lot of conversations we're having on prioritisation and efficiencies the current Government is interested in, but they are taking a 'softly softly' approach.
"Labour is very much into prevention but doesn't want to talk about prioritisation questions, while the Greens completely love what we're saying."
Mr Simmons said it was a classic left-right split.
"That's unfortunate because we need to move health from being a political football.
"We need stable, long-term planning.
"It's a multi-billion dollar business in New Zealand.
"We're spending $12 billion a year and we can't manage that if every three years you're changing the direction it's heading in."
john.maslin@wanganuichronicle.co.nz