A few days ago New Zealand got a slating on the OECD’s Better Life Index, one of the categories it scored poorly in was Housing.
Many migrants chose New Zealand because they’re looking for a better standard of living, what a surprise it is for them when they discover not only are the houses of poor quality (often likened to wooden shacks) but they’re also extremely unaffordable. Those two factors are now causing problems for the country’s over stretched health service due to an increasing number of hospital admissions caused by over-crowding. Furthermore, only one in three New Zealanders can afford to heat their homes properly - fuel poverty also has a major impact on the health of the nation’s young people (read New Zealand’s High Winter Death Rate And Burning Wood To Keep Warm)
If you’re thinking about moving to New Zealand we invite you to do your own research about this, we suggest starting with this link from our Wiki pages : Living Accommodation: Housing Issues In New Zealand.
According to research conducted by the University of Otago
One in 10 admissions to hospital in NewZealand to treat infectious diseases such as pneumonia, meningococcal disease and tuberculosis are the direct result of household crowding a new study has found. For Māori and Pacific Island peoples, the figure jumps to one in five…
In a lengthy press release issued on Friday the university says
“Released today by the University of Otago, Wellington, the Ministry of Health funded study includes a world-first systematic review and analysis of global literature on crowding and infectious disease. These findings were combined with housing data from the 1991, 1996, 2001 and 2006 Censuses, and previous Health Research Council funded University research showing a dramatic jump in admissions to New Zealand hospitals for infectious diseases over the last two decades.
The review started with almost 10,000 published studies from which researchers selected the most relevant and highest quality 350 reports. Lead investigator Professor Michael Baker, who was assisted by Dr Andrea McDonald and He Kainga Oranga colleagues, says these studies provide consistent evidence that household crowding is an important risk factor for nine major categories of infectious disease — gastroenteritis, hepatitis A, Helicobacter pylori infection, pneumonia and lower respiratory infections, upper respiratory infections, Haemophilus influenzae disease, bronchiolitis, meningococcal disease and tuberculosis.Across these diseases, household crowding is estimated to cause more than 1300 hospital admissions a year in New Zealand, along with some deaths.
The study highlights large ethnic inequalities and is particularly relevant to child health, Professor Baker says.
“Most of the diseases in the study have especially high rates in children. Children are more susceptible to meningococcal disease, gastroenteritis, pneumonia and most other infectious diseases, and our analysis shows that their risk is strongly associated with exposure to household crowding.”
In terms of ethnicity, the research shows that for European/Others, exposure to household crowding is estimated to cause 5 per cent of hospital admissions (in the nine disease groups examined). For Asian peoples, the figure is 13 per cent. For Māori the estimated contribution rises to 17 per cent, and for Pacific peoples it rises to 25 per cent.
“This study is a significant step forward in understanding these huge ethnic inequalities,” Professor Baker says. “Fundamentally what it reveals is a very real and urgent need to lower household crowding as a first step to reducing these serious diseases among our most vulnerable populations.”
Professor Baker says interventions such as Housing New Zealand’s Healthy Housing Programme in Auckland, Northland and Wellington, which focuses on reducing crowding, improving housing conditions and linking households to health and social services, is successfully lowering hospitalisation rates for children in those areas.
The budget announcement to add 3000 new state house bedrooms and 500 new homes is promising, but considerably more social housing will be needed to have a significance impact on infectious diseases, he says.
“New Zealand faces a severe shortage of affordable housing. The proportion of children exposed to household crowding has been rising in New Zealand. About 45 per cent of Pacific children and 28 per cent of Maori children are living in crowded houses, compared with 8 per cent of European/Other children. New Zealand needs a large scale programme to construct thousands of additional social and affordable houses if it wants to reduce household crowding and prevent many cases of serious infectious disease.”
Professor Baker says this study has underestimated the likely contribution of household crowding to serious infectious diseases. Due to a lack of high quality published studies, several important infectious diseases, notably skin infections and rheumatic fever, could not be included.
“Although household crowding is likely to be important for such diseases as rheumatic fever and skin infections, we cannot currently put a figure on the likely number of cases of these diseases caused by this exposure.”
The full report: Infectious diseases attributable to household crowding in New Zealand: A systematic review and burden of disease estimate, is available on the He Kainga Oranga / Housing and Health Research Programme web site:
- House overcrowding disease fears (stuff.co.nz)
- New Zealand’s High Winter Death Rate And Burning Wood To Keep Warm (e2nz.org)
- Overcrowded households ’cause serious illness, death’ (stuff.co.nz)
- Household crowding a health risk – study (nzherald.co.nz)
- Overcrowding ‘missing link’ on hospitalisations (radionz.co.nz)
- Meningococcal disease shown to last days outside body (stuff.co.nz)
- International Mother’s Day, New Zealand plunges in ‘Best Place to be a Mum’ rankings (e2nz.org)
- NZ’s Human Rights Record Stained by Child Poverty, Lack of Investment in its Young: Amnesty International; UNICEF and OECD (e2nz.org)
- Migrant Tales – New Zealand is Over Rated (e2nz.org)
Moving to New Zealand because you’ve heard its ‘free’ health service is world class, or maybe you’re a medical professional hoping for a better working environment?
Think again, when it comes to health care you get what you pay for. (Read our posts tagged health service)
The Association of Salaried Medical Specialists is so concerned about the lack of public hospital specialists in New Zealand that it has issued a press release warning that sub-standard conditions have become the norm in the small Pacific nation. Not only could this cause cuts in clinical services but it is also causing a retention crisis for both junior doctors and specialists.
Entrenched public hospital specialist shortages becoming increasingly unsafe
Media Statement – Ian Powell, Association of Salaried Medical Specialists
3 February 2013
“Many public hospitals will need to reduce services in the near future as a result of continuing shortages of medical specialists,” said Mr Ian Powell, Executive Director of the Association of Salaried Medical Specialists, today.
Mr Powell’s warning comes with the release of a comprehensive report by the Association on key issues concerning the demand and supply of specialists in New Zealand public hospitals. “The report’s conclusions are based on the best health intelligence available.”
“Specialist shortages, which have existed for many years in many areas, have become so entrenched that the resulting sub-standard conditions have become the ‘norm’. 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.”
“As a result, hospital specialists are caught between the proverbial rock and hard place. On one side they have increasing clinical workloads. On the other there is mounting pressure to spend more time supervising and training resident (junior) doctors, and engaging in clinical leadership activities.”
“Up until now services have been held together by specialists giving priority to meeting patients’ clinical needs at the expense of their supervising, training and leadership roles. But that situation is becoming increasingly unsafe, it is limiting the training and experience of our future specialists, it is hugely wasteful, and is contributing to a high turnover of both resident (junior) doctors and specialists.”
“This assessment is based on government documents, published research and the most recent workforce data from the Medical Council of New Zealand and District Health Boards.”
“Unless there is an urgent quantum leap towards addressing our retention crisis, we are approaching the point where there is no option but to cut clinical services,” concluded Mr Powell.
You may also be interested in our NZ Health Wiki which has specific sections headed Health Service – effects on Patients, effects on Staff; Under Staffing* and Inefficiencies.
- There is a workforce crisis in New Zealand’s hospitals. Specialist senior doctors are being lost and there is a shortage of cancer specialists. Staff are lost to Australia (where the salaries are 35% higher) and to private practice. The causes are low pay by international standards, overwork and lack of resources to do the job.
- New Zealand has an estimated shortage of around 600 specialists and that’s set to get worse, according to the Association of Salaried Medical Specialists. Growth has not kept pace with increasing need in an ageing population.
- The senior doctor’s union estimates there is a shortage of 638 medical and surgical specialists and that having to treat too many patients is driving doctors away from NZ. The country “needs at least 1100 more specialists if it were to match the number per head of population in Australia, the union says in a discussion paper based on data from 2007 and 2008.” Source NZ Herald.
- New Zealand’s has a high dependence on overseas-trained doctors, the highest in the OECD , who comprise 40% of specialists. In some areas, such as psychiatry, the figure is closer to 60%.
- So many NZ trained registrars go overseas when they’re qualified that it’s hardly worth training them at all. Medical registrars can earn around $70,000 more in Australia and difference in salaries is one of the major drivers for the exodus. “The situation is a crisis and a crisis generally comes before a collapse” -says Association of Salaried Medical Specialists executive director Ian Powell. See the bullet point above for the other drivers.
- “New Zealand’s paediatric surgeon work force is declining as trainees are lured to Australia… Between 2005 and 2009, the number of paediatric surgeons dropped from 16 to 14. Christchurch Hospital clinical director of paediatric surgery, Spencer Beasley, said New Zealand needed 18 or 19 paediatric surgeons. There was a worldwide shortage and only three of the past eight Kiwi trainees are working in New Zealand.“
- Junior doctors at Christchurch Hospital say patients and doctors are at risk because of understaffing. A spokewoman for the RDA said that over the last 4 weekends there weren’t enough junior doctors on duty. The acute area only had 3 out of a necessary 5 juniors and there was neither an orthopaedic house surgeon, nor an acute-surgical house surgeon on duty over the weekend, or the previous night. According to a report in The Press the doctors were supported by the out-of-hours clinical coordinators who had written to the CDHB chief executive saying that “shortages were compromising patient safety.” (27 Jul 2010)
- A surgeon has been censured again for speaking out over his concern about the safety of radiololgy services in W(h)anganui. ”Mr Solomon said in March a single Whanganui radiologist was doing the work of three doctors and was being paid more than $600,000 a year – three times the usual radiologist’s salary…In 2007, Mr Solomon was censured for the first time by the board, for speaking out about patient safety fears because of alleged staffing shortfalls.” (July 2010)
- “Taumarunui Hospital is facing a critical shortage of qualified medical staff after one of its remaining two doctors resigned in the wake of the town’s after-hours care crisis.” (March 2010)
- Report: Hospital cutbacks looming (nzherald.co.nz)
- Report on specialists leaving NZ welcomed (radionz.co.nz)
- Specialist doctors continue to quit New Zealand (stuff.co.nz)
- Minister disputes staff shortage claims (nzherald.co.nz)
- NZ medical experts brace for arrival of deadly flu (nzherald.co.nz)
- Legal action against DHB considered (radionz.co.nz)
- Hospital and midwives criticised over baby death (stuff.co.nz)
- Doctors’ union says specialist shortage a safety risk (radionz.co.nz)
- Patient alert system for disease ‘not carried over’ (nzherald.co.nz)
Continuing in our series of Migrant Tales, first hand accounts of the migrant experience of New Zealand taken from places around the net.
Today’s tale was a response to a thread we started on Expatexposed.com a self help and support network for migrants to New Zealand.
The author is a British migrant who returned to a better life in the UK. He experienced racial discrimination and hatred whilst living in New Plymouth. Whilst there he identified a multi-million dollar loss in a bandages contract in a local hospital but no-one in the chain of command from hospital to the Health Minister was interested in the information. You can read more about NZ’s health service here.
Thank god I have Left New Zealand
Having lived in New Zealand for 6 1/2 years I am now safely back in the UK. We moved to New Zealand for a “better quality of life” and after 6 1/2 years we have concluded that we had a far superior quality of life in the UK, hence we have come home.
The journey has been long and hard, lived in Auckland then New Plymouth, had a “can do, be positive attitude” only to be sucked dry and felt feeling demoralised, brow beaten and inferior, what quality of life is that!
The Kiwi’s have a good pattern of looking you in the face and lying to it whilst stabbing you in the back. The amount of scamming, corruptness and racial hatred to you as an “immigrant” by people and the Government is astounding. We had our Residency Permit from day one as I had skills the country needed, but after being made redundant in Auckland and 4 years of being told “you are too qualified” I’ve had enough.
I worked as a hospital analyst and identified a massive financial loss to the local hospital that I worked, ($72 Million) in a bandages contract, wrote a report went all the way through the chain of command, Supervisor, Manager, Department and Clinical Manager, Finance Director, Chief Executive Office, Health Minister only to be told we “don’t care” and by the way you can now leave. I was astounded, so I went to the papers, the apathy was amazing. This is just 1 story of many I can post on here.
In short, before you move to NZ with it’s extremely high cost of living versus wage ratio, bad driving, Hoons, taxation, kiwi “can do attitude”, they “can do everything badly”, crap schools etc put down the holiday brochure, obtain the “real” facts of living in NZ, look at your country again and compare, you won’t get on the plane!
New Zealand’s education and health ministries are among the worst-performing government departments, according to a report card ranking state agencies and bosses.
The report found excessive red tape, bureaucratic systems and ineffective consultation are hampering government departments.
The Health Ministry, bottom for value for money overall, was “struggling“. It is “really confused, with too many sections not knowing what others are doing, and doing stuff without consultation in the affected communities.”
The ODT is carrying a report about the resignation of the Clinical Leader of its emergency care facility. He’s resigning in protest at proposed staffing levels:
“Dr Tim Kerruish resigned as clinical leader yesterday morning after about 15 months in the role, effective immediately, but will stay on as a specialist.
His position was “untenable” because of a disagreement with management over doctor numbers. Senior medical staff had “serious doubts” about providing a safe level of cover, he said.
The $2.7 million, 10-bed ED observation unit opening in June or July might not be able to open on weekends because of inadequate staffing, he said…” read more: ED boss resigns over staffing frustrations
The New Zealand health service has been struggling for years with a lack of resources, low moral and a high turnover of staff – many of them leaving to take up position in neighbouring Australia. It is to his credit that’s he’s staying on at the hospital for the near future.
Putting our patients first
In 2009 Dr Kerruish criticised Dunedin’s emergency department’s “Putting our patients first” project, saying although it had made some gains it may not get much further without a change of culture at the hospital.
“He said he had tried to find a philosophy statement on the board’s website and was not sure he ever did.
Dr Kerruish is one of the members of the team for the pilot project, which was designed to introduce the Toyota vehicle manufacturer’s lean thinking methods to reduce waste, increase efficiency and improve patient flow.
The pilot is part of a national programme called “Optimising the Patient Journey” being tested in various hospital departments in several locations…” read more: Specialist urges lift in hospital culture
Dr Kerruish, 45, has only been the clinical leader of the emergency department since January 2011, taking over from his predecessor Dr John Chambers who’d been in the post for 17 years. In the months leading up to his appointment. Dr Kerruish and his colleagues had been “increasingly outspoken about the hospital’s poor performance nationally in ED length-of-stay statistics and the lack of progress in this area.”
Then in April of last year Dr Kerruish voiced his concern that both senior and junior staff were worried that staffing levels were unsafe. The ODT obtained a letter showing that staff had written to Chief operating officer, Vivian Blake, in December detailing their concerns about staffing levels:
“Only one registrar and one house surgeon were on duty between 1am and 7am during the week and midnight and 7am at weekends.
The doctors gave the example of a night in October, when the number of patients in the department at one time peaked at 35 and 41 patients were seen by the night shift doctor team during its shift…. read more ED staff express concerns for safety
His departure as department head is likely to keenly felt by many colleagues who were very supportive of him. One may only hope that patient care isn’t compromised, either by his resignation, or the level of staffing cover he was protesting about.
Dr Kerruish, an old boy of the Castle Rushen High School in the Isle of Man, studied at the University of Liverpool and has lived in Dunedin for 11 years.
You may also be interested in:
Migrant’s Tale: “The Health Care System is Second Rate“
“…This story was written by a nurse with over 30 years of experience. In it she tells of prejudice and how difficult it was to find a job. She also talks about how thousands and thousands of health care dollars are being wasted because there is no incentive to change and of how people wait so long for some tests and treatments that permanent damage is done to their health. She is minded to stay and work through this but her Kiwi partner is starting to look toward Australia to make some money…
“…Another negative here – they are resistant to change moreso than anywhere I’ve ever seen. I worked in the health insurance industry for 10 years before I came here, and one of the things I looked for were areas where money was wasted. Here, I can see thousands and thousands of health care dollars wasted because there is no incentive to change things. And they do some things here the same way we did them in US hospitals when I was a student nurse. And since residents here see health care as “free”, they really don’t care. And they don’t realize the health care system is second rate. Yep, I said it and I really believe it. I see things every day that scare the hell out of me. People have to wait days for some tests and treatments that would be done in a matter of hours in the US. By then, permanent damage has been done. But, oh well, that’s just the way it is...” more here
For an overview of the NZ health service go to the Health Service section of this page.
Thinking about emigrating to New Zealand as an investor?
On May 6 Immigration Minister Jonathan Coleman announced that over $560 million in potential capital investment is poised to flow into the NZ economy and planned changes to the Government’s business migration scheme will increase investment further. source
The Government’s business migration scheme offers two investment categories:
Investor Plus – minimum investment of $10 million for at least three years
Investor – minimum investment of $1.5 million for at least four years.
Some of the key changes to the business migration scheme includes:
• Reducing the residence requirements for Investor Plus migrants during the three year investment period from 73 days to 44 days per annum.
• Investment opportunities will be expanded by allowing migrants to invest in entities established by parent organisations to raise funds. Migrants will also be allowed to invest in bank bonds and equities.
• More flexibility is being provided around the requirement for business experience. Instead of previously having to meet both conditions, business migrants only need to meet one of the following criteria – to have owned or managed a business with five full time employees or to have owned or managed a business with a minimum $1m in annual turnover.
• Migrants will be allowed to transfer funds through foreign exchange companies which recognises the emerging international trend in funds transfer.
• Residential property is to be included as an acceptable investment. Safeguards are required so that residential property investments create economic growth and increase the total housing stock available to New Zealanders.
NZ Prime Minister John Key: “we’re pro immigration” “issue for NZ is whether people can bring skills or bring capital”
From the BBC Hardtalk interview conducted with Stephen Sackur.
Before you reach for the visa application form and cheque book you may like to read about a British investor who has just been made to leave after establishing a North Island business with a turnover of $2 million a year. Why should you? because although New Zealand likes the wealth he generates they don’t like the chance that his (resolved) health condition may place undue strain on the country’s health service.
This could so easily be you.
Martyn Payne has been forced to leave New Zealand, his family, staff and business as a result of an unjust decision. Visit the Facebook page set-up to support him
Martyn Payne moved to New Zealand from the UK nearly seven years ago.
He invested his life savings of $700,000 and six years of his life into turning a struggling Northland garage into what has become a thriving business and centre of the local community.
Martyn’s business employs seven staff and turns over $2 million a year, providing vital employment and income for his small town which has been hit hard by the recession.
The Immigration department agrees that Martyn was providing a ‘valuable service’ and a ‘worthwhile contribution’ but has decided his health will potentially cause a drain on the NZ health service despite a doctor’s report stating otherwise.
Martyn lodged an appeal with Associate Immigration Minister Kate Wilkinson asking her to intervene in this case and allow him to stay, however this request was declined on April 20th. The Associate Minister stated that no new information has been put forward and unless there is a significant change in Martyn’s case and circumstances his appeal will not be looked at again.
This despite new information being sent after the original decision in the form of a second doctor’s report and a specialists report both confirming Martyn is not expected to be a drain on the health service as is suggested.
Martyn Payne was forced to leave New Zealand on 23rd April, leaving behind his business, staff, daughter and grandchildren. He will not be allowed back into New Zealand for at least 6 months, and then only if sponsored. His family are fighting to bring him back. source
Mr Payne is now holed-up in Brisbane, Australia whilst a decision is made on his application for a temporary 12 month NZ work visa and even that may be refused. Under the circumstances why should he bother staying, why not just pack up, sell the business and call it quits on a country that puts its own interests before his? There are many struggling migrants that would quite happily trade places with him.
Immigration New Zealand took the the unusual step of publishing a press release in an effort to “clarify the facts” of Mr Payne’s case. It makes the Long Term Business visa look even less attractive, if such a thing is possible
“Immigration New Zealand wishes to clarify the facts around the case involving Martyn Payne.
In November 2005, Mr Payne arrived in New Zealand with a work permit valid until August 2006. He was then granted a work permit under the Long Term Business Visa category until November 2008.
Mr Payne was advised in writing that a long term business visa was no guarantee that a subsequent residence application would be approved and that any application would be assessed under the policy applying at that time, including meeting health requirements.
In January 2010, Mr Payne’s residence application under the Entrepreneur category was declined by Immigration New Zealand as he did not have an acceptable standard of health. A medical waiver was carefully considered but declined by Immigration New Zealand.
Immigration New Zealand’s decision was upheld by the independent Residence Review Board (RRB) in August 2010. In its decision the RRB noted that although the family otherwise met residence policy, Mr Payne’s heart condition was estimated to cost New Zealand’s health system at least $25,000. The RRB mentioned that this was a “substantial sum for an overburdened health service.”The RRB also agreed with INZ’s decision to decline a medical waiver. “There is nothing about the appellant, his wife or their son, or the family cumulatively which could be described as compelling, such as to justify a waiver, when weighed against the high probability of significant medical costs at some point in time.”
The RRB has jurisdiction to recommend to the Minister of Immigration that they grant residence as an exception to policy. The RRB declined to recommend this in Mr Payne’s case.
The Associate Minister of Immigration has declined to intervene in the case as it has already been carefully and thoroughly considered by an independent review body which agreed with Immigration New Zealand’s original decision.
The Head of Immigration New Zealand, Nigel Bickle acknowledges the connection Mr Payne has made in Northland.
“There is no doubt he has a lot of support in the community but its impossible to ignore the fact that at some point in the future he’s likely to impose significant costs on New Zealand’s health services.”
Not out of the woods yet
Update: Mr Payne was eventually allowed to re-enter NZ on a temporary work visa, where he will eventually be able to apply for permanent residency. Of course there’s no guarantee that he will be permitted to remain permanently but it does give him time to put his affairs in order should he be refused a second time. We wish him well.
From 3 News:
Martyn Payne’s family say they miss him very much, but today they have found out that he will be able to return to New Zealand on an eight month work visa.
His daughter and grandchildren – as well as the small community of Kapiro – have been anxiously awaiting an immigration decision that will allow Mr Payne, who is originally from England, back into New Zealand.
A statement from New Zealand Immigration today says this decision will allow Mr Payne to “get up to date medical assessments from his specialists in New Zealand so that he can lodge a new residence application”…more here