New Zealand has moved from first to fifth place in international health rankings of seven countries, carried out by the Commonwealth Fund
The slide is due mostly to issues of access, high costs preventing people from visiting doctors or filling prescriptions, safety and management of chronic illness and New Zealanders being the patients most likely to get an infection whilst in hospital. They were also in the bottom three for medication errors and being the victim of a medical mistake.
Interestingly, it was ranked last for the percentage of money spent on health administration and insurance. According to Stuff:
Labour health spokeswoman Ruth Dyson said the fall was “devastating”.
New Zealanders had worked hard to get an excellent healthcare system and were now “just watching [it] slip away”.
Government contracts held by district health boards for community-based management of chronic conditions had been cut around the country, she said.
The high infection rates were a surprise, but could be the flow-on effect of Government “penny pinching”.
It was disappointing New Zealanders were still struggling to access primary healthcare as it was crucial to early treatment and keeping people out of hospital, she said…”
Per head Australians spent US$3,357 on helathcare, Canadians US$3,895, Germans US$3,588, the Netherlands US$3,837 and Britons spent US$2,992 on health in 2007. New Zealand spent the least at US$2,454.
We can’t say that we are surprised by New Zealand’s poor showing and this is why:
New Zealand has a workforce crisis in its hospitals with specialist senior doctors being lost, there is also a shortage of cancer specialists, paediatric surgeons and radiologists and when doctors and specialists speak out about their concerns over patient safety they are censured, most of them simply resign rather than take the flack for being a whistle blower.
The average medical student in New Zealand finishes training with a debt of $75,000, forcing many of them overseas soon after graduating. Australia is their most likely destination. But money isn’t the only factor making them leave. One study found that just 25% of students believed they would be valued as employees by hospital management or the Government, something that affects their long term commitment to their country and has implications for specialist training.
261 people in Canterbury are waiting more than six months for cancer-detecting colonoscopies, raising alarm among doctors. In July 2009 the figure stood at 75 people. A private procedure costs £1,000.
The Health Ministry is allegedly among the worst performing government departments. According to a report card ranking state agencies and bosses excessive red tape, bureaucratic systems and ineffective consultation hampering a number of government departments. It placed the Health Ministry bottom for value for money overall, and said it was “struggling“ and
“really confused, with too many sections not knowing what others are doing, and doing stuff without consultation in the affected communities.”
Disgust at the plight of one hospital -Hawera – has inspired a well-placed business analyst to blow the whistle on what he sees as millions of dollars worth of financial inefficiencies and loss at the deficit-plagued Taranaki District Health Board.
Paul Anwyll left his job as a business analyst at the TDHB’s Management of Information Unit…citing “weak leadership and poor management” as reasons in his letter of resignation. An experienced auditor, the Englishman said he had identified financial problems and loss but the TDHB had refused to consider his proposal of a test study that could potentially save them millions.”
Pharmac doesn’t allow New Zealanders to access new medicines for five to 10 years after they are widely used elsewhere in the world. It waits until they are generic until they are widely used. The system keeps prices down for the Government but is criticised for restricting drug choices and delaying the arrival of some new medicines.
There was a 50% rise in complaints against pharmacists in the year to June 2009 , including 5 pharmacists who were convicted of crimes. Similar sounding and look-alike medications are ‘to blame’ for the rise. City Health Pharmacy in Palmerston North was fined $10,000 in 2008 after six drug dispensing mistakes in two years, including giving a two-year-old an anti-psychotic drug instead of cough medicine; it’s still in business. There is no compulsory bar-coding of drugs.
For a first hand account of what it’s like to work in New Zealand’s health service you may wish to read our Migrant Tale “The Health Care System is Second Rate.” Written by a nurse with over 30 years experience, she talks about resistance to change and the wastage of thousands of dollars because there is no incentive to change things.
At the time nurses in Nelson were speaking out about horrific workloads that were causing many to resign. Nurses went public because of a lack of action when they raised their concerns with the New Zealand Nurses Organisation and hospital managers.
For more read our Health and Death page
One reader of the blog left the following comment for us a week ago, if health care in New Zealand matters to you you may wish to read Gareth Morgan’s book -see a report on it here
I would like to mention that gareth morgan has a book about the nz health care system that anyone migrating for the health care ought to read, seriously.
Health Cheque: The Truth about NZ’s Health System it is called
It’s a frank book that discusses the problems with the way they rationalise care in which he states a theory that the high quality of the doctors and nurses are the only thing holding the system together.
Yet New Zealand has the highest percent of migrant doctors in the OECD, a staggering 52%
says in the review this book that:
“The New Zealand health workforce is under pressure from a number of sources. In addition to those problems that are shared by other countries – such as an increase in the proportion of part-time workers due to the feminisation of the workforce, increased demand for health services, and the aging of the health workforce – New Zealand faces major challenges from the internationalisation of health workers. It has the highest percentage of migrant doctors among OECD countries (52 percent compared with an OECD average of 36 percent) and one of the highest for nurses (OECD, 2008). **It also has one of the highest rates of outward migration of health workers. Four years after graduating, around 25 percent of NZ trained doctors are no longer registered in New Zealand and the loss increases to around one third after 9 years.**”
The doctors and nurses seem to mostly be british people who are outdoorsy migrants, or locum americans taking a working vacation, or political or crime refugess who could not get into other countries such as oz or canada. The kiwis just bugger off out of their own country and people from countries where the native language is not English are often only offered less responsible positions, in caregiving and cleaning.
The National led government has recently announced that it will be putting further pressure on the health service by giving employers the authority to make workers obtain GP sickness certificates for a single day’s sick leave from work.
“General Practice New Zealand chairwoman Bev O’Keefe said the change could put pressure on medical centres.
“The issue for general practice is how we accommodate all those people who need to claim medical certificates because they will need to be seen and assessed which means they are going to impact on what is already the heavy workload of general practice. “One thing we are not happy to do is to furnish medical certificates without seeing people because that’s just hearsay.” Another issue was people may go to work ill.”
Just days after two policemen were shot and a police dog killed in Christchurch, there’s been a similar shoot out on a suburban street in New Zealand, this time in New Lynn, West Auckland; plus an armed police operation in Dunedin.
in the New Lynn incident a man was taken from the scene with a gunshot wound to the stomach. The shooting occurred during the execution of a search warrant in connection with an arson incident:
“Late last night, police said they had gone to the Nikau St address about 6pm to arrest the man over an alleged arson. Asked if police were armed on arrival, police spokesman Kev Loughlin said police did have guns. “But I am not going to make a statement about when the officers were armed,” Mr Loughlin said.
A fight broke out and the man fired at officers. They fired back, hitting him in the stomach. The man, aged in his 30s, is understood to have lived in a caravan alongside six blocks of two units down a right-of-way…”
The Police Union say that an attempt use a taser to subdue the offender had failed and they emphasised again the importance of firearms being available to front line officers.
As the day progressed news was released about an armed police operation in Dunedin this afternoon. Witnesses said a number of armed officers and police cars converged in the city and had cordoned off Dundas St, near Logan Park, at Clyde St, Forth St and Harbour Terrace; near Otago Polytechnic. Reports of shots being fired would not be confirmed by police but a number of witnesses said they thought they heard shots.
Neighbour Brylie Meng said police first arrived around 1pm, and ordered the man, who she believed was in his early twenties, to surrender, while armed police trained their guns on the house. “All we could hear was ‘If you come out now, we won’t hurt you, come out with your hands in the air’.”
Eventually, about 15 armed police went around the side of the house before about five shots were fired. A man was lead outside a short time later, she said. Ms Meng said she was not sure whether they were gunshots but “it was really, really loud”
Smoke was seen coming from the house on Dundas St at around the same time…”source
The incident was talked about on the Trademe forum as the event unfolded, with one person giving a possible explanation for the panic:
I thought it was in Dundas Street, some guy was obsessed with a girl and had been snooping around her for ages then decided to turn up with knife today and hide in the bushes near her flat? That’s the word at uni
A little over a week ago a party of tourists on quad bikes near Ahipara, Northland were caught up in the aftermath of an armed “squabble” between two brothers.
The group was stopped by fully kitted out Armed Offender Squad officers looking for the offenders, no doubt scaring the wits out of the visitors looking forward to a quiet day at the beach.
Elsewhere, police are still looking for a breakthrough in their hunt for the killers of Feilding farmer and family man Scott Guy who was shot to death on his driveway a week last Thursday.
Gun crime is shockingly frequent in New Zealand where there are thought to be at least 1.1 million legally owned firearms in circulation. Hand guns, rifles and shotguns are frequently used in armed robberies.
See also: Posts tagged Gun Crime
New Zealand, the country perceived to have the ‘lowest rates of corruption’ has suffered more than $72 million dollars worth of fraud in the first six months of 2010, but that is only the “tip of the iceberg” says KPMG forensics expert Stephen Bell.
According to an article on Stuff:
Cash-strapped Kiwis bitten by recession have resorted to fraud and the full extent of it will not be known for years.
New Zealanders have swindled about $240.6m in large frauds since January 2008 and the average size of large frauds is now more than $2m, KPMG’s latest large-scale fraud survey shows.
KPMG forensics partner Stephen Bell said the extremely high level of fraud was not surprising given the backdrop of the recession.
“We haven’t seen the end of it. In the past 12 months there’s been about $150m in large recorded fraud. Our expectation for 2010 is that it will be a record year. Typically the second half of the year is larger in terms of reported frauds and their dollar value.”
KPMG monitors cases coming before the courts that exceed $100,000 and the individuals involved must be charged or sentenced for their case to be counted.
The report revealed just the tip of the fraud iceberg, Mr Bell said.
Business New Zealand chief executive Phil O’Reilly said the actual level of fraud for the period was likely to be much higher than $72m as the most common kind of fraud was small-scale.
“You can probably double that number – that’s a guess but the [value of small-scale fraud] will be a big number.
“One of the issues is that companies either don’t find out about it or if they do, they often keep it a bit quiet because of the corporate reputational harm that’s done by admitting you’ve got a problem.“
Any business handling cash or dealing with complex financial transactions would be at risk of fraud “at some time”, but it was important to remember the vast majority of employees were honest, he said…more here
For background reading about the lack of controls over the high levels of fraud perpetrated in New Zealand read blog:
The ever widening gulf between the country’s dirt poor and the wealthy classes has been recognised on an international stage but it remains something that is unlikely to be mentioned next time one of those ‘most livable’ surveys gets published (most livable for whom?)
If you ever see PR hype hailing New Zealand hailed as a ‘great place to raise kids’ or the sixth best country in the world to be mother it’s worth remembering that 230,000 children live in unacceptable poverty in New Zealand and that Kiwi youth suffer some of the worst health outcomes in the developed world.
Whilst the fat cats feasted on marinaded fish salad yesterday, metres away queues formed for bread and jam and generations are born into and die in poverty:
Millionaire Auckland mayor John Banks told the conference at the SkyCity Convention Centre that “there are pockets of social deprivation” that needed to be addressed.
“We have to bridge the gap between the very poor and dispossessed and those of us who are making great progress,” he told delegates.
When he spoke of great progress, he may have been referring to the National Party coffers: yesterday morning, MPs learned that Prime Minister John Key’s neighbourhood restaurateur had donated $105,000 to the party.
Chef Tony Astle whips up a grilled venison back steak with celeriac salad, pearl barley and Madeira jus for a swift $50 at Antoine’s Restaurant, in Parnell – a profitable little business, it appears, enabling generous donations.
But yesterday, conference delegates had to settle for a three-course lunch of flash-fried asparagus shoots and marinated fish salad, baby spinach leaves with toasted pinenuts, crispy prosciutto and garlic aioli.
Just 250m away at the Auckland City Mission, dozens of homeless people queued up for handouts of bread and jam.
A spokeswoman said the United Nations rated New Zealand with the sixth greatest gap between rich and poor among developed nations last year.
For Stephen Flowers, who has lived on the streets for about 10 years, Banks’ words were empty rhetoric. He said: “It does make you laugh when you hear people like Banks and John Key talk as if they know what life is like for us. They have no idea, I haven’t seen any improvements since National came to power. After my fines have been paid I’ve got $60 a week. … Lunch for me usually consists of picking food out of rubbish tins.”
Flowers has lived under the Hobson St overpass for two years, with his mates Chris and Edwin, who was left brain damaged after being stabbed.
Good Samaritan Claire Adams-Adamiak, who delivers food parcels to the homeless, said: “There are people living with rats who are at risk of starting an outbreak of rabies or TB. They are born in poverty, they live in poverty and they die in poverty.”
Thanks to Netizen and ‘Waiting for them’ who sent us a very salient links to a report on the United Nation’s report into income inequality across the world and another which shows half of disabled Aucklanders are living on the poverty line.
“There are 77,000 disabled people living in Auckland, the majority of whom earn far less than their non-disabled counterparts, even when they have a tertiary qualification. poverty is a daily reality for many disabled Aucklanders and their families, and from available figures estimates that about half of disabled Auckland adults have personal incomes of less than $20,000, predominantly sourced from benefits, casual, part-time, and/or low-paying work
The United Nations report on income inequality:
“…ranked countries and regions based on a number of factors, including their Gini coefficient, named for Italian statistician Corrado Gini.
We have listed the world’s most advanced economies based on their Gini score, with zero marking absolute equality and 100 absolute inequality. Scandinavian countries, Japan, and the Czech Republic have the least amount of inequality. The U.S. is among the most unequal, but it’s not No. 1. To see which economy is, read on…”
The to 10 countries for income inequality were ranked as follows
1. Hong Kong, Gini score 43.4
2. Singapore, Gini score 42.5
3. United States, Gini score 40.8
4. Israel Gini, score 39.2
5. Portugal Gini, score 38.5
*6. New Zealand, Gini score 36.2
7. Italy and Great Britain, Gini score 36
9. Australia, Gini score 35.2
10. Ireland and Greece, Gini score 34.3
*”According to the OECD, New Zealand had the biggest rise in inequality among member nations in the two decades starting in the mid-1980s. The country’s economy emerged from recession in the second quarter, but with growth of just 0.1%, the central bank is likely to keep interest rates low until well into 2010.”
But this blog is written from the point of view of the migrant or visitor to New Zealand, how is this relevant to them? Because, believe it or not, migrants are unexpectedly finding themselves caught in New Zealand’s poverty trap due to the low wage economy, or through losing their jobs in the recession and having no safety net. Some can’t find skilled work and are forced to take on more menial jobs.
Readers will remember the blog we wrote a week ago about the young couple (an American and an Australian) caught up in a cold poverty trap and unable to borrow money to insulate their timber home.
We’ve also written about immigrants forced to live in third world conditions, – skilled migrants that lost their jobs and, faced with high rents, were forced into living in cars, vans and overcrowded houses. The unlucky ones lived on the streets.
If you’re about to move to New Zealand we recommend that you read them and posts tagged Poverty.