Health services bracing for more sickness

When demand dries up in the economy, there is no matching reduction in the number of people who get sick.

Health services are are bracing for more sickness as the recession deepens and more people lose their jobs.

But because the Government has committed itself to pre-set increases in health spending, the public health service may be insulated from the worst effects.

The private sector, funded through health insurance and individuals paying for their own care or for medications not subsidised by the state, is more exposed.

Primary care straddles public and private sectors - the average patient is 70 per cent state funded and pays the rest of the fee.

"There is an increase in illness through financial turmoil," said the Public Health Association's national executive officer Professor Gay Keating.

Professor Keating called on the Government to limit the effects by ensuring that the social effects of economic changes are well managed.

Demand for state-paid healthcare always exceeds capability, and severe shortages of doctors, nurses, midwives and other health workers have already been caused by factors including capped student numbers and the attractiveness of working overseas.

The previous Labour-led Government's last Budget assumed its $11.9 billion expenditure would rise by $800 million next year, followed by increases of $850 million in the two following years.

But before last year's election it reverted to increases of $750 million for each of the three years.

The new National-led Government has adopted this financial path but acknowledges it leaves little room for new initiatives in 2009/10 after population growth and cost increases account for $550 million, and district health board deficits consume possibly $150 million.

Health Minister Tony Ryall has demanded hospitals do more elective surgery and reduce cancer care delays "through your existing resources".

He expects his ministerial task force to find savings in bureaucracy.

The Government's commitment will maintain services at their current level, but give little leeway for the wage increases some groups, particularly doctors, consider necessary to stem the flow of health workers into higher-paid jobs overseas.

Pay is not the only issue. There are hopes the financial pressures on health boards will force them to agree to more-flexible working hours for house officers and trainee specialists.

Deborah Powell, general secretary of their union, the Resident Doctors' Association, said only 41 of New Zealand's 2800 resident medical officers had part-time positions.

She says allowing more part-time work, in a sector where many employees are women in their child-bearing years, would encourage many who now work as casual locums back to permanent health board work, where they cost the state less.

Dr Powell said Auckland needed 900 residents, but was 200 short.

Nurses Organisation president Marion Guy said the recession might encourage nurses back to the job, but many who had not practised for more than five years were put off by the high cost of having to attend a four-week back-to-nursing course.

In the private sector, hospitals report a drop-off in the number of operations funded by individuals for cosmetic surgery, but not in treatment of non-cosmetic conditions.