Kathy Spencer: Health Minister lacks answers - so what to do?

Health Minister Andrew Little. Photo / Mark Mitchell, File

OPINION

Health Minister Andrew Little issues a continuous stream of excuses, deflections, and denials in response to multiple failures in our public health system.

He answers questions about unacceptable waits in emergency departments with information about funding.

He answers questions about long waits to see a GP by saying that the problem has been a long time in the making and won’t change overnight.

Listening to him, you would think that the Government had just inherited the situation and that health workforce issues had only just come to light.

In fact, a Labour-led government has been in charge of the public health system for five years and Little has been Minister of Health for the last two of those.

GP shortages have been signalled for many years by GPs, workforce advisory boards, and the Ministry of Health.

Illustration / Rod Emmerson

What the public needs is a health minister who takes responsibility for ensuring the system has adequate staff to deliver high-quality, timely care.

We have the right to expect that people in the system are looking ahead, getting advice in a timely way and acting on it, not waiting until there’s a crisis then denying there is one.

There are problems wherever you look.

Excessive waits to be seen in emergency departments were met by Te Whatu Ora urging people to “seek out care early” by seeing their GP instead of turning up to EDs. If only they could.

The Te Whatu Ora spokesperson seemed to be unaware of advice from the College of GPs that people were waiting two to six weeks for an appointment.

It’s worse still when it comes to seeing a specialist and accessing surgeries like a hip, knee, or heart valve replacement, a cardiac bypass, or major back surgery. In June this year, over 35,000 people had been waiting more than four months to see a specialist and, of these, over 4000 had been waiting longer than a year.

For those who had managed to see a specialist and be assessed as needing treatment, over 28,000 had been waiting more than four months for surgeries, and more than 5500 of these had been waiting for over a year.

What can we expect by way of improvement? Te Whatu Ora has advised: “It is anticipated that waiting lists will continue to increase in the short to medium-term.”

Of the $1.9 billion mental health package announced in Budget 2019, $235 million was earmarked for five capital projects to upgrade and/or expand the capacity of mental health facilities. When it was reported that acute bed numbers had not increased, Little told us: “The funding was available from 2019, the commitment was available from that time. It still beggars belief for me that it has taken this long to get those things going.”

So what has he, as Minister of Health, done about it? It’s the attitude of powerlessness that beggars belief for me.

Kathy Spencer. Photo / Supplied

In what seemed like a rare bit of good news, Little announced that work to redevelop Whangārei Hospital will finally start … but not for another two years. It’s simply not good enough when you consider that Northland DHB started to work through Treasury’s complex and drawn-out business case process in 2015.

And what of the new Maori Health Authority that has been set up to deliver better health outcomes for Maori? The Health Transition Unit, responsible for designing and advising on the reforms, has said: “It is unlikely that results of change will be clear any sooner than five years.”

But that’s what tends to happen when you rearrange everything – it takes a very long time to get people into new roles and for them to get up to speed, let alone start to solve problems.

So what are the alternatives?

It was a significant loss for Health when Chris Hipkins gave up the role of minister after the last election.

As Minister of Police, Hipkins showed his willingness to take responsibility when he responded to the horrific stabbing of a dairy worker outside Rose Cottage Superette in Auckland. He acknowledged that something could have and should have been done to try to prevent the tragedy, and he has followed up.

If Hipkins can’t be spared, Dr Ayesha Verrall has done a very credible job as Associate Minister of Health, and shown she is prepared to take bold actions.

For those inclined to vote to the right, National’s health spokesperson, Dr Shane Reti, offers a very strong alternative. He understands the health system, and he makes sense when he talks about it.

However, in the lead-up to the last election, both Reti and Hipkins said that they personally had private health insurance, which tells me that neither had confidence in the public health system.

For whoever takes on the role next, the goal should be to make the public health system one that all New Zealanders can rely on, even the Minister of Health.

Kathy Spencer was a deputy director-general in the Ministry of Health, a general manager in ACC, and a tax policy manager in the Treasury.