The Sunday Panel: How can we get the balance right for healthcare?

This week on the Sunday Panel, journalist and editor Jo McCarroll and NZ Herald senior writer Simon Wilson joined in on a discussion about the following issues of the day - and more!

The private v public healthcare debate continues - how can we keep the waitlists down? There doesn’t seem to be an obvious solution, but this week, the Government is claiming to have 9696 extra elective surgeries, putting it on track to reach its end-of-June target of more than 10,579 operations. What do we make of this?

Should we have price controls in place for alcohol sold at off-licences in an attempt to reduce harmful drinking at home and boost hospitality? 

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Episode Transcript

Speaker 1 (00:06):
You're listening to the Sunday Session podcast with Francesca Rudkin
from News Talks EDB all the highs and lows talking
the big issues of the week. The panel on the
Sunday Session.

Speaker 2 (00:19):
Joining me on the panel today, we have journalists and
editor Joe McCarroll.

Speaker 3 (00:23):
Good morning, Joe, Good morning, Panjeska and.

Speaker 2 (00:25):
New Zealand Herald's senior writer Simon Wilson. Good morning, Simon.

Speaker 4 (00:29):
Hi, Francesca, Hi Joe.

Speaker 2 (00:32):
Good to have you both here. Okay, I was just
talking to doctor Evor Popovich and he was talking about
the difficulties of getting the balance right between private and
public healthcare in New Zealand. Earlier in the show, I
had the Health Minister, Simeon Brown on the show where
we're talking about the fact that the government has completed
nine six hundred and ninety six extra elective surgeries, which
is putting them on track to reach its target at

(00:54):
the end of June. I said to him, hey, look,
is this an approach that you were going to continue using?
And this is what he.

Speaker 5 (01:01):
Said, this is something that needs to continue to happen
so that we can continue to reduce the number of
people waiting for those surgeries. The weight lists ballooned over
the last six years. That's unacceptable for patients, and I'm
committed to continuing to use both the public and private
system to make sure we reduce that weight list and
ensure patients get seen in a timely manner.

Speaker 2 (01:22):
So, Simon, is this the way forward? Is this the
way we're going to keep on top of our waitlists.

Speaker 4 (01:27):
Well, I've had some experience of this. I've had a
couple of procedures started off in the public system referred
to the private system. I have to say that it
was fabulous in the sense that the care was very good,
and the facilities of the private system that I was
in were clearly newer and much more, much swankier than

(01:51):
in the public system. So it does work. The Minister's
quite right that they can get more surgeries done, they
can get more procedures done, and those people who are involved,
who are put through that process fit enormously. If you're
waiting and there's no end to it, that's a great benefit.
But there are some obvious problems. One of them is

(02:13):
that each one of these procedures must be more expensive
than it would be in the public system. In other words,
this is the very addition of very definition of throwing
money at the problem, which is something that a fiscally
responsible government ought to be thinking hard about whether it's
the right solution. Bulstering our public system over time should
be more cost efficient than simply sending out the work

(02:37):
to the private I suppose.

Speaker 2 (02:38):
It depends on it and what kind of deal they're
making with these private providers, doesn't it. I mean we
don't know the details there.

Speaker 4 (02:43):
Well, the private providers overheads are going to be higher
because they are because of all the costs associated with
the higher wrap around quality care that you get in
the private sector.

Speaker 2 (02:57):
Possibly, Joe, your thoughts, Do you have any concerns? I
know that some you know, clinicians are really concerned that
if we're not doing enough surgeries in the public sector,
you know, we are not training doctors to get them
to the standard that we need them to be at.

Speaker 3 (03:12):
Yes, I have real concerns. I mean, I do not
think healthcare a healthcare should be a non profit service,
a public health care and the idea that as Simon
just said, that if this money is going into private healthcare,
it's an individual solution, but it doesn't deal with a
systemic problem. I mean, one of my brothers in law

(03:33):
is waiting for heap replacement right now, and I would
love for him to have the operation tomorrow, you know,
I would love that. But if that money is going
into the private sector, it ends up in the hands
of equity firms and investors and it doesn't go into
building improving health care for everyone. And as your guest
doctor Profits just said, Francisca, I mean what the system

(03:55):
needs is investment.

Speaker 2 (03:58):
Yeah, yeah, I mean I'm sort of slightly torn because
if you've been waiting, you know, as you mentioned Simon,
if you've been on a waiting list, and you need
that need and you need that hit done, you need
that Care Act done, and we're whipping through them, then
I just think that's brilliant. I don't think anyone cares
where it gets done. They're just like, I need it done.
And so there's that initial, that immediate kind of Yes,

(04:19):
this is fantastic. But I suppose, I suppose my concern is,
so what are we going to commit You know, every
two years, we're going to go, oh, okay, right, we've
got three months, let's throw it out back out to
private and try and catch up. Again, it doesn't feel
like a sustainable solution.

Speaker 4 (04:33):
I completely agree with you, I having been on the
end of you get the letter and it says we're
going to be able to see you in six to
eight months, and then a week later you get a
phone call saying we're the private provider that has been
had this work outsource to us and we can see
you next week. That is a fantastic phone call to
cat And of course it's good for those patients now,
you know. So there's no argument there. But the larger

(04:56):
question of the cost, the larger question of training, the
larger question of what does this mean for the ongoing
viability of the public health system is a really serious one.
And governments can't simply be looking at waiting this. They
have to look at the whole system.

Speaker 2 (05:12):
Yeah, and look, it's not even just the elective. I mean,
my partner had acute surgery. He had an injury which
had to be an accident and he had to have
a bite biceps, someone back onto a bone kind of thing,
and it had to be done within a couple of weeks,
and the public service couldn't do it. They put him
out to private and he was like, I don't care.
Let we just got to get the sorted.

Speaker 4 (05:34):
I've got I've got a.

Speaker 2 (05:34):
Time frame here. But that's that wasn't even elective surgery, so,
you know, no, pretty interesting stuff. It'd be interesting to
see how things proceive. But look, if you are on
a list, I hope they get to your hope, like Simon,
you get that call really quickly. Hey guys, let's talk
about alcohol. There was some comments made at a Hospitality
New Zealand conference that maybe actually we should be putting

(05:56):
price controls on alcohols sold at off license stores so
that we can boost hospitality and we can stop people
sitting at home and drinking too much. Is this a solution,
do you think, Joe?

Speaker 3 (06:07):
Well, you know, price controls, they're one of those sticky
solutions to suggest because if you're doing okay, you're not
going to notice them much at all, and if you're
really struggling, they represent a significant barrier. But I mean,
I think that point made by the owner of the
Cook and Hamilton East. I think a very good pub
right near where my parents live than there many times.

(06:28):
But you know, I mean, we have some perverse outcomes
where the alcohol and an on license premise ends up
very expensive, and I do think most of the harm
is not people drinking on an unlicensed premise where they're socializing,
they're seeing friends, there's supervision, there's security. I think it's
people drinking at home. So yeah, I see some advantages

(06:51):
to disincentivizing through price.

Speaker 2 (06:54):
I mean, Simon and I get it that we have
a problem with alcohol and some people need to drink
less alcohol and it is cheap to do it at home.
But I I we shouldn't be doing it just so
that hospital's more. For the booze in a restaurant is
so expensive and such a big markup, maybe if they
want more people to go to hospital, they should just
love the prices a little bit.

Speaker 4 (07:15):
Look, well, I don't want to argue that for hospital,
because I know hospital is a very marginal industry and
you know, it's not like people many people in that
sector are making a lot of money. But you're absolutely right,
it costs a lot more to drink in a restaurant
than it does at home. And what we're really talking

(07:36):
about here, we're talking about poor young people's students. We're
talking about a whole lot of other people who were saying, actually, no,
we don't think you should be drinking on Friday night
in your flat or going to a party with booze
that you've bought yourself, and think that's a bad thing,
go and do it in a restaurant. That's a nonsensical argument.
That is simply not what's going to happen. So I'm

(07:59):
not really convinced that it's being approached in the right
way here.

Speaker 2 (08:03):
No, you raise a really good point there. Yeah, I've
got a teenager at university who's cut back on the
drinking because they can't afford it, Simon, which.

Speaker 4 (08:09):
Is one day your teenager will be old enough and
with a job enough, paying enough to be able to
eat perhaps regularly or semi regularly or occasionally in restaurants.
But it's not likely to be now.

Speaker 2 (08:24):
No, thank you both very much, Simon Wilson and Joe
McCarrell for joining me today on the panel.

Speaker 1 (08:30):
For more from the Sunday session with Francesca Rudkin, listen
live to News Talks It'd be from nine am Sunday,
or follow the podcast on iHeartRadio.