Monday 8 Jul 2002
Ken Shirley
Speeches -- Health

Monday 8th July 2002 At 11.30 Am Wakefield Hospital Wellington

Health has emerged as one of this year's key election issues, and this morning it is my privilege to launch ACT New Zealand's Health policy.

Quite simply, the New Zealand health system is in serious trouble. Such trouble, that it has seen one of the most significant, but little noticed comments from the Labour Government this year.

A few months ago the Minister of Health said in relation to New Zealand's health services, quote, "We need to be realistic about comparing ourselves to the likes of Australia, Canada, the United Kingdom, and the United States, whose affluent economies can support more elaborate health systems than ours".

That is a statement of economic and political failure.

It is a surrender. To declare New Zealand unable to deliver health services of the quality of these countries we once ranked above is just unacceptable.

Why has the Government made this admission?

Because they know, and the facts show, the health system, is in deep trouble.

Consider these facts.

In the year just completed, despite cuts to services, none of our Health Boards could pay for all the health services they delivered.

They delivered $240 million in health services that they did not have the money to deliver.

This was $180 million worse than the $60 million in services they couldn't pay for the previous year.

Next year, and the year after, and the year after that, these same boards are projected to provide another $200 million in health services they do not have the money for. That is another $600 million all up.

So on top of $300 million having to be borrowed just to keep our 21 health boards afloat in the last two years, the realisation of the projected $200 million deficits for the next three years would see a total debt of $900 million just to keep the current health system afloat.

And despite this borrowing to keep our hospitals solvent, the waiting lists are no better.

The only reason they look better is because the Government has created the new category of Active Review, in which over 30,000 patients wanting surgery are parked in limbo, effectively the waiting list for the waiting list. They are not counted, as well as those thousands dismissed to GP Care.

The problem has been exacerbated by the Government cutting health system in the 2001/2002 in real per person terms, the first real cut to health in a decade.

New Zealand's public hospitals have no choice but to make cuts of $200 million this year. That is why Auckland Hospital is in crisis, Kaitaia Hospital is retrenching, mental health in crisis, waiting lists are growing, nurses continue to strike, and we cannot afford to pay our skilled surgeons enough to keep them in our country.

ACT is there only political party whose policy will provide a long-term solution, and that doesn't promote the deception that the only answer is to throw more and more public money at public hospitals.

ACT's key health policies are:

· Policies for Economic Growth, which make health, care more affordable.

· To harness the use of the Private health sector, and give patients greater choice though tax cuts, so that more people can fund their own comprehensive health insurance.

· Provide a Patients Guarantee. All patients waiting on waiting lists for more than the recommended medically safe time will be funded to have that operation done at the hospital of their choice, whether that hospital is public or private.

· ACT promises not to cut health spending, and will fund our tax cuts from the surplus, and removing spending on the wasted areas of the super fund, Maori TV, and Jims Kiwi bank.

· Replace Labours race based health priorities with need-based criteria.

· Make mental health services a key priority, including an urgent review of the mental health deinstitutionalisation strategy and current service crisis.

In concluding, ACT's health policies are the only policies in line with latest international advice and experience.

The World Health Organisation has recommended New Zealand should make greater use of the private health sector. So has the OECD.

WHO rankings of the responsiveness of nations health systems have Belgium, France, Germany and the Netherlands, all in the top 12 nations of the world.

All have insurance-based systems.

The public hospital system is heading toward insolvency. In many ways it closely resembles the collapse of Soviet economies.

ACT says the problems are going to worsen, and ACT has the answers.

Harness the private health sector through tax cuts and giving people choice, provide people on waiting lists Patient Guarantees to end waiting beyond medically unsafe times, replace race based priorities with need being the sole criteria, and make addressing the crisis in mental Health a key early priority.

We have some very good working examples, which illustrate the greater efficiencies and better services than can be provided by engaging the resources of the private sector.

1. Several years ago the Urologists in the Bay of Plenty combined within the Venturo Group and undertook to meet all elective surgical needs. Waiting lists were slashed and patient needs were met at a cheaper price. This model has now been extended to adjoining District Health Boards and a parallel group is meeting the needs for elective orthopaedic surgery.

2. Five years ago all elective surgical operations funded by ACC were required to be performed in a public hospital and ACC patients languished on waiting lists. Today, ACC calls for competitive tenders for its 25,000 per year elective surgical operations. The key criteria under the tender process are price, timeliness and quality of outcome. It is interesting to note that nearly 90% are performed by private hospitals.

Why can't all patients have this level of choice and quality treatment?

3. Several years ago the waiting lists for heart operations in Wellington Hospital was out of hand and a contract was let with the private Wakefield Hospital. Again, waiting lists were slashed; patients needs were met at prices comparable with the public hospital. The incoming Labour Government cancelled this contract and today the waiting times for non-urgent patients in Wellington's Public Hospital is over one year, compared with 48 days in an Australian public hospital.

The number of people waiting past the 6 months recommended maximum time has doubled since the contract with Wakefield was cancelled last year and according to sources in the health system, two people have died as a result of delayed surgery.

When it comes to meeting the health needs of New Zealanders we can do better and we must do better. ACT's policies offer sensible and proven solutions.

Ends

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