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New Zealand was promised health improvements with the creation of two new national health authorities, but logos are the only thing that’s changed so far, doctors say.
In July, the country’s 20 DHBs were replaced by national health agency Te Whau Ora – Health New Zealand and and Te Aka Whai Ora Māori Health Authority, but many health statistics are only getting worse.
The waitlist for elective surgeries across the country grew to 27,000 this year, up from 8000 in February 2020. The difficulty of getting a GP appointment is mounting, with one in 16 Kiwis not even enrolled in a practice. Hundreds of New Zealanders are in the line for help fighting an eating disorder. Waikato children are waiting up to 180 days for a diagnosis of autism spectrum disorder or other developmental issues. More than 760 Southland women are waiting to see a gynaecologist as Southland Hospital’s Obstetrics and Gynaecology service has not been fully staffed for two years.
The issue is compounded by a crisis-point shortage of medical professionals – or example psychologist vacancies have risen from 47.80 in 2017 to 114.90 in 2022.
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National’s health spokesperson, Shane Reti, said the Government had already broken its promise to end the health system’s postcode lottery – where the quality of treatment depended on where you live.
He received figures under the Official Information Act (OIA) about how the urgency of orthopaedic surgery in each region was determined.
“People in South Canterbury will be pleased they only need to meet a minimum priority rating of 36 in order to be seen. On the other hand, Capital and Coast’s minimum requirement is twice as high, with a rating of 75 – meaning patients there will have to be in desperate need of surgery to be seen as a priority,” he said.
Health Minister Andrew Little promised an end to the postcode lottery, but said it was still early days for the new system.
Christchurch GP Dermot Coffey said he asked colleagues around the country if they had seen any improvement in the three months since Te Whatu Ora was created and whether they had been able to refer people across the old DHB borders.
The unanimous response was that there were no improvements – in fact access to specialist services was worse.
“The only difference we have seen is the change in letterhead on the letters rejecting our referrals,” he said.
“It’s very hard. Morale is as low as I have every seen it in my 20 years working in the system. There is still a lack of acknowledgement of the problem from the Ministry [of Health] and Te Whatu Ora.”
GPs had no choice but to continue prescribing high doses of pain medication to help patients, he said.
“They are very significant problems that are not going to kill the patient but will severely impact their quality of life. It’s not very nice having to tell people on a daily basis that ‘we know what you need but you have to just pay for it or put up with it’.”
Figures released under the OIA show the percentage of people being admitted to hospital within six hours of presenting to an emergency department varied across the country.
It was 68% in Auckland and Canterbury, but as low as 29% in MidCentral and as high as 89% in Tairāwhiti in the three months to July 2022.
In 2019, 88% of patients were admitted within six hours in Auckland and 90% in Canterbury.
Reti said the Government was wasting billions of health funding on bureaucrats and centralisation while frontline health workers were struggling and New Zealanders were being denied the health care they need.
“New Zealand is still desperately short 4000 nurses, with that number looking to increase as more decide to leave. Emergency department wait times are ballooning and specialist and surgical waitlists are only increasing. It begs the question, what was this disruptive restructure for?”
Association of Salaried Medical Specialists executive director Sarah Dalton said the previous system had been underfunded for decades and could not be easily fixed by a centralised system.
“We don’t have enough hospitals. Even if we were fully staffed we simply wouldn’t have enough beds for the people turning up.”
A Te Whatu Ora spokesperson asked the public to note it had only been existence since July 1. Work to address inequality involved a two-year plan.
“The aim is to achieve greater national consistency. In the next few months, we will be working on initiatives to expand workforce, implement national initiatives to support catch up on specialist services and strengthen public health services.”
It could mean patients would be seen outside their normal district or in a private hospital to get their specialist care sooner, he said.
Flexibility in funding and regulation changes would allow for more health care workers and the use of kaiāwhina (assistant health workers) would increase access for patients.
The interim New Zealand Health Plan would be published later this month and would be replaced by New Zealand’s first national Health Plan in 2024, Te Whatu Ora said.
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