Suffering In Silence: The Government and its cash-strapped DHBs are relying upon the decency and stoicism of the average citizen to get them off the fiscal hook.
FUDGING THE FIGURES is what governments do when effective
policy solutions are ruled off the table. According to Radio NZ News: “New
research shows nearly 40 percent of patients who need hip and knee operations
in at least two district health boards are not getting them because of budget
restrictions. The study, published in The New Zealand Medical Journal, which
looked at Northland and Hawke's Bay, found the drive to cut wait times has left
36 percent of patients with moderate to severe pain and disability untreated.”
Clearly, the now retired National Party Health Minister,
Tony Ryall, was unable to persuade his fellow “Brat Packer”, Bill English, to
appropriate sufficient funds to keep our public health service up to the job of
actually serving the public.
One doesn’t imagine that English, an essentially decent
politician, was very happy about this. But with his colleagues demanding lower
taxes for the wealthiest New Zealanders (and some modest covering reductions
for the rest of us) he was left with little choice. It would require a
Labour-led government of more than usual fortitude and radicalism to institute
the fiscal reforms necessary to ready the New Zealand health system for the
influx of ageing Baby Boomers steadily falling prey to all the ills that flesh
is heir to.
Tony Ryall’s response to his increasingly underfunded health
system was, however, ethically extremely radical. According to the study
published in The New Zealand Medical Journal, he simply invisiblised upwards of
a third of New Zealanders in need of non-urgent surgical interventions.
Chairman of the Canterbury Charity Hospital Trust,
Christchurch surgeon, Philip Bagshaw, told Radio NZ that focusing on the length
of time people were waiting, rather than the length of the waiting lists
themselves, was “a great way of hiding the scale of the problem”.
“It’s become smoke and mirrors”, said Mr Bagshaw. “They’ve created
a self-fulfilling prophecy, so they say the waiting list is only six or four
months, but that’s because they only allow that many people onto the waiting
list.”
Smoke and mirrors it may have been, but the practice
permitted Tony Ryall to boast that the time spent waiting for elective surgery
was steadily decreasing. According to Mr Bagshaw, haemorrhoids, cataracts,
hernias and varicose veins – among a host of other debilitating conditions –
are simply not being treated in the public system until such time as serious
complications render them acute – and costly.
Allowing the condition of sufferers to deteriorate to the
point where they are forced to seek emergency admission to public hospitals is,
not surprisingly, a considerably more expensive proposition, long term, than
providing treatment early. “Investing in health early on is not only humane but
also makes good economic sense because to do things in a timely way is the
cheapest way,” Mr Bagshaw confirmed. “If you deny people treatment ... they
come back later with bigger complications and cost more money.”
As scams go, however, this is a particularly clever one,
because, obviously, not all of those sufferers rendered invisible will end up
undergoing emergency surgery. Most will simply go on suffering, unheard and
untreated.
In other words, the Government and its cash-strapped DHBs
are relying upon the decency and stoicism of the average citizen to get them
off the fiscal hook. Their deeply cynical – but apparently accurate –
expectation has been that the voters will evince little interest in how Mr
Ryall’s miracle is being achieved, just so long as the waiting period for
elective surgery keeps decreasing. And so it proved. On Election Day, most
people accepted without demur that John Key’s government was managing our
public health system with considerable skill.
So, it’s ‘all good’ for the Government? Well, not
necessarily. As the Baby Boomers find themselves relying more and more on the
public health system, they are bound to flex their still massive demographic
muscles to ensure that sufficient funding is appropriated to meet their growing
needs. With everything to fight for in terms of free medical care, there is
nothing to suggest that the ageing Boomers will not emulate the exemplary levels
of electoral participation demonstrated by older voters generally. In securing
their self-interested health objectives, the Boomers will be aided by the short-sighted
failure of so many young voters to participate in the electoral system.
The politicians of the future will respond to the medical
demands of the Boomers in the way politicians always do when presented with a
choice between serving the interests of citizens who vote and the needs of
citizens who stay at home. If young New Zealanders want a viable public health
system to still be in place when they reach their 60s and 70s, then they’d
better start voting in the same proportions as their elders. Otherwise the
health statistics being fudged will be their own.
This essay was
originally posted on The Daily Blog
of Saturday, 8 November 2014.
