Gareth Morgan and Geoff Simmons, Authors of Health Cheque
In general, National has been focused on improving the efficiency of service delivery, and ploughing those savings back into training more doctors and doing more elective surgery. No-one doubts that this has resulted in more operations, and kept health off the front pages of the newspaper. Whether or not it is making us healthier is a whole other matter. One of the more bizarre announcements trumpeted 31 more operations for people over 100 years of age! Is this really our priority?
National’s target based approach has been criticised by some as narrow, but it seems to have worked well for certain easily measurable areas of healthcare, like improving immunisation rates.
National has made a big deal of cutting administration, but these savings are small bikkies compared to the real cost drivers in healthcare. Health has still been the fastest growing line in the Government’s budget, despite funding being below the generally recognised ‘health inflation rate’ (the increase needed to keep the same services going) of 4%. While the increases in spending have been lower than the preceeding 9 years under Labour, we are still a long way from having the health budget under control.
The early period of the last Government was characterised by a number backward steps in preventative measures, particularly removing several policies to promote healthy eating. Labour’s approach was characterised as ‘scattergun’, which is probably fair because there was little concern for spending on what works, but the changes made by National made the same mistake in ignoring the evidence and proceeding with a dogmatic anti-‘nanny state’ approach. For example they claim to have brought greater ‘balance’ to the campaign on healthy weight, but the evidence suggests their focus on exercise is only a part of the puzzle.
More recently, sometimes at the behest of coalition partner the Maori Party, the Government has brought in a number of commendable preventative measures:
Increased focus on smoking prevention
Tackling rheumatic fever
Whanau ora – although this is a bit of a moving feast and may take many years to work out what it is, let alone whether it works.
Also of note was the supply agreement with the Greens which reinstated the previous Government’s home insulation programme – a massive win/win for energy efficiency and preventative health (though the job is far from done).