Fund a transition from acute crisis management to genuine healthcare

Obtain a mandate from the public to increase the proportion of GDP spent on healthcare. If you can't obtain the mandate, do it anyway. Then transform what is, at present, a functioning but under-pressure response system to acute emergencies into a system that increases the availability of counseling, mental health services, and elective surgery.

Do this by:

  • looking after medical staff so they don't leave/burn out.
  • taking back access to specialist care from the private sector.
  • investing in public equipment (the most glaring example is radiology and scanning equipment) so that NZ has a "First World" system.
  • increasing Pharmac's budget so that NZers have the same access to cutting-edge drug developments as Australians and people in other comparable jurisdictions, and fully subsidise wherever possible.
  • improving the attractiveness of general practice so that NZ has sufficient GPs (if necessary, create a GP-specific qualification, possibly with different entry requirements).

Why the contribution is important

NZ waiting lists for elective procedures are too long. The NZ public system works well when you have an emergency but does not work well when you require some other procedure that would vastly improve your quality of life.

People do not have sufficient access to mental health services, and the impact of untreated mental health problems is manifest in other costly services that we end up having to fund. Untreated mental health issues also create a ripple effect, causing more people to be victims.

There are insufficient GPs in NZ for NZers to have timely access.

Delaying access has measurable negative effects on patient outcomes!

by Sjlmass on February 26, 2023 at 10:59AM

Current Rating

Average rating: 4.8
Based on: 5 votes

Comments

  • Posted by Lorax March 11, 2023 at 13:10

    Agreed but improve access to primary care. I know we need more GPs but we can use existing GPs smartly by triage, phone and video consultations. Our trained doctors are always going to do their OE as doctors but they will bring their experience back when they return to raise their families.

    Just asking - I know we had a pandemic, but what resulted from the wellbeing budget of 2019?

    And we need to make access to primary care more accessible. I know it’s more affordable to those on a low income but what if you’ve moved house so many times you can’t find your CSC card? What if your family commitments mean you can’t wait 4 hours for a free clinic or you can’t get transport to the other side of town, but MSD are on your back to make sure you are fulfilling your emergency housing obligations? I don’t have the answers but these are the dilemmas.

  • Posted by Maree March 28, 2023 at 18:06

    I agree. However, I'm not sure that the answer is necessarily 'more GPs'. If you have a health problem, often it can take multiple visits to the GP, who act as gatekeepers to specialist testing and care, before a referral is made. Then you can wait months for the tests, and months more to see a specialist, even if you decide to go private to get seen a bit quicker. They may then order tests (sometimes the same ones that had already been done), and so the process slowly grinds on. Poor connectivity in patient records compounds the problem.

    It isn't surprising then that people instead turn up at the Emergency Department, either pre-emptively, or as a result of a mild problem evolving into a crisis due to the lack of treatment. Patients might have to wait a long time in the ED, but they are triaged, and sent off for required tests and imaging. The results of those tests and scans are immediately reviewed by a doctor with expertise in the relevant field, and appropriate arrangements made for follow-ups care.

    Given the importance of specialised tests and scans in diagnostics, and given the difficulty of a GP being an expert in everything these days, maybe our current system is not fit for purpose? Medicine now is fundamentally different to when our system of primary care was developed. The biggest advantage of the old primary health system - continuity of care - is mostly not being delivered now. It's almost impossible to see the same GP regularly; you just take whatever appointment might get you seen in the next week. And there's a massive churn in GPs; they aren't happy with the current structure either. The current primary health system isn't serving GPs or patients very well.

    Perhaps we need hubs for primary care associated with hospitals. So, instead of many GP clinics delivering sub-optimal care, have well-equipped large medical centres/small hospitals with the expensive diagnostic and treatment equipment and specialist doctors, better able to deliver one-stop care. For patients with chronic health conditions like diabetes, have centres with specialist nurses and doctors and other relevant medical professionals, streamlined screening and regular peer support meetings. Have much better national patient records so that continuity of care is achieved (just differently to how it was achieved in the days of the family doctor).

    The aim should be to actually identify problems and get people treated and feeling better as quickly as possible, rather than continuing to kick problems down the road and clogging the system with appointments that don't actually add value.
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