Government under fire on health

A health expert says New Zealand public hospitals are among the finest in the world, and has accused the government of creating a crisis to enlist public support for radical change.

Don Matheson, Professor of Health Policy at Massey University and a former deputy director-general at the Ministry of Health, says our public hospitals are not a basket case.

If anything, he says, continuous restructuring and reform is causing so much upheaval and disillusionment among staff that the drive for more efficiency is having the opposite effect. Matheson, writing in the latest newsletter of the Association of Salaried Medical Specialists, accuses the government of waging a spin campaign to convince the public of the need for major reform.

He took aim at the Ministerial Review Group, headed by Dr Murray Horn, established by Health Minister Tony Ryall to recommend ways to improve the public health system.

When it reported in June, the review group made 170 recommendations on how to reduce bureaucracy and improve health services. The government responded in October, announcing $700 million in savings over five years, which Ryall said would be "reinvested in frontline services". Ryall also announced that up to 500 jobs would be lost in the health bureacracy.

The minister appointed Horn the chair of the new National Health Board Advisory Board, a unit within the Ministry of Health set up to oversee the $9.7 billion DHBs spend each year on public healthcare.

Matheson, however, is not so impressed with Horn's work. He said the Horn report had no appreciation of the fact that New Zealand had one of the "highest performing health systems with the lowest expenditure amongst comparable countries."

"I've heard of creative accounting, but the statements in the Horn report break new ground in trying to turn good news into bad. From an international perspective we have a health system that contains much to make us proud, and is in fact the envy of the rest of the world in many respects.

"These `inconvenient truths' did not find their way into the Horn report. Instead, efforts were made to catastrophise the NZ health system, to try to ignite a very damp platform to usher in radical change. Why? In whose interests is it to deny our nation's success, trumpet our shortcomings, create fictitious pictures of the future, and attempt to create a climate of concern that justifies a panicked response?"In my view, the international comparisons are a cause for celebration, not panic."

Labour's health spokeswoman Ruth Dyson said Matheson had "hit the nail on the head".

The government was hellbent on implementing an ideology that shifted responsibility for healthcare away from the government to the individual, she said. "We have had an ongoing scaremongering campaign from the minister of health and this is clearly to frame the public thinking that radical reforms are necessary.

"There are always improvements to be made in any system, but what they are talking about is a fundamental rethink in the priorities in health."

But Ryall said the government refused to accept that the standard of healthcare in New Zealand was as good as it gets. The ministerial review group's recommendations had received "unprecedented support from the wider health sector".

"There's no point in people claiming the health service is perfect when patients and staff know it isn't."