National is offering cautious support for the Government’s intention to replace the Waikato District Health Board (DHB) with a commissioner, but on the condition David Clark commits to returning the board to the normal democratic process as soon as possible, National’s Health Spokesperson Michael Woodhouse says.
“The Waikato DHB has had serious issues in recent times such as unjustified spending from its previous Chief Executive, struggles to find a replacement, and a forecast deficit of $56m.
“Against that backdrop the clinical staff and outgoing acting CEO Derek Wright have worked extremely hard to maintain clinical and financial viability, and blame should not be levelled at those hard-working staff.
“While these issues are behind the Government’s decision, Dr Clark has had ample time to address issues and deliver on his pledge to rein in the deficits of our DHBs, but instead we’ve seen them sink further into a sea of red ink.
“With combined deficits likely to reach $500 million by year’s end, it’s clear that DHBs are poorly served by a Minister and Government that promised much and delivered little and we are starting to see the effect this is having.
“The board members of many other DHBs where the books have become worse off over the past 18 months will be looking over their shoulders to ensure they’re not next on the scrap heap to be replaced by a commissioner.
“The Minister’s priority now needs to be working hard to ensure the Waikato DHB’s status can be returned as soon as possible.”
The decision made by junior doctors to walk off the job for five days will cause enormous disruption and needs to be addressed by Health Minister David Clark, National Spokesperson for Health Michael Woodhouse says.
“Up to 4000 junior doctors have signalled they’re going to be putting down their stethoscopes and are walking off the job from 29 April to 4 May.
“After the last strike was deferred, the Minister and District Health Boards should have used that time to negotiate a deal that ensured our health services continued and further action avoided, so New Zealanders aren’t going to be at risk.
“Instead the Minister has sat on his hands and let the situation with DHBs get away from him. He’s let every single DHB sink into more debt since he’s taken over and the combined debt looks likely to reach $500 million by year’s end.
“This mismanagement has led to the upcoming strike, and if the Minister doesn’t get things under control then New Zealand could be set for a long year of strikes.
“There are still two weeks till the strike is set to take place, David Clark needs to prioritise sorting his mess out to ensure New Zealanders aren’t put at risk come 29 April.”
The Government’s underfunding of medicines is behind their failure to support a Health Select Committee Inquiry into Pharmac, says National Health Spokesperson Michael Woodhouse.
“National members voted in favour and the Labour and NZ First members voted against the motion, which resulted in the motion being lost.
“Malcolm Mulholland raised the possibility of an inquiry with the Select Committee last year and Labour members were supportive, but when he spoke to the Committee Chair Louisa Wall again in February she alluded to the inquiry being blocked by Health Minister David Clark.
“If this is the case then Dr Clark needs to come clean, and make sure he is not interfering with the Select Committee that he himself has said should be a ‘watchdog’ for his own actions.
“The Committee also received a petition to fund breast cancer drugs Ibrance and Kadcyla, with heart-breaking submissions from women with advanced breast cancer. They want answers as to why these drugs aren’t being funded and a broader inquiry of Pharmac would shed some light to the quality, transparency and timing of decision-making.
“Government members of the Committee must explain to those submitters and the wider public why they don’t agree.
“In Budget 2018 the Government decided not to reinvest the $200m of savings made by Pharmac taking over the purchase of hospital based medicines into new medicines. This was a huge lost opportunity.
“In February the Prime Minister said she would not block an Inquiry into Pharmac. The Labour members of the Health Select Committee need to explain why they know better than the Prime Minister.”
The Health Minister must be in panic mode this close to the Budget and with every single District Health Board in overdraft, meaning they will struggle to fund any new initiatives without cutting existing services, National’s Health spokesperson Michael Woodhouse says.
“Not only has David Clark failed to deliver on his pledge to rein in the deficits at our 20 DHBs, but they have also worsened on his watch.
“It is unprecedented to have the core of New Zealand’s health system mired in this much red ink and every sign is that their financial position will deteriorate this year. DHBs still have outstanding pay negotiations to be settled and any hope of more funding for priorities like mental health or cancer looks forlorn.
“There will be no room for new initiatives unless Clark cuts health services. That could be cuts to surgery, primary care and community health. Clark’s officials say as much – DHBs ‘will need to realise significant efficiency improvements’ to reach their full-year targets.
“Mr Clark has been forced to release details of the DHB shortfall after months of keeping them from the public and it is worse than we thought. At the six-month mark, the combined deficit of the DHBs is $207 million, significantly worse than expected and on track to eclipse the record combined DHB deficit reached in 2002.
“Because the recent trend is for the second-half deficit to exceed the first, the full-year budgeted deficit of $346 million is hopeful at best. If the pattern continues, a full-year deficit of more than $600 million will be reached.
“Frankly, Mr Clark is presiding over a mess. Almost half the DHBs don’t have their annual plans approved yet, meaning their budgets ‘remain draft and are subject to change,’ officials say. To put that plainly, about 73 per cent of Vote Health is in limbo.
“The Health Minister has misled the New Zealand public on health spending to hide his broken promises and to mask the fact that he isn’t delivering on the expectations he raised. It is concerning that his approach may not be confined to Health as he also has the portfolio of associate Finance Minister.
“National favours sensible economic policies that help the New Zealand economy to grow, create jobs and contribute to our wellbeing. We would focus on ensuring the best provision of core public service that matter to Kiwis such as health and education.”
It is disappointing that the combined deficit of New Zealand’s 20 District Health Boards looks set to balloon to about $500 million despite the Health Minister’s pledge when he took office that he would bring it under control, National’s Health spokesman Michael Woodhouse says.
“The deficit for 2018/19 could be more than four times as high as the last year of the previous National Government. David Clark said in December 2017 that DHB debt was ‘deeply concerning’ and ‘cannot be allowed to continue’ but it has worsened on his watch.
“More than a year after pledging to rein in the deficits, the DHBs are in a weaker financial position. Eight months into the latest fiscal year Dr Clark has yet to announce the approval of a single annual plan and he has stalled on releasing any financial details for the DHBs.
“National oversaw a combined DHB deficit of $119 million in 2016/17 and budgeted for a similar-sized deficit for 2017/18. DHB performance was tracking only slightly above budget until November 2017 when the new Government came in and the combined deficit jumped to $240 million.
“The Government has neither provided the funding they claimed they would nor set expectations for continued fiscal discipline. The financial chickens are coming home to roost. At some point, Dr Clark should stop blaming previous administrations and get on with the job.
“The Health Select Committee has heard from both Northland and Counties Manukau DHBs that their respective financial deficits are forecast to be double last year’s. My sources in DHBs across the country say they are in a similar position.
“Indeed it is likely that the deficits of just three DHBs, Counties Manukau, Canterbury and Southern, will exceed the total deficits of the 20 DHBs in National’s last full year in office.
“I call on Dr Clark to be honest with the New Zealand public about the situation and explain what he and his Government is going to do to stem the tide of neglect by them over the past 16 months. New Zealand’s health system requires diligent oversight, not wishful thinking.”
The Hawke’s Bay DHB must undertake a detailed, transparent review of the cause of the sterilisation failure which led to at least 55 patients having inadequately sterilised surgical equipment used on them, National’s Health Spokesperson Michael Woodhouse says.
“Mistakes happen, and they are generally the result of system failure rather than human error. But the health sector must do everything possible to ensure such events are rare, and that when they do happen they are dealt with promptly and fully, to ensure confidence in the health system is not undermined.
“I am particularly concerned at how this failure took ten days to be discovered. Far fewer patients would have been exposed to risk had it been picked up earlier, so we need to know why that’s the case.
“To help ensure confidence in the system is maintained the investigation into this failure must also be conducted in an environment of safety and openness and those involved must be able to speak freely about their actions or to raise their concerns.
“They need the confidence to come forward and speak frankly to ensure the relevant information is brought to light and the right lessons learned and necessary changes made.
“My thoughts and concerns are with the affected patients and their families who should be given every support through this stressful time.”
Pharmac’s ability to fund new cancer drugs would be much greater if the Government hadn’t cut $200 million from the medicines budget, National’s Health spokesperson Michael Woodhouse says.
“A report put out by the Breast Cancer Foundation in 2018 showed the average survival in New Zealand after a diagnosis of incurable advanced breast cancer was only 16 months, compared with two-to-three years in comparable countries such as Australia, Germany and France.
“That’s why a visiting world authority on terminal breast cancer, Dr Fatima Cardoso, is supporting calls from breast cancer patients for funding for Ibrance and Kadcyla.
“In Budget 2018, the Government cut $200 million from the cost of drugs we already purchase. Rather than use those savings to invest in funding new medicines, they cynically used that funding from the medicines budget to pay for other commitments. The Health Minister has admitted this.
“This cut was made despite the Labour Party’s election commitment to ensure New Zealanders get world-class cancer care and to fund the sector accordingly.
“This funding cut is delivering closer to third world treatment and is a damning indictment on a Government whose reality is the opposite of their rhetoric.
“Patients are dying or dying sooner than they should under this Government. The solutions are clear: greater transparency in decision making, more timely decisions and the reversal of this terrible cut in medicines funding.”
We are beginning to see what we have feared all along – the Government’s cancellation of the health targets is costing lives, National’s Health spokesperson Michael Woodhouse says.
“Health Minister, David Clark, claimed that the targets lead to perverse outcomes. What’s perverse is the fact that he is allowing people to die sooner because of his Government’s flawed ideological opposition to targets.
“Cancer experts are saying that people are dying without any national standard to drive treatment wait times.
“News that a patient would have had to wait eight weeks to be seen and may not be alive today had he not booked a private appointment proves why we need these targets.
“Over our time in Government, National set firm targets to ensure that every patient was getting radiotherapy or chemotherapy within four weeks. After that was met, our updated Faster Cancer Treatment target saw 82 per cent of patients go through the whole treatment pathway from referral to testing to the start of treatment within 62 days.
“The health targets represented areas of medicine that are vital to the health of New Zealanders. They covered areas such as faster cancer treatment, shorter ED wait times, access to surgery and more and research has proven that they saved lives.
“Clinicians have told me that they used the health targets to secure the resources to prioritise the provision of the services that Kiwis needed. The absence of national health targets means resources are harder to secure and the system is languishing as a result.
“People are dying and dying sooner because of the Minister’s action in removing the targets and his inaction in not replacing them.
“The Minister needs to wake up and re-establish the health targets originally put in place by Labour and improved by National or establish his own measures before more people slip through the cracks.”
The Prime Minister must explain her ties to convicted criminal Karel Sroubek and her role in allowing him to stay, as newly released text messages suggest a closer role than she’s let on, National’s Immigration spokesperson Michael Woodhouse says.
“The Government has started the year as it finished – cynically dumping information of real public interest late on a Friday afternoon, in this case just as the Prime Minister is about to head overseas.
“But the Prime Minister can’t hide from the serious questions the messages raise.
“Why was Sroubek’s main supporter texting her directly to pass on his ‘respect and praise’ over the decision to allow Sroubek to stay in New Zealand in spite of Sroubek’s criminal history and the fact he came here on a false passport?
“Why was one of Sroubek’s fellow inmates – Alex Swney - texting and emailing the Prime Minister information on the case, which has only now been revealed in spite of months of questioning? And what was that information and what is her relationship with Mr Swney?
“The whole thing stinks. Karel Sroubek should never have been granted residency, the Government should never have tried to keep it secret, and the Prime Minister should not be involved in any way in such a decision, especially ones which allowed a convicted criminal to remain in New Zealand.
“This Government is cynical and it continues to refuse to front up. It owes New Zealanders an explanation – even if the Prime Minister has to explain it from Europe.”
The refusal of the Minister of Health, David Clark, to publish the financial performance of DHBs is a cynical attempt at masking their precarious financial situation, National’s Health spokesperson Michael Woodhouse says.
“Reports on the financial performance of DHBs are usually published regularly on the Ministry of Health website, however, in the seven months of this financial year, not a single report on a single month has been published,” Mr Woodhouse says.
“Despite claiming to be the most open and transparent Government, it refuses to release the reports that will show that under the Minister’s watch the DHB books have blown out.
“I have heard reports that the Minister is expecting DHBs to cut costs and fund significant portions of the pay settlements without extra funding. Sources within DHBs have also indicated to me that the financial situation is dire, with DHBs struggling to meet the financial targets that the Minister refuses to sign off let alone the extra costs on top.
“When I asked the Minister why the reports had not been published he said it was because the DHB annual plans had not been finalised.
“This is a ridiculous response – the Minister himself is responsible for approving the annual plans. He is effectively using his failure to perform one role as the reason for his failure to perform another role.
“In the last full year of the National-led Government (2016/17) the combined deficits were $119 million. Last year (2017/18) the deficit blew out to $240 million, with the lion’s share of the deficit being recorded on the Labour-led Government’s watch.
“The Minister informed me prior to Christmas that he expected a report on financial performance to 31 October which would be published on the Ministry website in early 2019, but this hasn’t happened. He needs to be honest with taxpayers about what the state of DHB finances really are.”