BayBuzz - Be in the know

In the last BayBuzz Digest, the case of the man with a bleeding foot showed how impossible it can be for us to access what should be basic free Accident and Emergency assistance. It also showed we can’t know what is fair or which professionals offer the best value if we do have to pay.

Napier City Council produces a regular independent survey of residents, the Napier Social Monitor. The most recent survey shows that around 20% of city residents accessing health services encounter problems. The figure has steadily worsened across the past decade. In 2000, fewer than 3% of residents had problems.

Other evidence confirms this frightening trend. Council has been forced to form a Health Advocacy Committee. Chris Tremain said last year that between a quarter and a third of all business reaching his office was health related. Russell Fairbrother claims to have a “taskforce” working on Napier health services. A Public Health Action Group is active.

In other words, the system simply doesn’t work. And not just in Napier. Of the four territorial authorities covering Hawke’s Bay, three report access to health care as the number one concern for residents. A similar scenario would hold for much of the country.

So – why the deafening silence from our politicians? No party is seriously confronting this growing problem. ACT are busy trying to lock people up. The Greens have their hands full with the environment, and the Maori Party with Treaty issues. National want to focus on tax cuts. Labour is running to stand still. Meanwhile our media blows up personalities, which merely hinders everyone from tackling issues that really matter.

Health policies – national

ACT: “People should have a choice of competing healthcare products” with hospitals competing “in the business of health delivery.” Would like “optimal insurance agreements.”

Greens: “Health care must be publicly funded and be based on treating the whole person.” Want to introduce a free annual wellness check for all New Zealanders.

Labour: “is committed to improving the affordability, accessibility and quality of health services for all New Zealanders.” Emphasis on “more affordable primary health care.”

Maori Party: No website policy posted.

National: seeks more minor surgery in clinics and “the judicious use of public-private partnerships.” “Hospital emergency department delays can be reduced by some co-location of GP services.”

Health policies – local

Hawke’s Bay Hospital is overloaded, largely because the support facilities in the twin city aren’t adequate. So the answers given by candidates to two written questions put by the Public Health Action Group concern all Hawke’s Bay residents.

The questions were, “Following the expiry of the lease on the Wellesley Road Health Centre in 2011, will your party commit to replacing it by the kind of facility – a public community hospital – that Napier was supposed to have after the closure of Napier public hospital on the Hill? If not, what will you do to ensure that there is a free Accident and Emergency service within the city?”

Candidates were asked to discuss them with party health spokesmen before replying:

Greens (Brett Stansfield) – “Better services should be in place now, it seems unsatisfactory to have to wait until 2011… The Green Party will actively lobby government to ensure that adequate accident and emergency services are provided.”

Labour (Russell Fairbrother) – The future of the Wellesley Road Health Centre is “best determined by the elected representatives to the HBDHB.” “There presently is free Accident and Emergency Services in Napier and the Labour Party supports these services continuing. Patients not requiring the Accident and Emergency service but seeking instead after-hours medical care, pay for this as they would had they gone to their own medical practice after hours.”

National (Chris Tremain) – “The National Party is not prepared to commit to the return to full 24 hour A&E service delivery from Napier. We will commit to the current level of A&E service in Napier (8am to 10pm) plus continuing to enhance the 24 Hour full service A&E delivery from the Hawkes Bay Regional Hospital in Hastings.”

A personal view

With just four million people, New Zealand is too small for the American health model to work. In any case it’s a bad model! We need one public health system that works well and equally for everyone.

Both major parties have let themselves become entangled in private-partnership ideas that do not work. So instead of cash going directly into health care, we’ve ended up with a huge bureaucracy to explain why we can’t get care when we need it.

National’s published policies would only make things worse. Labour’s are better, but the Hawke’s Bay’s experience of the past nine years has not matched their aims of improving health accessibility and quality.

Labour deserves credit for resourcing public health better. National’s opposition MPs deserve credit for addressing the health issue locally. And the Greens, although they aren’t often quoted in relation to health, have the best policy of all the parties.