Crisis of unmet need in New Zealand’s health system

Harry Hall

The New Zealand public health system is in deep crisis. After the 2017 election the Labour Party-Greens-NZ First coalition government promised an end to decades of underfunding of essential services. Instead it has continued to starve hospitals of funds and staff, while funnelling more resources into military spending. As conditions continue to worsen throughout the government’s second year in office—falsely touted as its “year of delivery” on election pledges—Prime Minister Jacinda Ardern’s claims to be “transformational” stand exposed as a lie.

New Zealand is divided into District Health Boards (DHBs), which are under constant government pressure to be in surplus, despite rundown hospital buildings, growing demand and stagnant funding. Nineteen of the country’s 20 DHBs are in deficit, with the health system’s total deficit more than doubling over the last year.

An analysis by the Association of Salaried Medical Specialists and the Council of Trade Unions estimated that health funding is $139 million less than what is required to cope with this year’s increased costs and population growth. They concluded that the health system urgently needs an extra $2.5 billion to return to the funding levels of 10 years ago.

In August, Health Minister David Clark blamed the previous National Party government’s neglect, but then demanded further cuts: “Some DHBs manage to post small surpluses, break even or only post small deficits while maintaining services. It can be done,” he told the media.

Underfunding affects all areas of the health system and has resulted in many cases of serious harm, including deaths.

In mental health, the suicide rate has reached an all-time high despite the government holding a mental health inquiry and approving $1.9 billion in extra mental health funding. The rate for Pacific Islanders, among the poorest people in New Zealand, rose by an extraordinary 48 percent over the past year. Of the nearly $2 billion in extra funding, only $10 million per year is in suicide prevention.

Although the government has announced it will train 1,600 new mental health workers over the next five years, it is not clear that they will recruit enough workers to meet demand. The New Zealand Council of Trade Unions says specialist mental health services are still being underfunded by $55 million, taking population growth into account.

Maria Baker, chief executive of indigenous health organisation Te Rau Ora, told Newsroom, “socio-economic deprivation is a major issue for us,” and getting people out of poverty would make the most difference to suicide rates. Poverty and inequality have continued to soar under the Labour-led government.

There is a dire lack of treatment for cancer patients. A damning report commissioned for Southern DHB found that it had the country’s highest rates of bowel cancer, but the lowest rate of colonoscopies.

Report co-author Dr Phil Bagshaw said the DHB had “lost the war against bowel cancer.” A review of 20 cases found that 10 had undue delay to diagnosis or treatment. Patients have been denied procedures and medication despite clear signs they may have cancer, forcing them to wait for months or pay for care in private hospitals. Some have resorted to crowd-funding to access medicines that are not subsidised by the government’s drug funding agency Pharmac.

Southern DHB’s only neurosurgeon Dr Ahmed Taha says patients are also at risk because of a drastic shortage of specialist staff. “We have experienced a few unfortunate incidents where I was not covering where patients lost lives,” he recently told Radio NZ. Taha says that 30–40 percent of New Zealand’s 22 neurosurgeons in public hospitals may retire over the next 10 years. It takes 10 to 15 years to train a consultant-level surgeon, but New Zealand has not trained one for the last 10 years.

New Zealand is in the midst of a major measles outbreak, with more than 1,443 confirmed cases as of September 24. Of these, 1,203 are in the Auckland region, with the centre of the outbreak in economically deprived South Auckland. On September 27, Stuff reported that many children are “being turned away from pop-up clinics and GP offices” due to a shortage of vaccines.