Prebble on Why Health is Sick

From the latest “The Letter” by Richard Prebble.

There are now 12,000 health bureaucrats, one for every hospital bed. Despite an increase in hospital spending of around 40%, elective surgery has increased by just 8%.

The private system has always been more efficient but the gap is increasing. The cost of a night in intensive care at Auckland Public Hospital costs $3901, while at the private Auckland based Ascot Hospital it is just $929. The conclusion of the Gibbs Report into health, now 20 years old, is still valid. Gibbs found that the most efficient public hospital was more inefficient than the most inefficient private hospital. Answer; use the private system for all elective surgery.

Hospital Boards used to be connected to their local community and had a high degree of autonomy. Labour campaigned to restore elected boards and local control. But now the boards are there to do the Minister’s wishes. A directive by new Minister of Health Pete Hodgson dated 27 March stated that no MP may visit a DHB without ministerial “permission“. If given a briefing the DHB is “to provide the Minister with a written report on the nature and details of the visit.”

Not one board protested at this removal of even the pretence of local autonomy. It took a complaint from ACT MP Heather Roy to the Auditor-General for the Minister to claim the directive was unauthorized. However the “corrected” directive of 6 April says that “it is normal practice for them [MPs] to approach the responsible Minister and advise of their intention to visit.” (False, MPs have never sought ministerial approval to visit hospital boards). DHB’s are advised to “please ring or email the Minister’s office and check that the requesting MP has advised the Ministers office.” “Following the visit, we would appreciate a written report”.

Question from yours truly. Why are the two sectors that give everybody the most grief-Health and Education, also the two most socialised sectors of our economy?

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