Health and Disability System Review

Hospitals on the Edge

How much Health funding is needed in Budget 2019 to maintain current service levels?

How much Health funding is needed in Budget 2018 to maintain current service levels?

Did the Budget provide enough for Health 2016

Did the Budget provide enough for Health 2017

Budget 2017 mental health funding ‘boost’ a cut in real terms

Despatches from the front line: senior doctors talk about specialist workforce shortages in New Zealand’s public hospitals

Did the Budget provide enough for Health 2015?

This analysis compares the 2015 Budget with the analysis the CTU carried out prior to the Budget, which found a conservatively estimated $629 million of additional funding was required to maintain current levels of services and pay for new initiatives announced by the Government prior to the Budget.

Taking the temperature of the public hospital specialist workforce

New Zealand’s public health system is under pressure. It’s a struggle for many to get onto hospital waiting lists for surgery or to see a specialist, chronic illnesses continue to increase, and mental health pressures worsen. Senior doctors are working longer and harder to cover staff shortages, and hospitals are spreading themselves more thinly than ever in a bid to do more with less money. The Association of Salaried Medical Specialists (ASMS) is concerned about the pressure on the medical workforce and what this will mean for the provision of future health care. After analysing the best available evidence, the ASMS has prepared a report which highlights just how vulnerable the medical workforce is.

Did the 2014 Budget provide enough for Health?

This analysis compares the 2014 Budget with the analysis the CTU carried out prior to the Budget.

Executive Director’s Trip to Europe and United States, May-June 2013

This paper reports on Ian Powell's trip to Europe and the United States in 2013. It includes discussions on the health sector with a range of commentators, as well as a summary of issues discussed at several major conferences and meetings.

The Public Hospital Specialist Workforce: Entrenched shortages or workforce investment?

A comprehensive report by the ASMS on key issues concerning the demand and supply of specialists in New Zealand public hospitals. Public hospitals are not retaining enough of the specialists we train, are not recruiting enough specialists to fill the gap, and are not retaining many of those we do actually manage to recruit.

The private finance initiative: the gift that goes on taking

A British Medical Journal editorial (December 2010) on the experience with the Private Finance Initiative in the UK's NHS. A timely reminder of the pitfalls of this approach in light of the Government's interest in Public-Private partnerships in New Zealand.

The Medical Council Online Survey

The Medical Council of New Zealand (MCNZ) undertook a survey via email between 1 April 2010 and 30 June 2011 to find out why doctors chose to leave New Zealand and what might encourage them to return. The Medical Council has put a generally positive gloss on the findings. The ASMS engaged free lance health researcher Lyndon Keene to examine the MCNZ’s analysis.

Critical New Zealand Nurses Organisation review of the Physician Assistant Pilot and final evaluation report

The New Zealand Nurses Organsiation is critical of the final Evaluation of the Physician Assistant Demonstration Pilot at Counties Manukau District Health Board (CMDHB). That report by Siggins Miller purportedly provides the evidence of success on which a new, as yet unregulated, health practitioner role is already being implemented, the impact of which has been neither costed nor assessed.

Prioritisation of medical disciplines for funding by Health Workforce New Zealand

This is the article referred to in Assistant Executive Director Angela Belich's 2011 December Specialist article about HWNZ's prioritisation of funding for RMO training.

Report of the Wakatipu Health Services Expert Panel

The National Health Board established an Expert Panel to provide advice on the future of health services in the Wakatipu Basin.

CTU – Working Paper on Health No.5, June 2011

The Health Vote in the 2011 Budget was an estimated $127 million behind what is needed to stand still. While it listed services that will receive more funding, these come at the cost of cuts in other services. That is the conclusion of a comparison of the Budget with the analysis the CTU carried out prior to the Budget1 which found that $564 million was required to just keep up with rising costs, population growth, ageing and the growth in demand for health services due to the availability of new treatments.

CTU – Working Paper on Health No. 4, May 2011

The health system needs more money each year just to maintain its current standards and services. The population increases, the population ages, new treatments become available and general costs rise, as do new technology, pharmaceutical and salary costs. If we want improvements in the health system or to address existing problems such as persistent deficits in DHBs and loss of some services, further increases in funding are required over and above these.

Poor to mediocre performance by DHBs in clinical governance and leadership

In 2010, with the active support of the ASMS, Dr Robin Gauld (Associate Professor of Health Policy & Director, Centre for Health Systems, Dunedin School of Medicine, University of Otago) conducted a survey of ASMS members employed by DHBs on the application of the government’s policy statement on clinical leadership in DHBs known as ‘In Good Hands’. Executive Director Ian Powell offers his observations and conclusions also drawing upon his own insights of the DHB.

The Business Case (or securing a sustainable senior medical and dental officer workforce in New Zealand)

Jointly developed by the DHBs and ASMS, this document provides a blueprint for the future direction of a clinically and financially sustainable health system. The Business Case outlines the problem, canvasses two future options, describes the path to a sustainable future, the shape and timing of the investment needed and provides a menu of actions from which DHBs and their senior medical and dental officers can commit to make the required savings alongside a Government commitment to invest in the senior medical and dental workforce as a priority.

Medical Specialist Workforce Crisis

This issues paper discusses what we assess as a specialist workforce crisis in public hospitals. It deliberately excludes consideration of government objectives for DHBs which will require additional senior medical workforce capacity.

NZ registrars lost to overseas employers

This paper is based on an ASMS questionnaire that attempted to measure the loss of New Zealand's registrars to overseas employers in selected specialties in order to better prepare the ASMS in its understanding of the medical workforce situation in DHBs before it goes into national DHB MECA negotiations in 2010.

CTU – Working Paper on Health No. 3, June 2010

The Health Vote in the 2010 Budget was barely adequate to keep up with rising costs and population growth and ageing, but not adequate to fund new treatments. Instead it funded increases in services at the cost of cuts in others.

CTU – Working Paper on Health No. 2, May 2010

The health system needs more money each year just to maintain its current standards and services. The population increases, the population ages, new treatments become available and general costs rise, as do new technology, pharmaceutical and salary costs. If we want improvements in the health system or to address existing problems further increases in funding are required over and above these.

CTU – Working Paper on Health No. 1, March 2010

The report of the Ministerial Review Group, Meeting the Challenge (the “Horn Report”), claims that real health care costs will increase by almost 100% in the next 20 years as the population ages “and as more of us live longer with chronic long-term conditions”. This scenario is used to argue that the only way we can afford to “meet the challenge” is for our health services to do more for less.