Last week my wife and daughter spent eight days in what they now refer to as “Fucking Palmerston North” for The Performing Arts Competition of NZ (PACANZ). On the day they arrived they hired those Lime scooters, stop me if you can see where this is heading.
I got the message “I think I broke my arm” and so my darling wife was spending the first day of her trip to the Manawatu in the local A&E. “Eight hours”, the people at the Hospital told her it would be before she would see someone. Looking around at the people waiting she wasn’t sure if some of them would survive that wait - perhaps it would be quicker?
Imagine the stress such delays put on the people working there, and the would-be patients. It is like continuously running an overdraft, or a never ending balance with a loan shark, you’re constantly struggling rather than having an opportunity to clear it and get on top of things.
If you’ve interacted with our public health system recently, or spoken to people working in it, you’ll know it is struggling. Be it infrastructure, staffing levels, salaries not keeping up with living costs, or absences in a workforce who have slogged their guts out for the last two years and are still dealing with the effects of Covid. As much as some might like to pretend it just went away those numbers of cases and hospitalisations are going up not down at the moment.
Aside from delays at A&E we all know someone waiting longer than they should for a procedure intended to catch problems early. We know that people are ending up with much harder medical battles than if they’d been diagnosed earlier, no doubt in some cases even dying. The waiting list for non-emergency surgeries, hips and knees and things, is long and do doubt causing avoidable periods of pain or restricting lives.
Of course the media focus on the sensational, and the horror cases. The people experiencing problems need to have their stories told, patients whose health outcomes are impacted, people working long hours which never seem to end. But there are also other stories to be told, of grateful people speaking of how caring, pro-active, and dedicated the medical professionals are.
To add to my own observations I thought I’d ask some friends for their experiences, either working in the sector or as patients.
I've seen nothing but professionalism, efficiency, and caring in the hospital system for the last few years. That's covering my wife and her language issues, myself and my incredible lack of anything close to patience, and my father and his unfortunate passing after an accident. Top marks to all those keeping that system going.
The sample group being my friends list it is quite a left wing bunch and not of significant statistical value, it would be weird if it were comprised of completely random members of the public.
I do know non-left wing folks of course, I just don’t imagine my posts appear in their newsfeeds often. Occasionally one pops up with a different outlook but well considered views - concerns about our Health System are not the preserve of those on the left.
After a week in hospital a few years back and the following two years of of more surgery and all the shit that went with it, not any real complaints. Nurses fucken EARN their money and should probably be paid double what they get now.
They spoke of delays around non-urgent care and concerns about just how big the job is to undo decades of underinvestment by successive governments. But you ask a bunch of lefties and of course they’ll also tell you about the excellent service they’ve had, how wonderful the people they dealt with were, and how lucky we are here.
I had hematuria which began about September last year. Within a month I was booked for a CT scan that showed a cancerous growth in my bladder. I was placed on the waiting list and within another month I had surgery to remove the growth. I've had follow up appointments which showed another polyp that turned out to thankfully be non cancerous, and was removed anyway.
The treatment that I received at Christchurch Public was fantastic; the doctors and nursing staff were as busy as one-armed paperhangers yet took the time to treat me professionally and with amazing care. I cannot speak highly enough of them. If anyone moans to me about the state of our health system I quickly shut their bleating down.
Even though the current government has increased funding by a massive 40% it is not enough to deliver the sort of service people expect. Money isn’t the only issue but is definitely required to maintain and replace infrastructure, compete for talent in a global market, and have enough capacity so that long waiting times are not the norm.
From a nursing perspective, offering substandard wages to immigrants from low income nations is undermining the profession. Why is it out of the question to at least attempt to match wages in Australia? Instead we bring people in who will work for very little and NZ trained nurses go overseas.
We’re told that we need to accept senior executives must be paid high salaries that are internationally competitive as there is a limited pool of talent. Maybe that is the case but surely by the same logic we should be seeking or retaining the trained medical professionals we need.
A number of people responding said that when the system is really needed it kicks into action, but it is the volume of less essential cases really causing the bottleneck. Despite some sad cases recently the most urgent cases are getting the life saving emergency action we would expect.
Yo Nick, well having recently been a patient in a critically bad situation.... being in Ahipara suffering ruptured brain aneurysm luckily with my wifey present, ambo within 15 mins, Kaitaia hospital responding super fast, one helicopter ride to Whangarei Base Hospital..... time poor quick diagnosis, luckily then another chopper ride to Auckland hospital. Although that ride almost didn’t get off the ground..... malfunction? Finally made it to Akl within 9 hours roughly from event. Had brain surgery, successful followed by 3 weeks HDU. Then sent hope scared as f...k. Now 4 half month into recovery doing really well. Slowly but surely.
Part of the volume issue is people presenting at the A&E because they can’t afford to go to a Doctor or a White Cross, although no doubt those services would struggle if the folks going to A&E were diverted to them instead.
In 2001 when my mother was diagnosed with breast cancer her doctor assured her that while our health system was inept and inefficient at dealing with minor matters it swung into action for major medical issues. And so it did. Ultimately she died but it was not from lack of care or effort. Clearly things have deteriorated considerably over the past 20 years.
There will never be enough money for everything, for no delays to procedures, for access to all drugs, but I think the type of care that we’re seeing people access with private medical insurance includes things people expect in a reasonable timeframe from our public health system.
Disclaimer: We have private medical insurance, yes I struggle with the moral position of jumping the queue for a service having paid money to do so. Do I wish there was no need for Medical Insurance - Yes, am I going to cancel mine - No. I also eat meat, sometimes use fossil fuels unnecessarily, and don’t always put the recycling in the bin correctly - sue me.
Spent nine hours in ED waiting to be checked for a clot in my leg. They did a dimmer test after seven and a half hours, which could have been done when I first arrived and ruled it out! I was totally freaked out waiting that long . It was unnecessary. I had x-rays as well and was fine waiting, but the clot definitely should have been a priority. Was ruled out thankfully.
By promoting Tax Cuts National and ACT are signalling they think the service is ok with the current, or what would be lower, funding. They seem to believe by better management, tracking to targets, they can make improvements to the service without money.
Well they can’t, it isn’t possible. Yes there may be areas for improvement, more management may give you a clearer picture of where we are - or you could just look around you. But it won’t actually deliver any more healthcare, it just gives bean counters and spin doctors an illusion of control and a way to explain away problems.
The people in the system know what the problems are, they don’t need some management wonk coming in and micro managing them. They need the resources to do the job to the standard they no doubt always want to deliver to.
I spent a week in hospital during September (North Shore) due to an emergency. I've rather too much experience of hospitals over the years (mainly NHS/UK, US & Italy) this being my first NZ experience since childhood, so have a lot to compare and contrast to.
My overall view of my treatment (in hosp & outpatient).....Exemplary.....top doctors, brilliant nurses, acceptable food, FREE WiFi......but shit Tea.
Compared to experiences abroad, I found it much more efficient here....decisions were made and acted on quickly, there was little waiting about for x-rays etc, even my admission at ER (Waitakere) was swift and Nurses responded within 1-2mins of pushing the bedside buzzer. My outpatient appointments (Fracture Clinic) have happened on the dot as per appointment with little to no waiting (I'd have to devote half a day for an NHS appointment, wait literally hours for x-rays etc).
That's just my experience as I found it. With Covid, & all the media tales of Health service collapse, I was braced for the worst, but I can honestly say that my treatment far surpassed any previous hospital experiences........the NHS does better Tea thou'.
The fact is any money diverted into tax cuts is taken directly from budgets like healthcare. Imagine you are looking at a pile of money, let’s say stacks of $20 bills and you can give them to the rich guy so he can buy some more toys or to the health system so they can have enough people working to avoid long delays.
That is the choice you will be making next year in the election, tax cuts or health spending - where do you think money should be spent?
On my last serious visit I had spoken to the nurse at my local GP. They saw me at short notice and gave me admission papers for hospital. There was a long wait for an ambulance so it was quicker for me to wait for my wife to come back from work and drive me to Middlemore.
This caused some confusion and I ended up walking in to general admissions only to be told I should have gone to the emergency desk. As I walked there I realised things were getting worse and I might not make it. Walking past some ambulances parked outside the ED I stopped and wondered if my best chance would be to lay on the floor near them as they would be sure to find me reasonably quickly. I was told later that if I'd done that they wouldn't have seen me as those ambulances were being used as extra beds, which is why there were no ambulances when I needed one. Luckily I'd decided to persevere and managed to get to the ED entrance before I keeled over. Someone was shunted out of intensive care and I was given their place in a bed in the corridor.
Middlemore is run on an absolute shoestring.
For what it's worth I've had my life saved a number of times now but never, so far as I'm aware, by a multi millionaire. I'd happily redistribute the wealth if I could.
I don’t think I can sum it up better than those last two sentences.
Many thanks to all those who sent messages about their experiences. I’m sorry that I couldn’t include them all, they were interesting and much appreciated insights.
The last two sentences encapsulate the choices that NZers have next year, Nick.
We have had experiences with the NHS, plus private care in the UK, and public and private care here in NZ over the last four years. We don't have medical insurance but have self funded surgery and treatment when the situation has been urgent for us but not urgent in terms of other people's more pressing needs. We have family and friends who have required care and treatment in the public system here in the last couple of years and they have had nothing but praise for the professionalism, kindness and attention they have received. They have all been cognisant of the costs of the treatments they have received: chemo, stem cell transplant, intensive nursing, cardiac care, eye surgery et al.
My point really is that the care here in the public system is exemplary and even though our nurses, doctors and ancillary staff are stretched to the limit and beyond, they are still amazing.
There will always, very sadly, be failures in the system. However people here who complain need to be aware that failures abound in the US private medical system (which is probably what Luxon, Seymour and their ilk would like to have here so more rich people can get richer and the 'bottom feeders' who cannot afford insurance can die off perhaps?) - that is one reason why doctors in the US 1) have massive amounts of malpractice insurance, 2) are reluctant to do anything without a barrage of time consuming and expensive tests.
Once again, cheers, Nick, for an excellent and thoughtful piece. Thank you.
Cheers, Marilyn
Spot on Nick! After successive National governments running down health services, ironically when the Minister of Health was a medical doctor, as well as all other Public Services, so that Key and English could demonstrate their "Rockstar" economic management, this Government has done a sterling job of rebuilding in spite of unforeseen disasters like Covid. National and ACT don't have snowball's chance in hell of getting my vote.