Govt changes to health system

[Lilith7]

Have already caused havoc for some; several hundred positions have so far been disestablished. This was done the week before Xmas, not the best time of year to make people unemployed.



The NZDoctor site
"Four groups from the Government health agency have been notified of the decisions, chief people officer Andrew Slater says in a statement, including those in procurement and supply chain. “This means a total of 424 positions have been disestablished."




https://www.healthcoalition.org.nz/scrap...ri-health/

"The disestablishment of Te Aka Whai Ora – the Māori Health Authority – as proposed by the National, ACT and NZ First parties, poses a grave threat to the health and wellbeing of tangata whenua.
Health Coalition Aotearoa (HCA) calls on all parties to retain Te Aka Whai Ora as a Māori-led, independent Crown agency advocating for and commissioning services and policies to improve the health of Māori and address unacceptable inequities and institutional racism.
Policies to scrap the entity – after just over one year in existence – are politically-motivated, without regard for the years of evidence, planning and collaboration that underpin it, HCA board member Grant Berghan (Ngāpuhi, Ngātiwai and Te Rarawa Iwi) says.
“Stop playing party politics with our people’s health. It will take 20 years to turn back the damage this will do.”
The establishment of Te Aka Whai Ora followed recommendations from the Waitangi Tribunal and an independent Health and Disability System Review – which found the health system had failed to recognise and properly provide for tino rangatiratanga and mana motuhake (self-determination) of Māori health.
“[i]This [failure]resulted in the inequitable health status of Māori, who, on average, continue to have the poorest health status of any ethnic group in New Zealand – despite the Crown investing some $220 billion in the health system since 2000”.[/i] Waitangi Tribunal, Hauora report"




https://www.rnz.co.nz/international/paci...confidence


"One of New Zealand's most prominent Pacific health leaders says he has "no confidence" in the government after stepping down from almost every advisory role.
Long-standing champion for health Sir Collin Tukuitonga told RNZ Pacific he has resigned as the chairperson of Te Whatu Ora Pacific Senate, a week after the new government officially took over.
"I really don't want to work for this government. I have no confidence. They are not going to treat Pacific people well and I want to be free to speak up and speak out."
Sir Collin had also stepped down from several other government advisory groups.
"I was appalled at the decision to repeal the smoke-free legislation, because it is Māori and Pacific people who are going to pay the price. That really annoyed me no end."
Sir Collin said he was unhappy with how the government was scrapping legislation "for tax cuts," which he believed "was immoral."







Finance Minister Nicola Willis has previously said scrapping smokefree laws would help fund tax cuts.

However, Sir Collin said disestablishing the Māori Health Authority/Te Aka Whai Ora was "pre-mature and ill-advised," and that "Māori deserve better".

"The government needs to do more with and for Māori. They have some of the worst health outcomes in the country as do our [Pacific] people."

[joe 90]

Good job thetime & money wasted on making the maori health authority could have been spent at the coal face .The health system has become bloated as labour solution was to employ more non clinical staff . Isaw the result first hand in Nov waiting 14 hours after a stroke in a wheelchair in A&E waiting room u ntil a bed became available. Even took 5 hours for first assessment so short of staff .on the front line

[Praktica]

Good job  thetime & money wasted on making the maori  health  authority  could have been spent at the coal face  .The  health system has become bloated as labour solution was to employ more  non clinical  staff  . Isaw the result first hand in Nov waiting  14 hours after  a stroke  in a  wheelchair in A&E waiting room    u ntil a  bed became available.  Even took  5 hours for first  assessment  so short of staff .on the  front line

Where will these "front line staff" come from?

[harm_less]

Good job  thetime & money wasted on making the maori  health  authority  could have been spent at the coal face  .The  health system has become bloated as labour solution was to employ more  non clinical  staff  . Isaw the result first hand in Nov waiting  14 hours after  a stroke  in a  wheelchair in A&E waiting room    u ntil a  bed became available.  Even took  5 hours for first  assessment  so short of staff .on the  front line

Where will these "front line staff" come from?

My sister is a nurse with 45+years experience and a nursing degree. She works in orthopaedics and with a skill set that rivals some of the specialists she 'assists' in terms of hands on care she has over the past few years increasingly needed to add upskilling immigrant nursing staff in what should be basic skills (injury diagnosis, appropriate patient care and applying casts). Further adding to her additional workload is the deficient English language skills of many of these recent immigrants with misunderstandings and patient communication issues presenting real risks of inappropriate treatments being carried out.

For a senior nurse this time consuming and frustrating situation is on top of an overwhelming patient load, sometimes nonsensical technological 'improvements', juggling schedules around non-shows and patients delayed by traffic issues and ambiguity of patient identification caused by gender neutral terminology among other shortsighted improvements to her work environment.

My point is that simply importing additional health workers comes with a whole new set of problems (and potential risks) for an already deficient hospital system.

[Praktica]

We need to go back to a system of workforce planning - nursing and medical students provided with fees relief and living allowances, in return for a bonded work period after graduation and completion of training. We could also close entry to medical training for non citizens. If we started now, we would see an improvement in 10 years or so.
The current "market led" system has proved totally deficient, over the last few decades. I don't expect any meaningful efforts, however, from the bunch of idiots we have in government.

[Lilith7]

Good job  thetime & money wasted on making the maori  health  authority  could have been spent at the coal face  .The  health system has become bloated as labour solution was to employ more  non clinical  staff  . Isaw the result first hand in Nov waiting  14 hours after  a stroke  in a  wheelchair in A&E waiting room    u ntil a  bed became available.  Even took  5 hours for first  assessment  so short of staff .on the  front line

Do tell us all exactly how these frontline staff - y'know,the ones who've all just lost their jobs the week before Xmas thanks to this govt - are going to somehow miraculously cope with & improve, the situation.....??

I'm sure we'll all be just fascinated to learn how this govt can apparently improve the lack of staff by disestablishing so many positions.




Fewer staff than ever is highly unlikely to help the situation & is far more likely to make it considerably worse.

---

We need to go back to a system of workforce planning - nursing and medical students provided with fees relief and living allowances, in return for a bonded work period after graduation and completion of training. We could also close entry to medical training for non citizens. If we started now, we would see an improvement in 10 years or so.
The current "market led" system has proved totally deficient, over the last few decades. I don't expect any meaningful efforts, however, from the bunch of idiots we have in government.

Indeed, ( & possibly fewer managers might not be a bad idea from what's been said in the media) but of course that would make sense & it seems that's what is lacking in the various govts which have helped create this situation.

Why the devil idiot politicians can't simply ask those working in health (or teaching or whatever it might be which they want to improve) what is needed & act on that is one of the great mysteries of life.

[Zurdo]

The priority is to pay for the tax cuts, we gotta pay for the tax cut, so there will be some job losses and a few hiccups along the way...but eventually we will pay for the tax cut.

[TinkandTiff]

Getting rid of the unnecessary BS, would free up $$$$ to enable fees relief for nursing and medical students. Would also free up $$ to allow for better salaries to attract much needed qualified specialists and consultants from over seas. Had 2 family members - both Dr's - looking to come back to NZ to live/work from UK. They didn't bother with NZ. Went to Adelaide instead.....much better money, and a house supplied too!!! NZ cant compete. One was NZ trained/kiwi, other was her German surgeon husband. Now, one of their sons is studying to be a Dr. If NZ was able to offer a comparable salary, they would have moved back here.

[Praktica]

Getting rid of the unnecessary BS, would free up $$$$ to enable fees relief for nursing and medical students. Would also free up $$ to allow for better salaries to attract much needed qualified specialists and consultants from over seas. Had 2 family members - both Dr's - looking to come back to NZ to live/work from UK. They didn't bother with NZ. Went to Adelaide instead.....much better money, and a house supplied too!!! NZ cant compete. One was NZ trained/kiwi, other was her German surgeon husband. Now, one of their sons is studying to be a Dr. If NZ was able to offer a comparable salary, they would have moved back here.

What do you class as "unnecessary BS"?

[Olive]

The idea that getting rid of "back room" staff will somehow not affect the performance of "front desk" staff is childishly simplistic.   Who will administer the IT?   The nurses???   Who will develop and analyse policy?   The doctors???

It's like someone watching The Chase and thinking that there is nobody vetting the contestants, planning the format, editing the footage, devising and balancing questions, designing the scenery, operating the cameras etc.

[Lilith7]

The priority is to pay for the tax cuts, we gotta pay for the tax cut, so there will be some job losses and a few hiccups along the way...but eventually we will pay for the tax cut.

The tax cuts must be made; this govt's reputaion depends on it, & at this stage of things that's still important.
Therefore, tax cuts will be made. Come hell or high water.

[king1]

Good job  thetime & money wasted on making the maori  health  authority  could have been spent at the coal face  .

Except it won't though will it? Where will it go?  obviously tax cuts for the wealthy...

[SueDonim]

From the DHB years we had 22x the management of all functions, inclusing all the non-clinical roles. 22 IT departments. 22 Finance departments. Etc. All doing the same thing. Within that there were initiatives to try and get collective buying to save purchase prices and streamline procedures. Etc. But that couldn't work because product and system vendors were selling 22x whatever the base product was and wouldn't budge on price. Even though NZ's whole health sector is only about the size of a medium-sized hospital in the US. So the merging into a single entry was by far the best thing to do. I just hope that it is/has been done sensibly as some tasks need the same number of overall staff, but with less management. The discipline that I worked in directly saved clinical staff from having to do non-clinical background and needed to grow overall, not reduce.

Duplicating the new structure to include an additional Maori health stream was expensive nonsense. People are people and racial and cultural aspects need to be part of the bigger picture, not held aside.

The proposed tax cuts might just help the overworked and underpaid staff, both clinical and non-clinical, get a few more $ in the hand, but not by a lot. The minimum wage still puts people in the second tax bracket and people on an average salary are still high in the third bracket. Only the consultants and a few of highest level managers are likely to see a significant increase in real income. Hopefully it's enough to keep a few more of them in NZ but I fear many professionals at all levels will still head offshore unless the actual work environment improves greatly in the new structure. Fingers crossed.

[zqwerty]

Every company or industry I have ever worked in has been badly organized, with all sorts of inefficiencies and misunderstandings.

The jobs I have worked in are mostly manufacturing electronic mechanisms with one of them being a very well-known and lauded NZ company, you'd expect a high level of co-ordination and application to the job in hand, sadly not the case.

The intricacies of the tasks in assembling complex electronics to be mastered would probably not be as complex as dealing with large groups of ailing people in all stages of sickness and distress in varying sizes all round the country.

The stuffed up systems I have had a hand in repairing at least temporarily before I left in disgust from multiple jobs would be nowhere near as complex as the tasks and co-ordination to do the Herculean job required to be undertaken by the Health system; with current attitudes in the NZ workforce in general I see little hope of any improvement with either top down or bottom up solutions.

Too many chiefs and not enough Indians. With the Chiefs and middle-chiefs all too ready to pontificate on tasks they know nothing about and to treat everything as if supplying bottles of soft drink is the same thing as supplying air travel facilities or Health Care, leaving 'where the rubber hits the road tasks' up to the skilled staff but interfering all the way through the process to make their management mark on the processes like graffitiing a wall for all to see.

Taking every helpful suggestion as a challenge to their authority status.

The emphasis on individualism in NZ is not conducive to groups working like a clockwork machine to undertake what would be required in the Health sector.

People blindly/religiously following orders is the last thing needed. Top down main frame computer type models to govern complex systems is a sure-fire way to either fail abysmally or produce a system which limps along like we have now.

[harm_less]

Every company or industry I have ever worked in has been badly organized, with all sorts of inefficiencies and misunderstandings.

Examples of the 'Peter principle' in action?

[Lilith7]

From the DHB years we had 22x the management of all functions, inclusing all the non-clinical roles. 22 IT departments. 22 Finance departments. Etc. All doing the same thing. Within that there were initiatives to try and get collective buying to save purchase prices and streamline procedures. Etc.  But that couldn't work because product and system vendors were selling 22x whatever the base product was and wouldn't budge on price. Even though NZ's whole health sector is only about the size of a medium-sized hospital in the US. So the merging into a single entry was by far the best thing to do. I just hope that it is/has been done sensibly as some tasks need the same number of overall staff, but with less management. The discipline that I worked in directly saved clinical staff from having to do non-clinical background and needed to grow overall, not reduce.

Duplicating the new structure to include an additional Maori health stream was expensive nonsense. People are people and racial and cultural aspects need to be part of the bigger picture, not held aside.

The proposed tax cuts might just help the overworked and underpaid staff, both clinical and non-clinical, get a few more $ in the hand, but not by a lot. The minimum wage still puts people in the second tax bracket and people on an average salary are still high in the third bracket. Only the consultants and a few of highest level managers are likely to see a significant increase in real income. Hopefully it's enough to keep a few more of them in NZ but I fear many professionals at all levels will still head offshore unless the actual work environment improves greatly in the new structure. Fingers crossed.

Succesive govts have managed to add managers to our health system, which hasn't helped. What's more likely to help is increased numbers of properly trained frontline staff but of course that can't happen overnight.
Maori & Pacific people have been at the bottom of the heap when it comes to health;the changes were intended to remedy that. Naturally a right wing govt sees no merit in that & has removed it with unseemly speed.