Josiah Profile

Time to trade in: NZ healthcare needs an upgrade

By Josiah Brown August 13, 2024

The New Zealand health system is on life support. Hospitals don’t have doctors, newly built facilities sit empty, and patients endure agonising wait times. “Crisis” might describe the situation—if the word still had any meaning. The problem is simple: Kiwis are not getting timely care due to space and staff shortages.

While political drama swirls around Health NZ’s $1.4 billion deficit, people suffer.

Now we have a commissioner tasked with fixing our health system. Can one man succeed where others have failed? Will more tinkering with decades of tweaks help? Insanity is repetition with the expectation of different results.

As long as we rely on patch-up jobs, stories of public healthcare failures will persist.  

Consider these examples: a man referred by his GP to North Shore Hospital’s emergency department waited ten hours to see a doctor, relegated to a corridor passing for a ward. In another instance, a newly opened 150-bed facility that promised to slash surgery wait times has failed to treat additional patients; operating theatres elsewhere closed to staff it.

If our health system were a vehicle, you’d say smoke is pouring from the proverbial car bonnet, obscuring our view as we hurtle toward oblivion.

This understaffing issue has become a self-fulfilling prophecy. As workloads increase, fewer people want to remain in NZ’s public health system. A student doctor revealed to me that many of her peers plan to work overseas. According to the New Zealand Medical Journal, reasons include “excessive workloads, significant on-call duties, long hours and unpaid administrative tasks.” And doctors aren’t the only ones feeling the heat.

A medical laboratory scientist told me that their department has been down a full-time equivalent for more than three months despite prior warning. The position was advertised and people applied, but central management failed to approve the hire. They didn’t reject it, though. They just didn’t respond. A centralised bureaucracy will do that.

If our health system were a vehicle, you’d say smoke is pouring from the proverbial car bonnet, obscuring our view as we hurtle toward oblivion.

By identifying opportunities to develop our existing workforce, we can maximise output and alleviate burdens elsewhere.

It’s clear that we need to train and retain more health professionals. A report titled Lifeline for Health found that more than 300 GPs need to join the workforce every year for the next decade just to maintain our rate of GPs per capita. This is partly due to an ageing workforce. A 2022 survey found that 37% of GPs intend to retire by 2027 and 55% by 2032.

Staff retention is somewhat dependent on competitive pay with Australia, which may require different funding or delivery models to achieve. But equally important are steps toward improving working conditions for medical staff who report alarming levels of burnout.

By identifying opportunities to develop our existing workforce, we can maximise output and alleviate burdens elsewhere. More nurse practitioners could be part of the solution, being able to diagnose, treat, and manage patients in ways that registered nurses cannot.

The government needs to be more ambitious in its problem-solving. Reducing bureaucracy and wasteful spending will help, but fine-tuning an old Volkswagen Beetle won’t win us any races. In fact, it’s got us where we are now.

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Communications Coordinator Josiah Brown explains the thinking behind his column.

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