ASMS

Working for better health care in New Zealand

The Association of Salaried Medical Specialists (ASMS) is the professional association and union uniting doctors and dentists in New Zealand.

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It’s time to start counting the real costs of health rationing

30 January 2020 Sarah Dalton - ASMS Executive Director

I have never been a great fan of maths. I sometimes refer to myself as “not very maths-y.” It’s a self-concept that has always worked for me and — if I’m honest — I can’t think of a time when my relative ‘maths-less-ness’ has held me back.

However, they say that all good things must come to an end and maybe I, too, need to reach for the abacus. Why? Because it’s time we started counting the real costs of health rationing. That’s what New Zealand’s currently got – and I reckon it’s costing us a lot more than it’s saving.

What if you can’t get an operation, so you lose your job? There was a bloke talking about precisely that on RNZ the other day. He’s gone from a holding down a good job at an Auckland meatworks, to starving three days a week so his kids can eat, while he waits for an operation. He and his family share one room – that’s their living accommodation and their new normal.

Call me picky but that makes me queasy. What’s the actual human cost of this situation? What are his kids missing out on, apart from decent housing and food, that is? How much is it costing us all – in social AND economic terms – that this bloke has lost his job and can’t find alternative work, because he needs a relatively straightforward surgical procedure – and he can’t get it?

What about the people in Northland who are on a three-year waiting list for an appointment at the sleep clinic? Heaps of them won’t be able to work either. Why? Because, if you can’t sleep at night, and might be prone to nodding off during the day, you can’t safely operate moving vehicles, machinery, make decent decisions – you know, participate safely or productively in paid work…

What about the people with preventable blindness who can’t get their cataract surgery? The ones with the stuffed hips, who are in constant pain and can’t walk properly? What about the Counties-Manukau women whose painful gynae conditions aren’t life threatening and therefore aren’t a priority for treatment? How useful are they around the place? Must I go on?

And don’t start me on damp housing. Asthma, bronchitis, sores, measles, mumps… all preventable, all disabling, all bloody expensive – both for the families who are afflicted and for their communities. Ask the Ministry of Education about the long-term penalties on kids who miss a lot of school. The more you’re at school, the better your life chances. It’s hard (for me) to put a number on that, but I bet someone can.

So, should we shell out a bit more up front (taxes, that is) and contribute to the actual price of timely healthcare. The cost-benefit people (the ones who were better at maths than I was at school) will most likely tell you that it’s money well spent. It’s what Phil Bagshaw, at the Christchurch charity hospital will tell you; and almost certainly what Helen Paterson and her team aboard the women’s health bus will say. I’m not sure what Phil’s and Helen’s numeracy is like (probably way better than mine) but I’m pretty sure that they, along with our many members who are senior doctors and dentists in the DHBs, family planning clinics, GP practices and rural hospitals, will have many more stories like these.

And while all these patients wait, our members are faced with a different cost. It’s the cost of knowing that they’re not offering best care. It’s knowing that timelier medical or surgical interventions would yield better outcomes for the people they treat. It’s the moral injury you suffer when you know you’re part of a system that isn’t working properly for the people it was supposed to be designed to serve.

Public health is the cornerstone of our country’s wellbeing. Let’s put our hands in our pockets and insist that our government – whatever its stripe – makes a proper investment in all of our health.