February 17, 2025 • 19 mins
‘Chaos’, ‘overstretched’, ‘a bloodbath’ -- these are just a few descriptions of New Zealand’s health sector in recent days.
It’s as the sector faces its third resignation of its top brass... Director-General of Health Diana Sarfati will finish up Friday – ending her term two years earlier than expected.
Her resignation came soon after Health New Zealand chief executive Margie Apa -- followed by Public Health Director, Nicholas Jones, who quit just days after.
We are constantly being told the health system is in crisis, “on the brink of failure” – spending beyond its budget, waiting times getting longer, suffering from widespread staff shortages.
But, the decades-old question is, how do we fix it?
Today on The Front Page, University of Otago professor of public health, Peter Crampton joins us to give a rundown on our health system.
Follow The Front Page on iHeartRadio, Apple Podcasts, Spotify or wherever you get your podcasts.
You can read more about this and other stories in the New Zealand Herald, online at nzherald.co.nz, or tune in to news bulletins across the NZME network.
Host: Chelsea Daniels
Sound Engineer/Producer: Richard Martin
Producer: Ethan Sills
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
Kiota.
Speaker 2 (00:06):
I'm Chelsea Daniels and this is the Front Page, a
daily podcast presented by The New Zealand Herald. Chaos, overstretched,
and a blood bath. These are just a few of
the descriptions of New Zealand's health sector in recent days.
Speaker 1 (00:24):
It's as the sector faces its third.
Speaker 2 (00:26):
Resignation of its top brass Director General of Health Diana Sarfati,
will finish up this Friday, ending her term two years
earlier than expected. Her resignation came soon after Health New
Zealand Chief Executive Marjie Arper, followed by Public Health Director
Nicholas Jones, who quit just a few days later. We're
constantly being told the system is in crisis, on the
(00:49):
brink of failure, spending beyond its budget, waiting times are
getting longer and suffering from widespread staff shortages. But the
decades old question is how do we actually fix it?
Today on the front Page, University of Otago Professor of
Public Health Peter Crampton joins us to give us a
rundown on our health system. So, Peter, it's no surprise
(01:16):
that the health system is in crisis. In fact, it
feels like we're constantly being told this what kind of
challenges is it facing right now.
Speaker 3 (01:25):
Well, the word crisis has been used quite a lot
over the last twelve months. It's a word I would
use with a great deal of caution. In my professional life.
I've been observing this closely for at least thirty years.
I don't think I've seen so much pressure and uncertainty
in the health system as I see now that there
are new factors led upon old factors. In terms of
(01:47):
the stress is being brought to bear in the new
zin and health system and also all around the world,
I'd say number one as the fact that healthcare gets
more complex and more expensive by the day. And in
a country such as New Zealand, it's driven by the
aging population. We get sicker and we get older, and
we're living longer, and we drive the costs of healthcare delivery.
(02:10):
And that means that well, for example, increasingly individuals as
they get older have multiple conditions that would need treatment.
At the same time, that complexity brings with it increase
need for healthcare, professional time, more medicines, more expenditure on
expensive medicines, and so on. And that is a real driver.
(02:33):
It's a driver of complexity. It's a driver of difficulty,
it's a driver of expenditure, and that's no one's fault.
It's not a bad thing. It is a fact. Nevertheless,
what it does mean is that there is pressure on
a government, on all governments, to deliver in those circumstances
where there's a great deal of pressure driving upward expenditure. However,
(02:56):
hard governments try that pressure on and it can only
be partly addressed through increasing product to video or increasing efficiency.
It does, in the end need more expenditure per capita
per person. I would say that in our system we
have over the long term, we've underinvested in primary care,
by which I mean nurses, doctors, and all those people
(03:19):
in the community who look after us when we get
on will and that's where the bulk of healthcare is provided,
and we've underinvested in that, and that is at the
point of extreme stress right now. And what that means,
amongst other things, is that we get sicker, we're not
treated early enough, and then we end up in the
hospital system, costing the system more and also driving up pressures, stresses,
(03:42):
and waiting times in hospitals. So that's in there as
an underlying reason. Look, I think there's two more immediate
aspects of the health system which need to be commented on.
The first is COVID and post COVID politics. There has
been a rapid shift to political populism and that brings
with it less trust in so called elites, less trust
(04:06):
in science, less trust and experts. And because the health
system so reliant on experts and science, and while groups
of people who are regarded as being elite has a
destabilizing effect in the health system. And not just in
New Zealand but all around the world. That this is
a new phenomenon. And of course COVID. Coming back to COVID,
(04:29):
it brings with it all the stress is on the
country's finances that we know are very very difficult. Again,
this isn't about this government or the previous government or
any government. It's just countries around the world are experiencing
huge stress post COVID. In addition to that, the previous government,
the Labor government with Andrew Little as the Minister of Health,
initiated a set of major reforms of the health system.
(04:51):
This kicked off under Minister David Clark who initiated a
review of the health system. I was on that review panel.
We made a number of recommendations to the then government.
Some of those recommendations were taken up, others were not.
In the event, Minister Little made his own decision to
centralize the health system under one organization, to Fatal Order
(05:15):
Health New Zealand, and that of course represents what is
undoubtedly the largest merger ever in New Zealand's history, bringing
together the twenty district health boards into one organization. And
another of other changes were initiated at that point, and
then there was a change in government, so the new
government inherited this rather complex and difficult set of circumstances.
(05:39):
This would have been very difficult for any government. There's
no doubt this was a very challenging set of circumstances.
And what they've done since then is introduced their own changes.
For example, they scrapped order the Maori Health Authority, which
brought expertise into the center of the system. Last year
the Board of Health New Zealand to Fatal Order was
(06:00):
sacked and replaced with a commissioner, along with several co commissioners,
and since then there have been a number of resignations,
thinking particularly back to last week where we had three
important resignations in the health system, but the government was
not responsible for the challenging circumstances it inherited. But it
(06:22):
is of course now in charge and has been for
well over a year, and is making its own decisions
about how to lead the system.
Speaker 4 (06:30):
I mean, it might be scary to have to respond
to the Prime Minister, the Minister of Finance and the
Minister of Health, but nothing is more scary than my
own wife holding me to account for the health system.
And I love her and respect her, and I'm going
to make sure I'll keep it that way because she's
(06:52):
holding me to account, which is a different time but
type of accountability.
Speaker 2 (07:01):
You mentioned Health end Z Commissioner Lester Levy. He was
broad on board last July. He was tasked with solving
an estimated one point four billion dollar overspend and then
he and then chief executive Marjie Arper have been in
charge of a reset, so to speak, so to ensure
it's spending within its budget after it was found in
July to be spending one hundred and thirty million dollars
(07:22):
more than its budget each month.
Speaker 1 (07:25):
How do you think all of this is.
Speaker 2 (07:27):
Going the cutting, the cost cutting, I suppose, I.
Speaker 3 (07:31):
For one, feel unclear about the actual state of healthcare expenditure.
Generally there is a single source of authority d data
about how much we're spending on health per capita and
how that fits into the long term trends. I would
say at the moment, I, for one, don't have that clarity.
You know, the government says repeatedly that it's spending more
(07:52):
on health now than has ever been spent before. There
is the expenditure above budget that you've just talked about
with in Fascil order. But as I said, I'm unclear
on this point. There was one analysis I read last
year from a well respected health economist which looked at
the twenty year healthcare expenditure and it went up per
capita around four to five percent during the first more
(08:16):
or less during the first decade of the century. That
was with the Labor government. That per capita annual increase
in expenditure went down to I'm remembering three or four
percent under the nine years of the subsequent national government,
and then it went back up again slightly to or
four plus percent annual per capita increase in expenditure during
(08:38):
the last Labor government. And according to that analysis, the
twenty twenty four year was the first time in that
twenty four year period that the health systems faced an
actual decrease in per capita healthcare expenditure. Now, that was
just one analysis. It received some publicity at the time,
(08:59):
but incredibly important that we actually know whether or not
that's true, because if it is true, it explains so
much of the intense stress and pressure within the health system.
Because basically the health system which is facing real per
capita decrease in expenditure is sort of an unprecedented thing.
Not many countries would ever attempt to do that. Now,
(09:20):
government's making claims that that's not the case. Some economists
or this one in particular, is making a claim that
is the case. I think we need authoritative analysis around that.
Coming back to your question about how is it going
into fatal Aura, Well, look, I would say three things. Firstly,
that fat AURA is a highly stressed, highly disrupted organization
(09:41):
at this point in time, there is a great deal
of change and uncertainty and that affects probably the vast
majority of people who work within the organization. And remember
this is a huge organization. This is a single employer
of When I last heard the numbers, it was between
eighty and ninety thousand people doing all lots of jobs
all the way from the frontline clinical roles through to
(10:05):
IT systems and procurement and supply and all the things
that are a huge organization like that is responsible for
doing so a great deal of disruption in that organization.
How it's going financially, I don't know. Again. I think
that we need authoritative financial data being produced at regular
intervals so that we can we the public can make
(10:27):
judgments on that point. And certainly I've no doubt at
all that Commissioner Lester Levy is working extremely hard on this,
as are the other co commissioners. That that's I think
as much as I can say on how it's going,
because this is the story is unfolding in front of us.
Maybe one can take a little bit of a steer
from the fact that there are senior resignations in the system,
(10:49):
some of which might have been anticipated, others not. The
resignation of the Chief Executive of Health New Zealand faceral
At Margie Upper, which was two Fridays ago, may have
been anticipated. I certainly wasn't expecting it to happen on
that day and that week her term came up for
a renewal later on this year, and I was expecting
her to step down perhaps at that point, because that
(11:11):
had been signaled.
Speaker 1 (11:23):
And what about Diana Saferti's resignation.
Speaker 2 (11:25):
I don't know about you, but where I work, i'd
need to give at least four weeks notice, and she
finishes up this Friday.
Speaker 3 (11:31):
I think that is unusual, Chelsea. I think that is
a very unusual thing. It was an unexpected announcement. She
is leaving very abruptly within a week, so no notice
bit with those sorts of senior roles. Now we're talking
about Professor Diana Safati, who was the Director General of Healthcare.
Resignation was announced on Friday, taking effect this sometime this week.
(11:54):
That's very unusual with those senior roles. We expect that
a resignation to be announced well well in advance of
it taking effect, and their time for the system to
respond and an interim person or an acting person to
be put in place, and ideally a recruitment process to
be god underway. None of that has happened this time,
of course, so we don't know what lies behind that,
(12:16):
except this is an unusual circumstance. What we do know,
of course, is that we have a new Minister of
Health who's come in. The Honorable Sandertti has moved on
to other portfolios and we now have the Honorable Simeon
Brown in the role of Health Minister. He's brand new
to health. Not only is he brand new to the
portfolio as Minister of Health, he's also brand new to health.
(12:37):
Nothing wrong with that, per se, It's just that we
all need to recognize it will take him some time
to get his FETA under the desk properly and understand
this extremely complex system that he's now responsible for. And
I don't hold him. I don't think he's the author
of these resignations necessarily at all. But following his taking
on the portfolio of Health, there have been, as I said,
(13:00):
a number of very senior people resigning, and maybe with
the fullness of time, we'll understand more about the nine
amics there.
Speaker 2 (13:06):
Well, if we go back to the system itself, I
know that staff shortages have plagued the sector for years now,
and this is right across the workforce, from GPS closing
their books with nearly forty percent of them actually not
taking new patients last year to of course nurses being
tempted across the ditch by better pay, packets, added extras,
et cetera. Health New Zealand has released its workforce Plan
(13:28):
in December and that outlined how gaps will be filled
over the next three years, and the government's already made
moves to fund more homegrown doctors and midwives for example.
Speaker 1 (13:38):
Do you think it's doing enough?
Speaker 3 (13:39):
Health workforce probably is the number one or number two,
or at least one of the top issues in the
health system. And this is again not unique in New Zealand.
Health systems all around the world experiencing the same sorts
of health workforce pressures that we're experiencing. Is the government
doing enough well? I mean, the answer has to be known.
(14:00):
I say that was some sympathy for the government, but
the problems are mounting in the health workforce space. I
think the government wants to get on top of this.
A great deal of good work is being done. Certainly,
we don't have solutions to all the problems at the
moment at all, by any stretch of the imagination. And
I'll come back to point I made earlier about the
point you mentioned about general practices and general practitioners and
(14:24):
practice nurses in the community. That is an area of neglect,
which is one of the most urgent pressure points in
the health system, I would say, and it's not receiving
a huge amount of public air time. Is receiving some
but not a huge amount. The whole system is reliant
on that layer in the health system with GPS practice
(14:44):
nurses and or all the others who work in the
community keeping people well and out of hospital. The financing
situation for GPS is complex and has been neglected for
a long time. Work is underway by to Facial Order
Health New Zealand and by the Ministry of Health to
fix that, but it's a long time coming, and it's
(15:06):
it's an area of really considerable pressure and stress within
the system. I fear that these really important strategic or
long term issues like health workforce are probably being somewhat
neglected right now as the system goes through its own
processes of change.
Speaker 5 (15:23):
Official information reveals that in the first six months of
last year, more than three hundred thousand patients around New
Zealand who turned up in an imminently or potentially life
threatening condition were not seen in a clinically appropriate time.
Speaker 6 (15:41):
Is that a concern it's really concerning data and as
we have to do better. It is showing a system
under intense pressure, and it's showing a whole system under pressure.
Speaker 5 (15:53):
Is it showing a system failing by.
Speaker 6 (15:56):
The numbers you're telling me, it is showing a system
that is failing.
Speaker 4 (16:04):
Well.
Speaker 2 (16:04):
Something that does get a lot of airtime is ed
waight times. Right, we haven't even gotten to that yet.
We're constantly hearing horror stories about people waiting upwards of
eight ten hours for care. More than three hundred thousand
patients with time critical conditions were not seen within the
recommended time frames during the first six months of last year.
And this is where there's a bottleneck, isn't it. It's
(16:26):
like all the other areas of the health system when
they underperform.
Speaker 1 (16:29):
This is what we see. This is what we get.
Speaker 2 (16:30):
The fact that all of the country's eds are failing
to assess patients with eminently or potentially life threatening conditions
on time. That's a massive problem, isn't it.
Speaker 3 (16:41):
It is a problem, and it speaks to failure elsewhere
in the system. GP's books are full in many parts
of the country. Waiting time for CGP are unacceptably long
in many many places, the failure of primary healthcare to
meet the basic needs of people is one of the,
if not the most important factors leading to pressure on eds.
(17:03):
Because what do you or I do when we can't
get to see our doctrine, we're worried about our health.
We go to the ED. That is all we can do.
That's the only option available to us, So we go,
you know, And that's what people do. They're going to
ED departments and wait to be seen there rather than
having issues dealt with in primary care. And it's not
just the issue of closed books and pressure on primary
(17:26):
care services, so also the issue of cost for many people.
A lot of people can't afford even sometimes quite basic
elements of care. So there's constellation of factors there which
leads to pressure on ED departments. But yes, it's a
big issue.
Speaker 2 (17:41):
Finally, Peter, I feel like speaking about the health sector
and the health sector in crisis is just a broken record, right.
Is the health sector a prime example for the need
for long term bipartisan agreements, because surely we can't go
on like this.
Speaker 3 (17:58):
I think that is just so on the money, long
term bipartisan agreement around the direction of the health system.
I think one of the things that we're experiencing right now,
at least I am, and I think many people working
in the health system is a sense of not really
knowing what the direction is right now. Because it's a
system which is so reliant on good will, trust, people
(18:21):
working over beyond the call of duty, et cetera, et cetera.
There needs to be confidence that the systems lead in
a way that is consistent with the values that people
work in the system have, and that we have stability
in leadership and leaders who are capable of forming long
term relationships all around them to give confidence that we're,
(18:45):
even through tough times, that we're all pulling in the
same direction. And I think that having some sense of
direction for the public health system right now would be
immensely helpful because to my mind, there are mixed signals
at the moment around them. Role of I mean, the
natural default I think for many in the current government
would be private provision, a privatization of services, not just
(19:08):
healthcare but in many domains. And I think people working
in the public system, which so many people in New
Zealand are totally reliant on, they need confidence that there
is a long term commitment and a bipartisan approach I
think would be extremely helpful.
Speaker 1 (19:24):
Thanks for joining us, Peter pleasure to talk.
Speaker 2 (19:28):
That's it for this episode of the Front Page. You
can read more about today's stories and extensive news coverage
at enzdhrald dot co dot nz. The Front Page is
produced by Ethan Sills and Richard Martin, who is also
our sound engineer.
Speaker 1 (19:45):
I'm Chelsea Daniels.
Speaker 2 (19:47):
Subscribe to the Front Page on iHeartRadio or wherever you
get your podcasts, and tune in tomorrow for another look
behind the headlines.
Kiota.
Speaker 2 (00:06):
I'm Chelsea Daniels and this is the Front Page, a
daily podcast presented by The New Zealand Herald. Chaos, overstretched,
and a blood bath. These are just a few of
the descriptions of New Zealand's health sector in recent days.
Speaker 1 (00:24):
It's as the sector faces its third.
Speaker 2 (00:26):
Resignation of its top brass Director General of Health Diana Sarfati,
will finish up this Friday, ending her term two years
earlier than expected. Her resignation came soon after Health New
Zealand Chief Executive Marjie Arper, followed by Public Health Director
Nicholas Jones, who quit just a few days later. We're
constantly being told the system is in crisis, on the
(00:49):
brink of failure, spending beyond its budget, waiting times are
getting longer and suffering from widespread staff shortages. But the
decades old question is how do we actually fix it?
Today on the front Page, University of Otago Professor of
Public Health Peter Crampton joins us to give us a
rundown on our health system. So, Peter, it's no surprise
(01:16):
that the health system is in crisis. In fact, it
feels like we're constantly being told this what kind of
challenges is it facing right now.
Speaker 3 (01:25):
Well, the word crisis has been used quite a lot
over the last twelve months. It's a word I would
use with a great deal of caution. In my professional life.
I've been observing this closely for at least thirty years.
I don't think I've seen so much pressure and uncertainty
in the health system as I see now that there
are new factors led upon old factors. In terms of
(01:47):
the stress is being brought to bear in the new
zin and health system and also all around the world,
I'd say number one as the fact that healthcare gets
more complex and more expensive by the day. And in
a country such as New Zealand, it's driven by the
aging population. We get sicker and we get older, and
we're living longer, and we drive the costs of healthcare delivery.
(02:10):
And that means that well, for example, increasingly individuals as
they get older have multiple conditions that would need treatment.
At the same time, that complexity brings with it increase
need for healthcare, professional time, more medicines, more expenditure on
expensive medicines, and so on. And that is a real driver.
(02:33):
It's a driver of complexity. It's a driver of difficulty,
it's a driver of expenditure, and that's no one's fault.
It's not a bad thing. It is a fact. Nevertheless,
what it does mean is that there is pressure on
a government, on all governments, to deliver in those circumstances
where there's a great deal of pressure driving upward expenditure. However,
(02:56):
hard governments try that pressure on and it can only
be partly addressed through increasing product to video or increasing efficiency.
It does, in the end need more expenditure per capita
per person. I would say that in our system we
have over the long term, we've underinvested in primary care,
by which I mean nurses, doctors, and all those people
(03:19):
in the community who look after us when we get
on will and that's where the bulk of healthcare is provided,
and we've underinvested in that, and that is at the
point of extreme stress right now. And what that means,
amongst other things, is that we get sicker, we're not
treated early enough, and then we end up in the
hospital system, costing the system more and also driving up pressures, stresses,
(03:42):
and waiting times in hospitals. So that's in there as
an underlying reason. Look, I think there's two more immediate
aspects of the health system which need to be commented on.
The first is COVID and post COVID politics. There has
been a rapid shift to political populism and that brings
with it less trust in so called elites, less trust
(04:06):
in science, less trust and experts. And because the health
system so reliant on experts and science, and while groups
of people who are regarded as being elite has a
destabilizing effect in the health system. And not just in
New Zealand but all around the world. That this is
a new phenomenon. And of course COVID. Coming back to COVID,
(04:29):
it brings with it all the stress is on the
country's finances that we know are very very difficult. Again,
this isn't about this government or the previous government or
any government. It's just countries around the world are experiencing
huge stress post COVID. In addition to that, the previous government,
the Labor government with Andrew Little as the Minister of Health,
initiated a set of major reforms of the health system.
(04:51):
This kicked off under Minister David Clark who initiated a
review of the health system. I was on that review panel.
We made a number of recommendations to the then government.
Some of those recommendations were taken up, others were not.
In the event, Minister Little made his own decision to
centralize the health system under one organization, to Fatal Order
(05:15):
Health New Zealand, and that of course represents what is
undoubtedly the largest merger ever in New Zealand's history, bringing
together the twenty district health boards into one organization. And
another of other changes were initiated at that point, and
then there was a change in government, so the new
government inherited this rather complex and difficult set of circumstances.
(05:39):
This would have been very difficult for any government. There's
no doubt this was a very challenging set of circumstances.
And what they've done since then is introduced their own changes.
For example, they scrapped order the Maori Health Authority, which
brought expertise into the center of the system. Last year
the Board of Health New Zealand to Fatal Order was
(06:00):
sacked and replaced with a commissioner, along with several co commissioners,
and since then there have been a number of resignations,
thinking particularly back to last week where we had three
important resignations in the health system, but the government was
not responsible for the challenging circumstances it inherited. But it
(06:22):
is of course now in charge and has been for
well over a year, and is making its own decisions
about how to lead the system.
Speaker 4 (06:30):
I mean, it might be scary to have to respond
to the Prime Minister, the Minister of Finance and the
Minister of Health, but nothing is more scary than my
own wife holding me to account for the health system.
And I love her and respect her, and I'm going
to make sure I'll keep it that way because she's
(06:52):
holding me to account, which is a different time but
type of accountability.
Speaker 2 (07:01):
You mentioned Health end Z Commissioner Lester Levy. He was
broad on board last July. He was tasked with solving
an estimated one point four billion dollar overspend and then
he and then chief executive Marjie Arper have been in
charge of a reset, so to speak, so to ensure
it's spending within its budget after it was found in
July to be spending one hundred and thirty million dollars
(07:22):
more than its budget each month.
Speaker 1 (07:25):
How do you think all of this is.
Speaker 2 (07:27):
Going the cutting, the cost cutting, I suppose, I.
Speaker 3 (07:31):
For one, feel unclear about the actual state of healthcare expenditure.
Generally there is a single source of authority d data
about how much we're spending on health per capita and
how that fits into the long term trends. I would
say at the moment, I, for one, don't have that clarity.
You know, the government says repeatedly that it's spending more
(07:52):
on health now than has ever been spent before. There
is the expenditure above budget that you've just talked about
with in Fascil order. But as I said, I'm unclear
on this point. There was one analysis I read last
year from a well respected health economist which looked at
the twenty year healthcare expenditure and it went up per
capita around four to five percent during the first more
(08:16):
or less during the first decade of the century. That
was with the Labor government. That per capita annual increase
in expenditure went down to I'm remembering three or four
percent under the nine years of the subsequent national government,
and then it went back up again slightly to or
four plus percent annual per capita increase in expenditure during
(08:38):
the last Labor government. And according to that analysis, the
twenty twenty four year was the first time in that
twenty four year period that the health systems faced an
actual decrease in per capita healthcare expenditure. Now, that was
just one analysis. It received some publicity at the time,
(08:59):
but incredibly important that we actually know whether or not
that's true, because if it is true, it explains so
much of the intense stress and pressure within the health system.
Because basically the health system which is facing real per
capita decrease in expenditure is sort of an unprecedented thing.
Not many countries would ever attempt to do that. Now,
(09:20):
government's making claims that that's not the case. Some economists
or this one in particular, is making a claim that
is the case. I think we need authoritative analysis around that.
Coming back to your question about how is it going
into fatal Aura, Well, look, I would say three things. Firstly,
that fat AURA is a highly stressed, highly disrupted organization
(09:41):
at this point in time, there is a great deal
of change and uncertainty and that affects probably the vast
majority of people who work within the organization. And remember
this is a huge organization. This is a single employer
of When I last heard the numbers, it was between
eighty and ninety thousand people doing all lots of jobs
all the way from the frontline clinical roles through to
(10:05):
IT systems and procurement and supply and all the things
that are a huge organization like that is responsible for
doing so a great deal of disruption in that organization.
How it's going financially, I don't know. Again. I think
that we need authoritative financial data being produced at regular
intervals so that we can we the public can make
(10:27):
judgments on that point. And certainly I've no doubt at
all that Commissioner Lester Levy is working extremely hard on this,
as are the other co commissioners. That that's I think
as much as I can say on how it's going,
because this is the story is unfolding in front of us.
Maybe one can take a little bit of a steer
from the fact that there are senior resignations in the system,
(10:49):
some of which might have been anticipated, others not. The
resignation of the Chief Executive of Health New Zealand faceral
At Margie Upper, which was two Fridays ago, may have
been anticipated. I certainly wasn't expecting it to happen on
that day and that week her term came up for
a renewal later on this year, and I was expecting
her to step down perhaps at that point, because that
(11:11):
had been signaled.
Speaker 1 (11:23):
And what about Diana Saferti's resignation.
Speaker 2 (11:25):
I don't know about you, but where I work, i'd
need to give at least four weeks notice, and she
finishes up this Friday.
Speaker 3 (11:31):
I think that is unusual, Chelsea. I think that is
a very unusual thing. It was an unexpected announcement. She
is leaving very abruptly within a week, so no notice
bit with those sorts of senior roles. Now we're talking
about Professor Diana Safati, who was the Director General of Healthcare.
Resignation was announced on Friday, taking effect this sometime this week.
(11:54):
That's very unusual with those senior roles. We expect that
a resignation to be announced well well in advance of
it taking effect, and their time for the system to
respond and an interim person or an acting person to
be put in place, and ideally a recruitment process to
be god underway. None of that has happened this time,
of course, so we don't know what lies behind that,
(12:16):
except this is an unusual circumstance. What we do know,
of course, is that we have a new Minister of
Health who's come in. The Honorable Sandertti has moved on
to other portfolios and we now have the Honorable Simeon
Brown in the role of Health Minister. He's brand new
to health. Not only is he brand new to the
portfolio as Minister of Health, he's also brand new to health.
(12:37):
Nothing wrong with that, per se, It's just that we
all need to recognize it will take him some time
to get his FETA under the desk properly and understand
this extremely complex system that he's now responsible for. And
I don't hold him. I don't think he's the author
of these resignations necessarily at all. But following his taking
on the portfolio of Health, there have been, as I said,
(13:00):
a number of very senior people resigning, and maybe with
the fullness of time, we'll understand more about the nine
amics there.
Speaker 2 (13:06):
Well, if we go back to the system itself, I
know that staff shortages have plagued the sector for years now,
and this is right across the workforce, from GPS closing
their books with nearly forty percent of them actually not
taking new patients last year to of course nurses being
tempted across the ditch by better pay, packets, added extras,
et cetera. Health New Zealand has released its workforce Plan
(13:28):
in December and that outlined how gaps will be filled
over the next three years, and the government's already made
moves to fund more homegrown doctors and midwives for example.
Speaker 1 (13:38):
Do you think it's doing enough?
Speaker 3 (13:39):
Health workforce probably is the number one or number two,
or at least one of the top issues in the
health system. And this is again not unique in New Zealand.
Health systems all around the world experiencing the same sorts
of health workforce pressures that we're experiencing. Is the government
doing enough well? I mean, the answer has to be known.
(14:00):
I say that was some sympathy for the government, but
the problems are mounting in the health workforce space. I
think the government wants to get on top of this.
A great deal of good work is being done. Certainly,
we don't have solutions to all the problems at the
moment at all, by any stretch of the imagination. And
I'll come back to point I made earlier about the
point you mentioned about general practices and general practitioners and
(14:24):
practice nurses in the community. That is an area of neglect,
which is one of the most urgent pressure points in
the health system, I would say, and it's not receiving
a huge amount of public air time. Is receiving some
but not a huge amount. The whole system is reliant
on that layer in the health system with GPS practice
(14:44):
nurses and or all the others who work in the
community keeping people well and out of hospital. The financing
situation for GPS is complex and has been neglected for
a long time. Work is underway by to Facial Order
Health New Zealand and by the Ministry of Health to
fix that, but it's a long time coming, and it's
(15:06):
it's an area of really considerable pressure and stress within
the system. I fear that these really important strategic or
long term issues like health workforce are probably being somewhat
neglected right now as the system goes through its own
processes of change.
Speaker 5 (15:23):
Official information reveals that in the first six months of
last year, more than three hundred thousand patients around New
Zealand who turned up in an imminently or potentially life
threatening condition were not seen in a clinically appropriate time.
Speaker 6 (15:41):
Is that a concern it's really concerning data and as
we have to do better. It is showing a system
under intense pressure, and it's showing a whole system under pressure.
Speaker 5 (15:53):
Is it showing a system failing by.
Speaker 6 (15:56):
The numbers you're telling me, it is showing a system
that is failing.
Speaker 4 (16:04):
Well.
Speaker 2 (16:04):
Something that does get a lot of airtime is ed
waight times. Right, we haven't even gotten to that yet.
We're constantly hearing horror stories about people waiting upwards of
eight ten hours for care. More than three hundred thousand
patients with time critical conditions were not seen within the
recommended time frames during the first six months of last year.
And this is where there's a bottleneck, isn't it. It's
(16:26):
like all the other areas of the health system when
they underperform.
Speaker 1 (16:29):
This is what we see. This is what we get.
Speaker 2 (16:30):
The fact that all of the country's eds are failing
to assess patients with eminently or potentially life threatening conditions
on time. That's a massive problem, isn't it.
Speaker 3 (16:41):
It is a problem, and it speaks to failure elsewhere
in the system. GP's books are full in many parts
of the country. Waiting time for CGP are unacceptably long
in many many places, the failure of primary healthcare to
meet the basic needs of people is one of the,
if not the most important factors leading to pressure on eds.
(17:03):
Because what do you or I do when we can't
get to see our doctrine, we're worried about our health.
We go to the ED. That is all we can do.
That's the only option available to us, So we go,
you know, And that's what people do. They're going to
ED departments and wait to be seen there rather than
having issues dealt with in primary care. And it's not
just the issue of closed books and pressure on primary
(17:26):
care services, so also the issue of cost for many people.
A lot of people can't afford even sometimes quite basic
elements of care. So there's constellation of factors there which
leads to pressure on ED departments. But yes, it's a
big issue.
Speaker 2 (17:41):
Finally, Peter, I feel like speaking about the health sector
and the health sector in crisis is just a broken record, right.
Is the health sector a prime example for the need
for long term bipartisan agreements, because surely we can't go
on like this.
Speaker 3 (17:58):
I think that is just so on the money, long
term bipartisan agreement around the direction of the health system.
I think one of the things that we're experiencing right now,
at least I am, and I think many people working
in the health system is a sense of not really
knowing what the direction is right now. Because it's a
system which is so reliant on good will, trust, people
(18:21):
working over beyond the call of duty, et cetera, et cetera.
There needs to be confidence that the systems lead in
a way that is consistent with the values that people
work in the system have, and that we have stability
in leadership and leaders who are capable of forming long
term relationships all around them to give confidence that we're,
(18:45):
even through tough times, that we're all pulling in the
same direction. And I think that having some sense of
direction for the public health system right now would be
immensely helpful because to my mind, there are mixed signals
at the moment around them. Role of I mean, the
natural default I think for many in the current government
would be private provision, a privatization of services, not just
(19:08):
healthcare but in many domains. And I think people working
in the public system, which so many people in New
Zealand are totally reliant on, they need confidence that there
is a long term commitment and a bipartisan approach I
think would be extremely helpful.
Speaker 1 (19:24):
Thanks for joining us, Peter pleasure to talk.
Speaker 2 (19:28):
That's it for this episode of the Front Page. You
can read more about today's stories and extensive news coverage
at enzdhrald dot co dot nz. The Front Page is
produced by Ethan Sills and Richard Martin, who is also
our sound engineer.
Speaker 1 (19:45):
I'm Chelsea Daniels.
Speaker 2 (19:47):
Subscribe to the Front Page on iHeartRadio or wherever you
get your podcasts, and tune in tomorrow for another look
behind the headlines.
Popular Podcasts
Bookmarked by Reese's Book Club
Welcome to Bookmarked by Reese’s Book Club — the podcast where great stories, bold women, and irresistible conversations collide! Hosted by award-winning journalist Danielle Robay, each week new episodes balance thoughtful literary insight with the fervor of buzzy book trends, pop culture and more. Bookmarked brings together celebrities, tastemakers, influencers and authors from Reese's Book Club and beyond to share stories that transcend the page. Pull up a chair. You’re not just listening — you’re part of the conversation.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com