NZ Herald
  • Home
  • Latest news
  • Herald NOW
  • Video
  • New Zealand
  • Sport
  • World
  • Business
  • Entertainment
  • Podcasts
  • Quizzes
  • Opinion
  • Lifestyle
  • Travel
  • Viva
  • Weather

Subscriptions

  • Herald Premium
  • Viva Premium
  • The Listener
  • BusinessDesk

Sections

  • Latest news
  • New Zealand
    • All New Zealand
    • Crime
    • Politics
    • Education
    • Open Justice
    • Scam Update
  • Herald NOW
  • On The Up
  • World
    • All World
    • Australia
    • Asia
    • UK
    • United States
    • Middle East
    • Europe
    • Pacific
  • Business
    • All Business
    • MarketsSharesCurrencyCommoditiesStock TakesCrypto
    • Markets with Madison
    • Media Insider
    • Business analysis
    • Personal financeKiwiSaverInterest ratesTaxInvestment
    • EconomyInflationGDPOfficial cash rateEmployment
    • Small business
    • Business reportsMood of the BoardroomProject AucklandSustainable business and financeCapital markets reportAgribusiness reportInfrastructure reportDynamic business
    • Deloitte Top 200 Awards
    • CompaniesAged CareAgribusinessAirlinesBanking and financeConstructionEnergyFreight and logisticsHealthcareManufacturingMedia and MarketingRetailTelecommunicationsTourism
  • Opinion
    • All Opinion
    • Analysis
    • Editorials
    • Business analysis
    • Premium opinion
    • Letters to the editor
  • Politics
  • Sport
    • All Sport
    • OlympicsParalympics
    • RugbySuper RugbyNPCAll BlacksBlack FernsRugby sevensSchool rugby
    • CricketBlack CapsWhite Ferns
    • Racing
    • NetballSilver Ferns
    • LeagueWarriorsNRL
    • FootballWellington PhoenixAuckland FCAll WhitesFootball FernsEnglish Premier League
    • GolfNZ Open
    • MotorsportFormula 1
    • Boxing
    • UFC
    • BasketballNBABreakersTall BlacksTall Ferns
    • Tennis
    • Cycling
    • Athletics
    • SailingAmerica's CupSailGP
    • Rowing
  • Lifestyle
    • All Lifestyle
    • Viva - Food, fashion & beauty
    • Society Insider
    • Royals
    • Sex & relationships
    • Food & drinkRecipesRecipe collectionsRestaurant reviewsRestaurant bookings
    • Health & wellbeing
    • Fashion & beauty
    • Pets & animals
    • The Selection - Shop the trendsShop fashionShop beautyShop entertainmentShop giftsShop home & living
    • Milford's Investing Place
  • Entertainment
    • All Entertainment
    • TV
    • MoviesMovie reviews
    • MusicMusic reviews
    • BooksBook reviews
    • Culture
    • ReviewsBook reviewsMovie reviewsMusic reviewsRestaurant reviews
  • Travel
    • All Travel
    • News
    • New ZealandNorthlandAucklandWellingtonCanterburyOtago / QueenstownNelson-TasmanBest NZ beaches
    • International travelAustraliaPacific IslandsEuropeUKUSAAfricaAsia
    • Rail holidays
    • Cruise holidays
    • Ski holidays
    • Luxury travel
    • Adventure travel
  • Kāhu Māori news
  • Environment
    • All Environment
    • Our Green Future
  • Talanoa Pacific news
  • Property
    • All Property
    • Property Insider
    • Interest rates tracker
    • Residential property listings
    • Commercial property listings
  • Health
  • Technology
    • All Technology
    • AI
    • Social media
  • Rural
    • All Rural
    • Dairy farming
    • Sheep & beef farming
    • Horticulture
    • Animal health
    • Rural business
    • Rural life
    • Rural technology
    • Opinion
    • Audio & podcasts
  • Weather forecasts
    • All Weather forecasts
    • Kaitaia
    • Whangārei
    • Dargaville
    • Auckland
    • Thames
    • Tauranga
    • Hamilton
    • Whakatāne
    • Rotorua
    • Tokoroa
    • Te Kuiti
    • Taumaranui
    • Taupō
    • Gisborne
    • New Plymouth
    • Napier
    • Hastings
    • Dannevirke
    • Whanganui
    • Palmerston North
    • Levin
    • Paraparaumu
    • Masterton
    • Wellington
    • Motueka
    • Nelson
    • Blenheim
    • Westport
    • Reefton
    • Kaikōura
    • Greymouth
    • Hokitika
    • Christchurch
    • Ashburton
    • Timaru
    • Wānaka
    • Oamaru
    • Queenstown
    • Dunedin
    • Gore
    • Invercargill
  • Meet the journalists
  • Promotions & competitions
  • OneRoof property listings
  • Driven car news

Puzzles & Quizzes

  • Puzzles
    • All Puzzles
    • Sudoku
    • Code Cracker
    • Crosswords
    • Cryptic crossword
    • Wordsearch
  • Quizzes
    • All Quizzes
    • Morning quiz
    • Afternoon quiz
    • Sports quiz

Regions

  • Northland
    • All Northland
    • Far North
    • Kaitaia
    • Kerikeri
    • Kaikohe
    • Bay of Islands
    • Whangarei
    • Dargaville
    • Kaipara
    • Mangawhai
  • Auckland
  • Waikato
    • All Waikato
    • Hamilton
    • Coromandel & Hauraki
    • Matamata & Piako
    • Cambridge
    • Te Awamutu
    • Tokoroa & South Waikato
    • Taupō & Tūrangi
  • Bay of Plenty
    • All Bay of Plenty
    • Katikati
    • Tauranga
    • Mount Maunganui
    • Pāpāmoa
    • Te Puke
    • Whakatāne
  • Rotorua
  • Hawke's Bay
    • All Hawke's Bay
    • Napier
    • Hastings
    • Havelock North
    • Central Hawke's Bay
    • Wairoa
  • Taranaki
    • All Taranaki
    • Stratford
    • New Plymouth
    • Hāwera
  • Manawatū - Whanganui
    • All Manawatū - Whanganui
    • Whanganui
    • Palmerston North
    • Manawatū
    • Tararua
    • Horowhenua
  • Wellington
    • All Wellington
    • Kapiti
    • Wairarapa
    • Upper Hutt
    • Lower Hutt
  • Nelson & Tasman
    • All Nelson & Tasman
    • Motueka
    • Nelson
    • Tasman
  • Marlborough
  • West Coast
  • Canterbury
    • All Canterbury
    • Kaikōura
    • Christchurch
    • Ashburton
    • Timaru
  • Otago
    • All Otago
    • Oamaru
    • Dunedin
    • Balclutha
    • Alexandra
    • Queenstown
    • Wanaka
  • Southland
    • All Southland
    • Invercargill
    • Gore
    • Stewart Island
  • Gisborne

Media

  • Video
    • All Video
    • NZ news video
    • Herald NOW
    • Business news video
    • Politics news video
    • Sport video
    • World news video
    • Lifestyle video
    • Entertainment video
    • Travel video
    • Markets with Madison
    • Kea Kids news
  • Podcasts
    • All Podcasts
    • The Front Page
    • On the Tiles
    • Ask me Anything
    • The Little Things
  • Cartoons
  • Photo galleries
  • Today's Paper - E-editions
  • Photo sales
  • Classifieds

NZME Network

  • Advertise with NZME
  • OneRoof
  • Driven Car Guide
  • BusinessDesk
  • Newstalk ZB
  • Sunlive
  • ZM
  • The Hits
  • Coast
  • Radio Hauraki
  • The Alternative Commentary Collective
  • Gold
  • Flava
  • iHeart Radio
  • Hokonui
  • Radio Wanaka
  • iHeartCountry New Zealand
  • Restaurant Hub
  • NZME Events

SubscribeSign In
Advertisement
Advertise with NZME.
Home / New Zealand

John Tamihere: New Zealand's healthcare fit for museum, not hospital

NZ Herald
20 Feb, 2019 04:00 PM5 mins to read

Subscribe to listen

Access to Herald Premium articles require a Premium subscription. Subscribe now to listen.
Already a subscriber?  Sign in here

Listening to articles is free for open-access content—explore other articles or learn more about text-to-speech.
‌
Save

    Share this article

From the get go, nurses carry the load. Photo / Paul Taylor

From the get go, nurses carry the load. Photo / Paul Taylor

Opinion

COMMENT

When a conversation about health, welfare, education, justice or housing occurs in New Zealand, people's eyes can glaze over — and for good reason.

The question is always like eating an elephant. Where do you start, how do you start and why do you start. This requires an open and most importantly informed discussion on making things better.

Let's concentrate on health.

There are three major areas of health, and for the benefit of this conversation the first area we will delve into is public health.

Advertisement
Advertise with NZME.
Advertisement
Advertise with NZME.

This is an investment in changing attitudes to healthier living. For instance, eating and drinking the right things, not smoking, being positive about exercise and so on.

In effect it is about prevention and stopping our strong drive to continue to fund ambulances at the bottom of the cliff, rather than building fences at the top.

Then there's primary healthcare. In New Zealand, by and large, this is heavily controlled and influenced by the family doctor.

Advertisement
Advertise with NZME.

However, the untold and unlauded heroes are not general practitioners (GPs).

There are many thousands of allied health staff — from nurses to midwives to pharmacists to physiotherapists to psychologists and others that prop up primary healthcare.

Of course, GPs, like the family doctor are trusted and important. But in the new era, I suspect they will morph into quality assurance health personnel.

The problem we have is that the present funding model in rewarding GPs is skewed in favour of doctors with a chokehold over primary care.

Discover more

Opinion

John Tamihere: The Treaty as a roadmap

05 Feb 04:00 PM
New Zealand

Midwives picketed outside Tauranga Hospital

12 Feb 06:29 PM
New Zealand

Heavily pregnant woman twice turned away by hospital

16 Feb 04:00 PM
New Zealand|politics

Canterbury DHB heading for $100m deficit

20 Feb 01:46 AM

But change is coming to this area, quite rapidly and for several reasons. Our society can no longer fund a chokehold that is predetermined and works solely on one union called the New Zealand Resident Doctors' Association. The area of health must be widened in this modern era.

We must urgently acknowledge and provide increases in salary to the allied health staff who carry the majority of weight in primary health care — that is our nurse-led primary healthcare.

From the get go, whether it is holding the administration of primary healthcare, whether it is in meeting and greeting patients, whether it is triaging and identifying exactly what issues people are presenting with or whether it is giving good sound advice to new GPs straight out of medical school, nurses carry the load.

But this staffing pool is under-rated, under-respected and underpaid.

We must honour them by allowing nurses a far wider scope in healthcare, particularly in terms of writing "green prescriptions", where gym instructions are provided, all the way to writing a range of medicinal prescriptions.

In addition, nurses must be respected enough to be allowed to conduct, in their own name and signature, a number of phone, email or text interventions with patients they have built up a long and strong rapport with.

Advertisement
Advertise with NZME.

Some will argue that this capability is already available. For the few not the many.

Pharmacists are also underused. We use approximately 30 per cent capacity of pharmacists and must honour and respect them more with the right to provide over- or off-the-counter scripting at their pharmacies.

All of this is now underwritten and supported by the rapid and massive rollout of digital products. Within five years, there will be an extension to the Fitbit that allows blood pressure, heartbeat, and sweat gland information to be relayed to your remote health database.

Your Fitbit will vibrate, a text message will appear and advise you to go to your pharmacist because your present medication will either be increased or decreased.

The magic of this is that your health system will now be in constant surveillance and any issues that you have will be highlighted immediately. Accordingly, there will be no major traffic jams or road blocks at GPs.

There will not be requirements for the way in which we have a medical delivery mechanism that was built for a world that existed 200 years ago, but is no longer fit for purpose in a new world order.

Advertisement
Advertise with NZME.

The cost of producing one doctor after an 11-year apprenticeship — seven years of that for study — plus internship and residency can be as high as $400,000. That doctor would have built up a debt of at least $90,000 in student loans and could be snapped up by any other country while on vacation.

This is not an opinion piece attacking the good and hard work that GPs do. It is merely saying that the present system of primary health care needs a radical overhaul and that the present system of remuneration — and therefore rationing of service — is just plain wrong. The answer is in honouring a range of allied health professionals and lifting their mandate to deliver a range of care which does not have to be signed off by a GP.

Health is a large deductive algorithm that artificial intelligence won't always be able to take over. But a significant percentage of health decisions will be by way of referral of an in-time, on-time data warehouse that integrates your personal data from a device such as your Fitbit.

So given the rise of technological advances and the ability of allied health professionals, let's have an honest conversation about delivering primary health care. Secondary healthcare — or health care by hospitalisation or the like, requires an entirely new article.

But if we fund prevention more — remember the last administration reprioritised or dragged millions of dollars out of the health system — and we extend the rights of highly qualified trades in health to do more along with technological changes, we can free up investment to be applied elsewhere.

Save

    Share this article

Latest from New Zealand

New Zealand

'Serious-to-critical': Crash shuts SH1 in Northland, delays expected

06 Jul 08:48 AM
Crime

'No bad blood': Inmate apologises for shanking prison officer

06 Jul 08:00 AM
Wellington

'Exercise caution': Investigation into Kiwi's death in elephant attack

06 Jul 06:58 AM

There’s more to Hawai‘i than beaches and buffets – here’s how to see it differently

sponsored
Advertisement
Advertise with NZME.

Latest from New Zealand

'Serious-to-critical': Crash shuts SH1 in Northland, delays expected

'Serious-to-critical': Crash shuts SH1 in Northland, delays expected

06 Jul 08:48 AM

Emergency services were called to the scene about 7.45pm.

'No bad blood': Inmate apologises for shanking prison officer

'No bad blood': Inmate apologises for shanking prison officer

06 Jul 08:00 AM
'Exercise caution': Investigation into Kiwi's death in elephant attack

'Exercise caution': Investigation into Kiwi's death in elephant attack

06 Jul 06:58 AM
Police respond to assault at pool: One hospitalised, charges laid

Police respond to assault at pool: One hospitalised, charges laid

06 Jul 06:31 AM
From early mornings to easy living
sponsored

From early mornings to easy living

NZ Herald
  • About NZ Herald
  • Meet the journalists
  • Newsletters
  • Classifieds
  • Help & support
  • Contact us
  • House rules
  • Privacy Policy
  • Terms of use
  • Competition terms & conditions
  • Our use of AI
Subscriber Services
  • NZ Herald e-editions
  • Daily puzzles & quizzes
  • Manage your digital subscription
  • Manage your print subscription
  • Subscribe to the NZ Herald newspaper
  • Subscribe to Herald Premium
  • Gift a subscription
  • Subscriber FAQs
  • Subscription terms & conditions
  • Promotions and subscriber benefits
NZME Network
  • The New Zealand Herald
  • The Northland Age
  • The Northern Advocate
  • Waikato Herald
  • Bay of Plenty Times
  • Rotorua Daily Post
  • Hawke's Bay Today
  • Whanganui Chronicle
  • Viva
  • NZ Listener
  • Newstalk ZB
  • BusinessDesk
  • OneRoof
  • Driven Car Guide
  • iHeart Radio
  • Restaurant Hub
NZME
  • About NZME
  • NZME careers
  • Advertise with NZME
  • Digital self-service advertising
  • Book your classified ad
  • Photo sales
  • NZME Events
  • © Copyright 2025 NZME Publishing Limited
TOP