18 June 2022
Opinion as featured in the New Zealand Herald
Last week the New South Wales (NSW) state health ministry announced a $4.5 billion hiring package to recruit more than 10,000 staff.
This should send warning bells throughout New Zealand. How many healthcare workers will we lose this time when our healthcare system is already in crisis?
While COVID might have pushed it to the brink, the reality is, it is suffering years of neglect and underinvestment.
You just need to look at the dilapidated state of so many of our public hospitals, our overstretched mental health system, or the chronic shortage of health workers that sees so many Kiwis languishing on waiting lists or in corridors.
As a result, too many New Zealanders are dying from preventable deaths because we don’t have access to the healthcare that we need, when we need it. Our underserved Māori, Pacific, and rural communities are among the hardest hit – or even worse off.
This is not the fault of one singular government, governments of all colours share equal blame for the position we find ourselves in today.
The facts speak for themselves. If you suffer from cancer in New Zealand, you have a lower rate of survivability than you would if you lived in Australia. Many Kiwis are suffering in silence, unable to access medication that is taken for granted in other countries.
But it doesn’t have to be this way. There is no reason why Kiwis can’t be the healthiest people in the world, instead of where we find ourselves now – languishing towards the bottom of many global health indicators.
Too often I think the health system in New Zealand has been set up to meet the needs of bureaucrats rather than patients.
As a country, we need to be demanding more, prioritising spending on our health system, and investing in our frontline health workers who are the backbone of our health system (and our country).
Our entire country has ground to a halt for two years because of our poor health infrastructure, yet we are not doing enough to resolve the underlying problems in the sector.
We’ve labelled our clinical workforce as “essential”, yet what benefit is there to being essential? Our clinicians, in particular our nursing workforce and clinical support staff, are overworked, under-appreciated and underpaid.
Recently I saw a post from a frustrated father detailing the eye watering expenses his daughter was incurring from returning to nursing.
So not only are we not training enough nurses, but we are also making it hard for them to return to the workforce. Meanwhile, qualified nurses are being lured overseas with better paid positions and better working conditions.
We expect staff to work in substandard conditions. Much of our physical infrastructure is old and dysfunctional. Our hospitals are aged, and in many cases, relics of a bygone era that are no longer fit for purpose.
These are some of the reasons why we continue to suffer from chronic healthcare workforce shortages here in New Zealand.
The technology our healthcare workers are expected to use is heavy and dated. Just last week, the UK’s NHS was compared to the defunct video shop, Blockbuster, in the age of Netflix, and this analogy also rings true for New Zealand.
And then we have the issue of access to specialist medication in this country.
Have you ever wondered why there are so many campaigns on 'Give a Little’ from families trying to raise funds for medications to save their loved one’s life?
It’s because we have had underfunded Pharmac for years, meaning we can’t afford some of the latest life changing medications that are available in other developed countries. We are at the bottom of the developed world for per-capita spend on modern medicines. Countries like Colombia, Mexico and Belarus spend more per person than we do.
Yes, the recent budget has made an additional allowance but this is far from enough to bridge the gap we have. This is a national disgrace and impacts all of us.
The stark reality is that budget constraints will impact a clinician’s decision on how you should be treated, and there is a real chance you will not be getting the best treatment available because of the lack of funding.
So, what do we need to do? We need to stop playing politics with healthcare. It is too important to be used as a political football. Instead, the Government and Opposition need to come together to develop a bold new strategy that is government agnostic and sets a clear direction for health policy for the next ten years.
We need to recognise our health system is going to come under increasing pressure as our population ages. We need to make tough decisions now, and plan and invest into the future to ensure the system is in a position to meet our future needs.
This means focussing on workforce development, and ensuring a career in healthcare is valued, rewarded and attractive.
We can get inventive here. How about exploring lower taxes, free childcare or additional funding grants for essential workers when buying a home? We need to embrace all of those who apply to medical school or nursing and create pathways for them into the occupation they desire, rather than reject them. With an ageing population, we will never have too many healthcare workers.
We need to stop wasting the expertise of our pharmacists, who have been relegated to counting tablets because we have not empowered them to help patients manage their medicine. In the UK, pharmacists are now assessing patients and providing referrals to speed up the diagnosis process and support primary healthcare. A practical step to remedying some of our workforce crises.
And of course, we need to recruit from offshore, working to appeal to health workers and enabling them to easily move to New Zealand. We need to follow in Australia’s footsteps not just to attract, but also retain our critical workers.
We need to fund Pharmac appropriately and reframe the conversation from funding medication, to the return on investment we will all see from keeping our population healthy and productive.
The last two years should serve as a precautionary tale. An underfunded and under-prepared health system necessitated hard lockdowns.
We will face similar crises in the future and we can’t continue to take draconian measures to protect the system.
Instead, we should be preparing our health system now to meet the demands of tomorrow.