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Home / New Zealand

<i>Martin Johnston</i>: Promise of healthier management

By Martin Johnston
Reporter·NZ Herald·
11 Sep, 2008 04:00 PM3 mins to read

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Opinion by Martin Johnston
Senior journalist, NZ Herald
Learn more

KEY POINTS:

Stage one of National's drip-feed health policy aims to position the party as a better manager than Labour of a sector which hoovers up one in five tax dollars.

National soothes voters with an assurance it won't unleash restructuring on the sector and will stick to Labour's path
of annual top-ups of $800 million and more, but will manage the $12 billion industry "more wisely".

This is the historic pitch of National to handle the levers of power better and more efficiently than Labour.

With it comes a plan to shrink health bureaucracy - something Labour all too easily promised in opposition too, but has been unable to deliver, because health services have expanded.

But National's health spokesman, Tony Ryall, will not put numbers or a timeframe on reductions in bureaucrats, which will happen "by attrition. This is not a plan for a slash and burn of administrators at district health boards".

Nor will he discuss the comprehensive, leaked version of National's policy, which outlines plans for prostate cancer screening and 20 new operating theatres, and indicates the party wants better reporting on mental health. The next Government is also likely to face decisions on setting up a bowel cancer screening programme.

All these schemes will require bureaucrats.

National says the number of DHB managers and administrators has grown by 2200 since 2001, and the Health Ministry payroll by around 500.

The Government, however, says that since it came to office in 1999, managers and administrators have remained static at 19 per cent of the workforce, while nurses and doctors have increased from 52 per cent, to 56 per cent.

Labour and National continue to snipe over the similarity of their health policies, trading claims of "me first" for new ideas.

National had stood out over its intention to allow GPs greater freedom to set their fees, which Labour said would push fees up.

But National is now committed to universal patient subsidies and the fees review process Labour terms a "fees cap".

More troublesome for National, however, is the line in the leaked documents committing it to the current funding and approach in primary care "short term ... while a proper evaluation is completed" of whether the extra spending is achieving its purposes, like reducing hospital admissions.

Elective surgery will be an election battleground, after thousands were removed from hospital waiting lists as patients were more rigorously ranked in order of need.

National aims to increase elective surgery through a 10 per cent increase in the number of operating theatres, training an extra 750 health workers, and contracting the private sector to do more operations.

The Government's elective surgery graph had remained depressingly flat - partly because the clinical complexity of patients increased - but has picked up since 2006 after big cash injections for hips and knees and cataracts. A further $160 million for elective services was announced in May.

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