This Is Christchurch: NZ Pandemic Response Raises Questions Over Future Structure of Health System

First published on This Is Christchurch
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We’re still evolving what this site is about and how we will use it, but we are sticking for now with our plans that it won’t be a general political site, but that we will continue to use it to address a small selected range of issues that we feel are of key importance. The public health system of NZ and its structure is the issue we have been focusing on most recently.

The emergence of the Covid-19 pandemic and the resulting failures within our health system have naturally resulted in a focus on how to best address the incapacity within public health to gear up a rapid and effective response to events such as pandemics. The key suggestion is that the Government will have to find some way to increase capacity within the system. However, there does not appear to be any indication at present of any Government policy that would enable this to occur, especially compared with the ongoing debacle over CDHB. The Simpson Report does not propose to abolish the DHB system and we have not seen anything within it that suggests the focus be changed to predominant centralisation of health provision in the way that some political commentators are advocating for a Government response specifically to pandemic preparedness.

The real question now in light of the CDHB funding conflict is that the Government is actually prepared to produce an appropriate response to health system capacity issues and so far the evidence is not encouraging. Even if we take into account that this pandemic will eventually fizzle out, undercapacity in health is and has been a long term issue in NZ. So far the Government does not appear to have been able to address this, and it is questionable that the restructuring of public health proposed in the Simpson Report should become more important. At the end of the day, the work proposed by Simpson is very unlikely to change the nature of public health facilities as they currently exist within the community, because these facilities are the bare minimum of what is necessary to ensure the provision of services at just the current level.

The key credibility issue that it is necessary for the Government to address is, therefore, the failure of either the Prime Minister or the Health Minister to date to engage with the CDHB staff campaign, since the issues raised there are key to engaging with the undercapacity issue throughout the public health system as a whole. It is just possible that the Government is proposing that Simpson’s reforms will produce such massive efficiency improvements that the capacity issue can be addressed without major funding increases, but we believe this to be highly unlikely. It must therefore be asked whether the Government does, in fact, have any coherent policy on doing on what is actually needed to fix the health system, or whether the deeper issue is a lack of competence in this portfolio as in others.