“The Health Care System Is Second Rate”

11 February 2010
Continuing in our series of Migrant Stories: first hand accounts of migrant life in New Zealand, taken from locations around the net.

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.

“As a nurse in the US with over 3 decades of experience, I can tell you I had one helluva time trying to get registered to work as a nurse in this country. I have found there is prejudice here – even if you are skilled and willing to work, not coming here looking for a handout – just a JOB. (I lost track of the number of applications I filled out – to do ANYTHING – before I literally got lucky and got a job at a DHB hospital as a Health Care Assistant, which was a major stepping stone to getting the registration.)

My partner, a kiwi, was just as surprised (and disappointed) at the difficulty I had. I make a good living here, and it’s because I do work hard. And, to be honest, I’m going through some not unexpected issues where I work – but in talking with other foreign (and young, less experienced) nurses, it seems to be the norm. So I am just biting my tongue and getting through it; I know enough to recognize it and I can deal with it. Some of it is because it’s New Zealand, some of it is because it’s nurses.

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.

The saddest thing is, I believe New Zealand, because it IS a small country, has the potential to be a world leader in health care. Too bad it will never happen, because nothing will change unless there is a catastrophe that makes it absolutely necessary and without option.

My life here is simpler, and I do delight in the small things – like seeing the covey of quail cross the road when I’m on my way to work in the morning, or seeing gorgeous flowers in bloom, or just simply the ever changing scenery (which at the moment is pretty brown and crispy.) So, I’m staying, even though I know my partner is starting to get the itch to go back to Oz and make some money. He has been looking for a job for several months. So, yeah, even if you have experience and education, that doesn’t mean smooth sailing as far as getting a job here.

Excuse me, though, as I must put on my rose-colored glasses and go sit in the sun. (First applying sunscreen so I don’t develop skin cancer!)”

Doctors and Nurses Notes
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.

In 2008 The College of Nurses, Aotearoa, NZ Inc. advised the incoming government of the following problems:

*“Unmanageable workloads and limited job satisfaction through inability to maintain professional standards of care deter people from remaining in the nursing profession. Most nurses graduate with high levels of debt and emigration is seen as a sensible option for many who face many years of debt repayment in New Zealand.  Currently 23% of the NZ nursing workforce is imported, often from countries which can ill afford to lose nurses.

* The many innovations and initiatives that nursing has striven for (such as establishment of the Nurse Practitioner role and increased nursing services in PHOs) are consistently slowed, impeded or blocked at health policy level.

* The magnet hospital movement is a strongly evidence based solution to patient safety and nurse workforce recruitment and retention. It remains largely ignored in NZ despite vigorous efforts by nursing to see it promoted.

* A larger Maori nursing workforce is needed to provide services to Maori

See also an article in The Nelson Mail, 6 March 2010: “Nurses fear cutbacks put lives at risk” :

” The Nelson Marlborough District Health Board has been told by Health Minister Tony Ryall to stop spending so much money because of its worsening deficit, but nurses are saying the constraints are putting patients’ lives at risk.

Nurses who expressed concerns over these risks are too scared to be named for fear of losing their jobs…

(A) nurse said sometimes there were only two or three nurses on an afternoon shift for a full ward of 30 patients and one house surgeon for the whole hospital. “Concerns have been raised through the appropriate channels and nothing gets done about it,” she said.

A third nurse, who left her job because of the stress, ended up hating nursing. “You leave there feeling like you haven’t done your job.”

There was a culture of bullying and a “sit down and be quiet culture” at the hospital, she said.”

Updated 11 March 2010: The Nelson Mail
“Nelson nurses tell of ‘horrific workloads'”

“…One nurse, who said she sought counselling after months of stressful shifts, ended up resigning. She said six other nurses had also left their jobs at the ward she worked in since September last year and most were not being replaced.

The woman, who wants to remain anonymous, said she was speaking out because she believed it was important to battle for patient and nurse safety. She believed nurses needed a lawyer to work in their defence because of a lack of action over their concerns from the New Zealand Nurses Organisation and hospital managers. Letters shown to The Nelson Mail outline a detailed complaint she made to senior management, including the director of nursing, last year.  In the letter, the nurse points to a shift last winter which prompted nurses to file an incident form.

It was one of the “many horrific shifts” she had to work. There were four nurses when six should have been on with six admissions, a cardiac arrest and a death. She had no meal break and each nurse had seven to eight patients as well as a student to oversee…

SPEAKING OUT

Former Nelson Hospital nurse: “As nurses we expect the odd busy horrible shift, but this becomes an ethical dilemma when the majority of shifts are like this.”

Lives have already been put at risk, with deaths occurring.”

The environment at this hospital is already at crisis point, with staff leaving and patient deaths. How the hell are staff going to cope with cutbacks if the environment has already been so badly affected in the past few years? The winter will be a nightmare from hell.

Current nurse: “Maternity staff have been leaving in droves over the past 18 months and there has been a policy not to replace them.”

Today’s posts – click here

11 thoughts on ““The Health Care System Is Second Rate”

  1. from latest Dental Health Survey as described by age concern

    quotes
    “older people experienced relatively high levels of untreated decay and missing teeth.”
    National president Liz Baxendine says “most seniors get no help with dental bills, and many are struggling to pay for treatment. The problem will get worse as increasing numbers of older people enter later life with expensive-to-maintain fillings and partial dentures.”
    Almost half of the surveyed adults (44 percent) said that cost is a major barrier to visiting their dentist. One in four had had to skip recommended treatment because of the cost.
    end quote

    The national health care does not cover your dental and optical. Those are services you must pay for yourself. They are exorbitant:
    http://topnews.net.nz/content/211164-dental-care-costs-heavily-new-zealand

    Like

  2. I am a Canadian trained nurse with a 4 year university degree. I am amazed at how little is given to poor NZ nursing students in the way of learning. My education was much better than nursing here, and the nurses here are really just working as CNA’s. In Canada, nurses work WITH the doctors as a team, so it is very good for patient advocacy. Here in NZ, doctors are inferior (I find that most Canadian or USA professional nurses are trained beter than the doctors here in NZ since we have been trained to diagnose, etc)and have the GOD syndrome. This is very 1920’s-ish, and thus, NZ refuses to keep up with the rest of the world in healthcare. Nurses just don’t have any real power here, and are told to obey and shut up. God forbid you should have any real knowledge – because the doctors don’t want your input. It is very scarey indeed to think that these doctors will end up taking care of me if I get sick, and don’t want to be questioned. NZ needs to get with the times and make nursing a “professional group” — in other words, make it a SCIENCE, and offer 4 year university degrees like they do everywhere else.

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  3. Here’s a site you might like. You plug in two countties and compare them. The source seems to be the CIA Factbook, and note that many important things are not actually compared, such as the way large underclasses in some developed countries pull down the statistics – if you are not a part of that underclass, then you might not experience the disadvantages that are reflected in the general statistics. And of course the quality for value in the health care system…!

    http://www.ifitweremyhome.com/compare/NZ/SG
    If the statistics are properly reported for both countries (NZ and Singapore – latter picked at random) then:

    If Singapore were your home instead of New Zealand you would…

    consume 5.5 times more oil
    make 84.25% more money
    have 58.9% more chance at being employed
    have 52.16% less chance of dying in infancy
    have 37.36% less babies
    experience 32.87% more of a class divide
    spend 37.25% less money on health care
    use 12.54% less electricity
    be 2 times more likely to have HIV/AIDS
    live 1.58 years longer

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  4. http://www.odt.co.nz/news/dunedin/78593/colonoscopy-039the-only-way-be-sure039

    “Health services in New Zealand still seem to be an ambulance at the bottom of a cliff rather than preventative.”

    This still applies. Patients with symptoms of early cancer are denied expensive “technological” screening until they become dysfunctional enough in working life that it cannot be ignored. In the 5 years between this lady’s one colonoscopy and her next one, she could go metastatic, with a family history like that.

    Escapees from more capitalist healthcare systems, pay attention. The free for everyone healthcare is more of a free-fall.

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  5. Seen on Facebook, orig. spelling, how’s that great free health care in NZ? Citizens getting what they pay for?

    Iv had a really bad couple of weeks so haven’t come on here. but i should of. at least u girls understand. then i come bak on here and i just feel really mad. no one is listening to us in dunedin. the specialists don’t understand what its like trying to live day by day through all the pain and uncomfortable feelings we hav to endure. I refuse to lose my position in my job so take painkillers to get me through the day. i come home exhausted and nearly in tears from having to put up with the pain and stress all day. and i’m not the only one. there are so many women out there who suffer in silence because they are scared to go back to the hospital because they are not being heard. there are so many women suffering year after year because they are not being treated properly. its getin ridiculous and something needs to b done. but wat?????
    Dunedin Hospital fb page
    http://www.facebook.com/topic.php?uid=106624418622&topic=13148#topic_top

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  6. New Zealand is not a communist country, but it is much like Cuba in its misleading “self-reporting” and image management. The positive figures we hear are often calculated in such a way as to make New Zealand look as good as possible. Take for example the infant mortality figures described in the link below. Americans who love Michael Moore (and every NZ video store has stacks of his crap on the shelves – they lick up everything he says) should love New Zealand. Americans who think MM’s pieces are, well, at least in part propaganda will be unpleasantly surprised to find that New Zealand operates the same way. This is not some kind of free humanist paradise, believe me! It is harsh. If you have a car accident, you’ll be sewn up and maybe given an artificial limb in a few years if you’re young enough. Otherwise…

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  7. Access to new cancer drugs – New Zealand is among the slowest.

    The fact that so many old people move and retire here knowing (?) that they will not be prioritised for care, and will not receive good care when they are given it still surprises me.

    http://www.everybody.co.nz/page-3d14e2f5-1d22-4130-bd37-ef1dbe5531ca.aspx

    From that article:
    Patients’ access to new and better cancer drugs varies widely depending on which country they live in, a new Swedish study says.
    Researchers analysed data on access to 67 innovative cancer drugs in 25 countries, including Australia, Canada, Japan, New Zealand, South Africa, the United States, and 19 European nations.
    The study found that Austria, France, Switzerland and the United States are the leaders in the use of new cancer drugs, while New Zealand, Poland, the Czech Republic, South Africa and the United Kingdom are the slowest to use new cancer drugs.

    and

    “Progress in medical treatments has meant that over half of the patients diagnosed with cancer will now be ‘cured’ or die from other causes. However, these benefits are only realised once the drugs get to the patients,” study co-author Dr Bengt Jonsson, director of the Centre for Health Economics at the Stockholm School of Economics, said in a prepared statement.

    “Our report highlights that in many countries new drugs are not reaching patients quickly enough and that this is having an adverse impact on patient survival. Where you live can determine whether you receive the best available treatment or not. To some extent, this is determined by economic factors, but much of the variation between countries remains unexplained,” Jonsson said.

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  8. Pensioners intending to ail and die in New Zealand – take note. ‘Frustrated’ geriatrician leaves – bad news for New Zealand

    Dr Gerry McGonigal has expressed frustration at the way elder care and stroke services are arranged and delivered in many New Zealand hospitals. He is returning to the UK this month. This is bad news for New Zealand, which faces an overall shortage of geriatricians.

    Wellington hospital not having a specialist stroke unit is very unusual for a major tertiary centre in a developed country. “I could understand a very small hospital not having a stroke unit but this is a main centre. Stroke units were one of the major therapeutic advances of the late 20th century! Without such a unit it is not possible to deliver quality stroke care and this is one of the main professional drivers I have to return to the U.K,” he says.

    Retire to NZ, hand your pension over and die far from home and family with no smiles, respect or dignity…sounds like a good idea? Not.

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    • New Zealand’s loss is Britain’s gain.

      It’s shocking to know that migrant doctors, used to the demands of Britain’s NHS, can feel so frustrated and demoralised with the health system in New Zealand. This is another incidence of the country and its ‘world class health system’ being over-sold to the outside world.

      The biggest losers are of course the patients who are consistently losing out on first class health care, as we’ve said on many times before a country is best judged on how it treats the most vulnerable members of its society.

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  9. I do not think they do this deliberately as a policy of intentional cruelty. It is the result of no money, poor planning. I know very kind people who work with the terminally ill and aged. They do not have the funds here, and they make hard and sometimes poor choices with the funds they do have. This says it all –

    “Stroke units were one of the major therapeutic advances of the late 20th century!”

    Ill or old people cannot help New Zealand survive, so precious funds can’t be wasted on them. It is much like end-of-life Eskimoes being pressured to self-select and walking out into the snow to die. I do think many things about New Zealand can be explained by hard choices they have to make with very few resources.

    Where I truly object is where New Zealand advertises itself as a modern and thriving economy with a good living to offer. It may be true that the living is good compared to some areas of the world. But not to those from N/W Europe or North America. And in some respects, not even to those from other countries, such as Russia. The place has its good points. It has some great people. But the downsides should be given way more air time. Thank you for doing this!

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