John MacDonald: Now is not the time for fixing a broken health system

The emergency department at Middlemore Hospital is under severe pressure due to staff shortages. Photo / Sylvie Whinray

OPINION:

I want to know what brand of coffee Dr Shane Reti was drinking before he spoke to Mike Hosking on Newstalk ZB this morning. Because, whatever it was, the National Party's health spokesperson came out firing like never before. And he was brilliant.

Initially, he was talking about the health boards warning the Government 12 months ago that they were facing significant problems because of staff shortages.

As it's been reported, all the boards wrote a letter to the Ministry for Business, Innovation and Employment (or MBIE) saying that when the borders reopen (as they have done since), the system is going to struggle with an increase in demand for services.

They also talked about the need to get more doctors and nurses in from overseas ASAP.

Reti said this morning the letter didn't just go to MBIE, it also went to the Ministry of Health. Which is a key point because Health Minister Andrew Little has been saying he didn't know about the letter until last month.

He's got no voice today because he's crook. So, once he's got the voice back, it will be interesting to hear what he does have to say.

But as Reti said this morning, the Health Ministry and the Government were warned, did nothing and now we're seeing the consequences.

But he didn't stop there, and he moved on to the health reforms which kick in the day after tomorrow (Friday), with all the health boards around the country disappearing and the new Health NZ and Māori Health Authority taking over.

Like Reti, I've never been able to understand why the Government thinks pressing on with reforming the health system when we're still dealing with a pandemic, is a good idea. My confusion about its enthusiasm is even greater, now that we're dealing with this flu situation which is seeing people drop like flies all over the place.

Things have got so bad, in fact, that we've seen after-hours medical centres closing the doors because they can't cope with the demand.

But despite all this - hospitals over-run, after-hours medical centres over-run - the Government still thinks it's a good time to press on with the biggest health reforms in 20 years. It's nuts.

But, as Reti said this morning, the Government is driven by ideology and, when that happens, balls get dropped and the focus goes on project planning, team meetings, Gantt charts, consultants - not on what the health system is actually there for.

As he put it, when you're restructuring health the way the Government is, the restructuring is where the money goes (and we saw that in this year's Budget). It's where the attention goes, and anything else pretty much becomes an inconvenience.

I've seen this happen myself. Like many people, I've worked in the public service and I have always been dismayed at how the focus of government organisations gets lost when there's a big project on the go.

People working at these places start referring to the organisation as "the business". And they get all excited and drink the Kool Aid and bang on about how much better things are going to be because they're doing God's work. But, from my experience, these project people couldn't be more removed from the purpose of the outfits they work for if they tried.

And that's how I feel about these health reforms. There's been a series running on One News over the last few nights looking at the reforms - and you can see how the people running these new health entities have signed up to the ideology.

I suppose they have to be, because they're the ones who have to lead their people into the brave new world. But whenever I hear all that ra-ra, it just leaves me cold.

Because all the talk, the whiteboards, strategy meetings, planning sessions, project managers and change managers count for nothing when your surgery's being cancelled and when you're waiting six hours to see someone at the after-hours (if it's still open that is, and hasn't had to shut the doors because it can't cope with the demand).

There will never be a perfect time to overhaul the health system. But the middle of winter, in the middle of a pandemic and with influenza coming at us with a double-whammy, seems less than ideal - putting it mildly.

And I, for one, have very little faith that the health reforms the Government is so excited, and so keen to get on with, will deliver the types of benefits that will make it all worthwhile.

As Reti said this morning, come Friday it'll just be "the same team in different jerseys". And I couldn't agree more.