Running a stethoscope over health spend

This week relevant ministers in health portfolios can expect a grilling from Parliament’s health committee.

It is one of two scrutiny weeks for Parliament where the House is not in session but members of Parliament are expected to be involved with the various select committees, having a close look at the government’s spending in relevant areas.

This week looks at the estimates, and in December the committees examine what has been achieved.

The health committee has allocated four hours to hear from Health Minister Dr Shane Reti, Mental Health Minister Matt Doocey, Minister for Seniors Casey Costello, the minister responsible for Pharmac, David Seymour, and Judith Collins in her role as Minister of Science, Innovation and Technology.

Dr Reti has been allocated the longest time (90 minutes), while Ms Collins, who is responsible for the Health Research Fund, gets a mere 15 minutes.

With a plethora of issues plaguing our creaking health system, it seems hardly long enough to convince the public they are heading in the right direction.

Last week there was more consternation from health sector unions over Health New Zealand Te Whatu Ora’s book-balancing measures.

In an email leaked to RNZ, chief executive Margie Apa called for an organisation-wide immediate pause on all current and new recruitment of hospital roles that are "not patient facing and public health roles that are not community facing, with immediate effect".

This also applies to what Ms Apa called enabling services such as "people (which we assume is human resources), communications and finance".

Health sector unions are struggling to come to terms with Ms Apa’s reassurance the new measures will not impact frontline services.

The Association of Salaried Medical Specialists said roles such as radiologists and booking clerks were affected, and its members were also saying they were not able to recruit to roles including paediatricians, cardiologists, obstetricians, cancer specialists and public health physicians.

In the meantime doctors were working long hours to hold services together.

Parliament Buildings, from left, Bowen House, the Beehive, and Parliament House. PHOTO: NZ HERALD
Parliament Buildings, from left, Bowen House, the Beehive, and Parliament House. PHOTO: NZ HERALD
The Public Service Association said it was apparent in the Southern region all recruitment processes, including for clinical staff, had been frozen.

This, combined with the ongoing issues over what has been described as a chaotic patient management system, has left staff strung out.

The idea frontline services can be improved by doing away with what are portrayed by politicians as time and money-wasting backroom staff is particularly foolish in health services.

Of course any unnecessary layers of management should be removed, but clinicians need back room support to boost the amount of time they can spend with patients. We doubt patients want health professionals spending time on tasks which could more efficiently done by others.

On that question, it is not reassuring to learn half of the critical information technology (IT) hardware in hospitals is past its use-by date.

An HNZ briefing to Dr Reti, released to RNZ, said significant near-term effort and investment in hospital data and digital technology were needed just to keep the lights on.

In this year’s Budget $330 million of unspent funding set aside for IT initiatives over four years has been returned as savings, but Dr Reti has said he would consider new investment later this year when HNZ delivers a new 10-year digital plan setting out the scale of what is needed.

It will not be cheap, but cannot be ignored.

And another thing

Nasal decongestant pseudoephedrine is available again from pharmacies, but not all pharmacists may choose to stock it for fear of being burgled.

In May, a Motueka pharmacy had medicines containing the drug targeted in a burglary days after receiving stock.

It has been more than a decade since it was available, banned because of concerns about its use for methamphetamine manufacture.

As well as the burglary issue, there are also questions about whether its reintroduction is a good thing if it encourages more ill people to soldier on at work and spread respiratory illnesses rather than stay at home to recuperate.