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Leader's LetterJune 2006
Realism Required in Health PrioritiesHealth spending accounts for $9.6 billion annually and this year the Government will again inject an extra $750 million into the sector. As the stories of patients being returned to their doctors increase each day, it appears that even this huge sum of money is totally insufficient to keep pace with the rapidly increasing demand for elective services and of course, the ever increasing cost of health and hospital services. Add to this the demand for expensive technological advancements in medication and an aging population and we have a prescription for disappointment and disillusionment. New Zealanders will continue to be disappointed in the health system unless there is an honest and realistic evaluation of what the public health system can deliver and what the public ought to expect from it. It is this continuing debate on electives that we are hearing about. The New Zealand health system handles acute admissions relatively well – the acute admissions are all of those cases that can’t wait; heart attacks, respiratory disease, strokes, appendicitis, road accidents – and all of the follow-ups that occur after the initial event. This accounts for about 75% of all hospital admissions – there are about 620,000 discharges from our hospitals each year and this number does not count the maternity cases. The elective surgery statistics for the sector have steadily improved over the last 5 years. Hip replacements have increased by 24% since the change of government, knee replacements have increased by 52%, bypass grafts are slightly down but have been substantially replaced by a 75% increase in angioplasties and of course, we understand from the DHBs there will be a substantial increase over the next two and a half years. These figures can always be improved. In common with the rest of the world, workforce shortages in New Zealand make matters worse. More hospital intervention however, does not always mean better health. To some extent a good health system can reduce the occurrence of some ailments like diabetes or respiratory disease or even some cancers. Even as doctors and patients begin to speak out over the strains that are beginning to show, it is very clear that even another $4 billion per year is not the answer by itself, to the challenges facing our public health system. A comprehensive review of the public health system would help to define exactly what the public expects of the health system and what guaranteed minimum services the system can deliver. Elder Care FundingWe are moving another step forward with our Confidence and Supply Agreement with the Labour Government with the increase in this year’s budget for elder care. As you are also no doubt aware, this industry has been under funded by District Health Boards and of course, this results in staffing and many other challenges. Policy designed to impoverish our seniors is destructive and short sighted. I was pleased to hear from the Hon Pete Hodgson recently in question time that a payment mechanism is being worked out to ensure that this funding is used exclusively for its intended purpose and not distributed into other areas. We will be doing all we can to make sure that these funding increases are ring-fenced so that the money goes directly to the providers working in this sector. This funding injection into elder care is a start in working towards a long term sustainable solution to the aged residential care sector. Barbara Stewart MP
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