ASMS

We are the union for salaried doctors and dentists.

We promote, protect and support the interests of our members in all aspects of their working lives. We are working for an equitable, accessible public health care system that meets the needs of all New Zealanders.

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Southlanders – what price your health?

11 August 2020 ASMS opinion piece

Southlanders can feel lucky in the extent to which your district health board provides a contrast to the sorry events at Canterbury DHB, where a hostile board and Crown monitor have effectively led to the departure of the chief executive David Meates and three members of his senior leadership.

This is a disaster for Canterbury, as they were a very effective team. But they were left in an untenable situation with the board demanding excessive cuts to services in order to bring the deficit down and make the DHB’s balance sheet look pretty.

The Southern DHB, on the other hand, does not seem dead set against its own communities and you have senior clinicians and health managers who generally work well together in the interests of providing best care.  But like so many other parts of the country, your slice of the health pie is not sufficient to meet local needs. No matter which way you slice and dice it, no matter how carefully you portion the tiny pieces out, some of you will miss out.

Part of our role in representing senior doctors and dentists, is that we have regular high-level meetings with DHB leadership.

At our meeting with the Southern DHB the other day, we heard managers asking questions about how much more capital investment the region was likely to get, given it has already been given a big chunk of money for Dunedin Hospital and makes up only 7% of New Zealand’s population.

There is already a long queue of DHBs on the quest for new or improved hospital buildings. I used to describe it as a lolly scramble, but now I liken it more to The Hunger Games where DHBs are pitted against each other fighting for funding.

The thing is, DHBs are not queuing up for facilities on a whim. The Ministry of Health’s recent National Asset Management Plan has shown that much of our hospital infrastructure is tired and worn out – not unlike an increasing percentage of the healthcare workforce.

The mental health facilities across the Southern region, along with local GP shortages and the ageing and inadequate Invercargill Hospital, mean you still have a significant shopping list of core health infrastructure and services, and unfortunately no realistic prospect of seeing these purchased any time soon. In fact, if $100 million materialised overnight, your DHB would be faced with a Solomon’s choice between a new regional hospital or mental health services. Both key priorities, neither frivolous, but you could not have both.

We know that current provision in Southland is not up to snuff. If all the people needing timely care could be helped you would not have a new charity hospital in development. I don’t know about you – and this is meant with no disrespect for the amazing work of those who fund and staff charitable health services – but I expect better from our health system.

In which case, I suppose the question really is, what kind of public health system are we prepared to pay for?  Some of the answers to our health spend are found in the government’s priorities. Its shopping list is even longer than yours. But some of the answers ought to be tested at the upcoming election. The current government is trying to invest more in health. Not nearly enough, but it has taken some big steps in the right direction. The problem is it all comes after a very long starve for health, and now the hungry chickens are home to roost.

Our vision is that all the parties in parliament sort out some shared longer-term priorities for health and stick to them, irrespective of the makeup of the elected government of the day.

Meanwhile, as a small and mostly rural population in our health-stretched country, what are you prepared to step up and hustle for?  Adequate acute and community mental health services? Accessible, affordable primary health care? A fit-for-purpose hospital in Invercargill? All of the above? Your health is worth investing in.

Opinion piece by ASMS Executive Director Sarah Dalton as published in The Southland Times and on Stuff