Today’s Budget announcements for Vote Health amount to nothing more than another failure in this Government’s self-proclaimed ‘year of delivery’, National’s Health spokesperson Michael Woodhouse says.
“The sea of red ink we’ve seen our nation’s District Health Boards sink deeper into won’t be fixed and the $569m allocated for DHB cost pressures will hardly be enough to even keep the lights on. It’s even $81m less than the $650m David Clark said was needed two years ago.
“DHBs are going to have to start the new financial year already needing to scrimp and save, as this Budget doesn’t give them enough to get ahead when DHBs are heading for deficits of $500 million by the end of June.
“On top of this the following underfunded initiatives and broken promises is a sample of why the Health sector will be deeply disappointed in Budget 2019:
- No money for Independent Midwives.
- No remedy for the broken promise on GP fees reductions for all New Zealanders.
- A measly 1% increase in medicines funding that won’t keep pace with population growth and demand pressure.
- No free health check for senior New Zealanders.
“The Government was left with growing surpluses and made huge promises for the Health portfolio which they have failed to deliver on. Instead they have left a litany of broken promises.”
The Ministry of Health’s quiet apology to the New Zealand College of Midwives (NZCOM) for failing to secure adequate remuneration in Budget 2018 should have come from the Minister himself, says National’s Health spokesperson Michael Woodhouse.
“MoH and NZCOM agreed to a Co-Design process that assessed an appropriate remuneration for independent midwives in 2017, but they’re yet to see a budget allocation that reflects this.
“The cost to phase increases recommended by the Co-Design process over four years is around $55 million this year and $751 million over the next four years.
“Obtained Budget 2019 documents appear to show independent midwives have once again missed out on having their remuneration claim addressed, David Clark needs to apologise twice for this snub.
“In 2017 the previous National Government agreed to settle NZCOM’s application for judicial review alleging discrimination against midwives based on gender and kicked off the Co-design report.
“The Minister addressed a midwifery march on Parliament in May last year, telling them he was listening to their concerns. What he didn’t tell them was that he had months earlier received the report of the Co-Design group but had ignored the substantive recommendations in preparing Budget 2018.
“As part of the mediated settlement the Ministry was required to apologise for inaction in last year’s Budget. The apology should have come from the Minister himself as the Ministry are under his direction and the decision not to include increases in remuneration that reflected the Co-Design recommendations could only have come from him.
“One year being overlooked is bad enough, two years in a row is just disrespectful and won’t stop independent midwives leaving the sector in their droves. This must be remedied.”
The number of adults who aren’t seeing their doctor because of the price has increased by 38,000, making a mockery of the Health Minister’s promise to improve access to affordable healthcare, National’s Health spokesperson Michael Woodhouse says.
The 2017/18 New Zealand Health Survey estimates 585,000 people over the age of 15 could not afford to visit their GP, up from 547,000 in the 2016/17 survey – the highest this figure has been since the survey began.
“The fact that 38,000 more people haven’t been able to afford GP visits on David Clark’s watch shows the reality of the financial barriers to healthcare are a long way from his lofty rhetoric,” Mr Woodhouse says.
“In Opposition, David Clark said making sure everyone had access to affordable, quality healthcare was on his to-do list. But despite the Government’s commitment to reduce fees for all adults, last year’s Budget was a shadow of that promise.
“The result of overpromising and under-delivering is now plain to see.
“The Minister is clearly out of his depth and this is another example that a little money and a lot of hope does not improve the health of New Zealanders.”
This week’s junior doctors’ strike will not only cause mass disruption but could put lives at risk, National’s Health Spokesperson Michael Woodhouse says.
“Up to 4000 doctors are striking for the week meaning thousands of procedures and appointments will be cancelled. It’s the longest strike we’ve ever had.
“Major surgeries such as cardiac and cancer surgery are being delayed and it is not overstating it to say that the wellbeing of patients will be seriously compromised, possibly resulting in loss of life as a consequence of delayed treatment.
“Health Minister David Clark has sat on his hands and let this occur under his watch, he’s letting the unions have the final say when it should be down to district health boards (DHB) and hospital chief executives. He can no longer sit on the side-lines and leave it to the DHBs. He must ensure the dispute is settled so patients receive the care they deserve.
“Labour talked big in opposition about reining in the deficits at our DHBs but instead we’ve seen them sink further into red ink, with the combined deficit likely to reach $500 million by the end of the financial year.
“New Zealanders deserve the right to consistent and reliable healthcare. The Minister needs to sort his mess out or we’ll continue to have our health system mired by strikes for the rest of the year.”
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.”