Frustration, disappointment over health funding in Budget 2017

Health minister Jonathan Coleman said the government was committed to delivering better health services.
RICKY WILSON/FAIRFAX NZ

Health minister Jonathan Coleman said the government was committed to delivering better health services.

Patients and healthcare workers say they have been left frustrated and disappointed by "inadequate" funding for health in the 2017 Budget.

They said the Government's announcements on Thursday would not go nearly far enough in addressing concerns about overworked staff, access to new medicines, and access to mental health treatment.

The Government said total health spending would be a record $16.77 billion in 2017/18 - an increase of $879 million, with an overall increase of $3.9b over the next four years.

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Budget 2017: Finance Minister Steven Joyce gave DHBs $1.8 billion for the provision of tertiary health services over the next four years.

However, the record claim does not take inflation into account, and sidesteps the fact that almost half the spending will go toward mandated wage increases as part of the pay equity settlement.

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Here, Stuff dives behind the press releases to look at three key areas of Vote Health.

Only one in 10 Kiwis think the government is doing enough to tackle mental health in New Zealand.
LAWRENCE SMITH/FAIRFAX NZ

Only one in 10 Kiwis think the government is doing enough to tackle mental health in New Zealand.

MENTAL HEALTH

The government committed $224m in funding for mental health in this year's Budget.

That includes $100m for a new cross-government social investment fund that will "target innovative new proposals to tackle mental health issues".

A majority of healthcare workers in New Zealand feel they face an unreasonable workload.
123RF

A majority of healthcare workers in New Zealand feel they face an unreasonable workload.

A further $100m will go to District Health Boards to support local mental health and addiction services, with funding also earmarked for Maori suicide prevention.

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Mental Health Foundation spokesperson Sophia Graham welcomed the funding announcement as a "really positive step in the right direction".

However, she cautioned it was too early to celebrate.

Libby Burgess says Kiwi women with breast cancer will miss out on at least four effective new medicines.
JASON OXENHAM/FAIRFAX NZ

Libby Burgess says Kiwi women with breast cancer will miss out on at least four effective new medicines.

"It seems like a lot of money, but we need to see a commitment to sustained increases in funding," she said.

"It's critically important to look at how the money is spent, and make sure we don't just keep doing the same things that don't work."

Graham said key measures for success would be a reduction in the number of suicides, and a reduction in the number of people presenting critically ill at mental health units.

Andy Colwell stands in front of 200 life-sized cut-outs of health workers, said to represent 20,000 health workers ...
Supplied

Andy Colwell stands in front of 200 life-sized cut-outs of health workers, said to represent 20,000 health workers missing due to underfunding.

Meanwhile, mental health workers and union representatives said the funding was only a fraction of what was needed to adequately respond to demand.

Social worker Andy Colwell said he expected to see the gap between demand and funding get even worse as a result of Budget 2017.

"As a mental health worker, seeing families struggling with life-threatening situations not being seen as urgent is incredibly frustrating, and knowing it will get worse is incredibly distressing," Colwell said.

Dr Graeme Jarvis estimates it would cost $200 million to clear Pharmac's backlog of drugs waiting for funding.
SUPPLIED

Dr Graeme Jarvis estimates it would cost $200 million to clear Pharmac's backlog of drugs waiting for funding.

Health Minister Jonathan Coleman acknowledged there had been an increase in demand for mental health and addiction services in recent years.

"Cabinet will soon consider a new mental health and addiction strategy, which will include our new approach to dealing with mental health issues," he said.

Erin Polaczuk, national secretary for the Public Service Association, repeated calls for an independent review following the Budget announcement.

"It's disappointing but not surprising that the Government is still refusing to have an urgent independent review, which is necessary for a new approach to mental health that values patients and staff," Polaczuk said.

Mental health was the key focus for Vote Health 2017, following a stream of negative stories about cuts within the struggling sector.

The Government faced pressure to deliver, with a recent poll by UMR Research showing that only one in 10 New Zealanders thought enough was being done to tackle mental health.

Earlier this month Mike King came out against the Government's suicide prevention strategy, while Mental Health Foundation chief executive Shaun Robinson criticised the government's 38-page strategy document for failing to set any specific targets.

Last month, the People's Mental Health Review found respondents were worried about long wait times, strain on workers, and an under-resourced system.

OVERWORKED STAFF

Healthcare workers say they have increasingly borne the brunt of New Zealand's health funding squeeze.

The Budget allowed for wage increases for 55,000 care and disability support workers as part of the recent pay equity settlement.

That will cost $1.54b - nearly half of the $3.9b spending increase scheduled for the next four years.

Additional funding will go toward disability support services and emergency ambulance services. However, Coleman made no mention of overall healthcare staffing levels on Budget day.

Earlier in May he announced the number of doctors and nurses had increased by more than 6900 since National came to power in 2008.

Despite that, critics say overall staffing has failed to keep pace with the demands of an increasing population that is also ageing.

Jane MacGeorge, acting CEO for the NZ Nurses Organisation, said the Budget was a huge disappointment for nurses who already faced declining morale and job satisfaction.

"It's not enough," she said.

"We know that nurses are a cost-effective way of delivering better healthcare to our communities, so this is a real concern. Nurses are really committed in the face of these restraints, but it's putting a real strain on health infrastructure."

A survey of almost 6000 paramedics, nurses, mental health workers and support staff earlier in 2017 found 90 per cent felt the healthcare system was understaffed and under-resourced.

Some said they feared burnout could be jeopardising patient safety, and 72 per cent said their workload was not reasonable.

In March, a slew of new mothers came forward with horror stories about their negative birthing experiences due to staffing shortages in maternity wards.

One mother said poor communication from overworked staff had made things much worse than they needed to be, and as a result she felt put off from ever having another baby.

ACCESS TO MEDICINES

Vote Health also budgeted an extra $60m over the next four years for Pharmac, the government body responsible for funding medicines.

Coleman touted the increase as benefiting more than 33,000 New Zealanders.

However, it won't go far toward clearing a backlog of more than 90 drugs that have been recommended but are yet to receive funding.

The lack of access has forced cancer sufferers such as Jess Spence to travel to Australia to receive treatment that is not available in New Zealand.

One recent study ranked New Zealand 20th out of 20 OECD countries in terms of accessing new medicines.

The Breast Cancer Aotearoa Coalition welcomed the increased in funding for Pharmac, but warned it was not enough to make a real difference.

Chair Libby Burgess said Kiwi women with breast cancer would miss out on at least four effective new medicines as a result of the restricted funding.

"Our lack of funding for new and innovative medicines is robbing New Zealanders with serious illnesses of the opportunity to live full and long lives," she said.

"We need a significant funding boost for medicines in this country to ensure we can offer first-world healthcare."

Burgess's disappointment was echoed by Sandra Kirby, the CEO of Arthritis NZ, who said New Zealand was falling well behind in treatment access compared to other countries such as Australia.

"In Australia somebody might be able to cycle through three or four different drugs to find the one that works best for them, and we just don't have that luxury," Kirby said.

"These new drugs can actually arrest the disease in its tracks, and stop irreversible damage."

Graeme Jarvis, general manager of Medicines NZ, said the long waiting list for new drugs illustrated that Pharmac's current level of funding was inadequate.

"The sad thing is that some of these have been waiting with high priority for six years," Jarvis said. "Other medicines have been waiting up to a decade for funding."

"Some of these new drugs have given people a new lease on life, and actually allowed them to be healthy and productive again."

Jarvis estimated it would cost around $200 million to clear the backlog of drugs waiting for funding, or around $40 per person.

"Let's fund Pharmac at the right level, so it can do its job correctly, and patients get the right medicines at the right time," he said.

 - Stuff

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