Analysis: Government stops short of calling health system a crisis

Health Minister Andrew Little stopped short of calling it a health crisis.
Health Minister Andrew Little stopped short of calling it a health crisis. Photo credit: Newshub, Getty Images

Peter Wilson for RNZ

Analysis - A health 'crisis' is the latest of the government's cascading problems as National continues to claim it can't deliver anything that matters, the Gib board shortage is elevated to ministerial taskforce level and the new police minister gets to work.

Opposition parties call it "the health crisis". The government prefers "system under pressure".

The problems besetting it were front and centre on the political stage this week as one report after another suggested the opposition had got it right.

A 1News report last Thursday started it. A woman with a severe headache went to Middlemore Hospital's emergency department but left because of long wait times. Returning several hours later she was diagnosed with a brain haemorrhage and died in intensive care.

An investigation is underway.

This week it was reported that Counties-Manukau DHB was paying GP surgeries $350 per patient to offer free appointments to help ease pressure on Middlemore's ED.

Capital and Coast and Hutt Valley DHBs delayed planned care for four weeks, on top of a two-week deferment, as they struggled with unprecedented staffing shortages and demand from winter-related illnesses.

Hospitals in the Wellington region were handing out vouchers for free GP after-hours appointments for patients.

Last week Middlemore Hospital closed its ED for three hours and diverted patients arriving by ambulance to North Shore Hospital.

Dr Peter Boot, medical director at NorthCare Accident and Medical, told the New Zealand Herald he was waking at 4am worried about his patients after working gruelling 12-hour shifts.

"I'm burnt out and I've already been in tears… the whole health system is falling to bits," he said.

On Monday Boot saw 62 patients with many coming from ED where the wait times were unbearable.

To perform "safe, proper medicine" a GP should be seeing about 20 patients a day, he said.

The Herald published figures, obtained under the OIA, which showed Middlemore Hospital's ED managed only 68 percent of patients within six hours last month, leaving 32 percent (26,791) waiting longer than the target time.

Health Minister Andrew Little disputed the data, saying ED wait times fluctuated and it was impossible to establish a pattern from one month, the report said.

Questioned about the overall situation, Little acknowledged the system was under pressure, RNZ reported.

"We do have a staffing shortage, we also have a flu season at a level we haven't seen for the past couple of years and we have staff absenteeism at a level we've never experienced before," he said.

Despite repeated questioning, he stopped short of calling it a crisis.

National's health spokesman Shane Reti didn't have any doubts about it.

"He is dreaming. Show me one ED, show me one DHB, that is not in crisis," he said. "Just choose one, any one, and convince us that the health system is coping. He is wrong."

Reti said the system was slowly breaking, across all areas.

National's health spokesperson says the health system is breaking.
National's health spokesperson says the health system is breaking. Photo credit: Hui

National's leader Christopher Luxon weighed in on Morning Report: "We're 4000 nurses short at the moment and again a lot of it can be solved by actually opening up our immigration settings, making New Zealand attractive relative to Australia, Canada and other places," he said.

Luxon said his party had the answers and three things needed doing - bring in a skilled workforce and accelerate the path to give midwives and nurses residency; invest in frontline services and staff rather than bureaucracy; and put in place health targets which the government removed.

He expanded his criticism to include everything. "This government cannot get anything done. It doesn't matter which portfolio you pick up, they're actually spending more money, hiring more bureaucrats, and getting worse outcomes."

Luxon cited health waiting lists: "We've gone from 1000 people waiting more than four months to see a first specialist (a first specialist appointment) before Covid to almost 15,000 and now post-Covid we're at 37,000."

ACT leader David Seymour said Little had "become a spectator in in his own portfolio" and more had to be done to get health workers back on the job.

While this was going on, the government was facing criticism for allowing the shortage of Gib board to reach crisis proportions. The brand is produced here by Fletcher Building and seems to be used almost exclusively.

There were reports of stalled building developments and desperate attempts to import other brands of plasterboard. RNZ has previously reported the shortage has placed a stranglehold on the construction sector.

The building and construction portfolio was taken away from Poto Williams last week and given to Megan Woods, one of the government's can-do ministers.

She announced she had set up a ministerial taskforce to fix the problem. It includes key construction, building consent, and supply chain experts. The appointments have been made.

It will look at whether regulation of alternative products is needed, ways to streamline the use of products untested in the market, new distribution models, advise on consent approaches and supply chain concerns.

Luxon said forming another taskforce wouldn't get the job done. He wanted a bill to be passed under urgency allowing imports that met Australasian standards and actively seek them out.

Seymour said equivalent brands were used in Australia and the US.

"It's not technologically sophisticated, it's just a sandwich of cardboard and plaster of paris," he said.

"The government has rushed through every possible type of legislation under urgency and when it comes to a serious problem holding up the whole building industry, threatening industry players with bankruptcy, all of a sudden - crickets, they're going to set up a taskforce," he said.

National's Andrew Bayly questioned Woods in Parliament, wanting to know when something would actually happen.

The minister said the taskforce wasn't a formal inquiry, it was a group of private sector experts who would advise her to ensure "the effective and swift" implementation of measures.

"I expect issues raised at the first meeting next Monday will be actioned straight away," she said.

Megan Woods has set up a ministerial taskforce to address the Gib shortage.
Megan Woods has set up a ministerial taskforce to address the Gib shortage. Photo credit: Getty Images

New Police Minister Chris Hipkins got to work this week and acknowledged on Checkpoint that crime statistics would be a partial measure of whether he was making a difference in the job.

He said gang crime was clearly one of the areas where there had been "escalation" and it was a priority issue for him.

He would be looking to see if there were any other "legislative tools" that would help police, apart from the firearms protection legislation that's going through Parliament.

Banning gang patches, which National proposes, was not on his agenda, Hipkins said. There was evidence it did not reduce gang activity, just made it less visible.

National's police spokesman Mark Mitchell, who had been harassing Poto Williams for months until the portfolio was taken from her, had his first crack at Hipkins at question time on Wednesday.

He didn't find a soft target. Asked why the government hadn't "done something" instead of allowing gang membership to grow by 40 percent, Hipkins turned it back to National.

"When we make commitments around policing we deliver on them," he said. "I note that something like firearms protection orders, for example, were promised in 2014 and not delivered. They were then promised again in 2016 and not delivered. Our government is actually going to deliver them."

Mitchell went for the accusation which tends to make ministers angry.

"Why, under this soft on crime Labour government, with record investment and record police numbers, are our streets more dangerous, with 23 drive-by shootings in Auckland, terrorising local communities?" he asked.

It's the soft on crime bit that gets them.

Hipkins said he would tell the House what a soft on crime position was. "It's saying that, if gang activity is taking place, as long as we can't see it, it's not a problem. That is the most soft on crime position I have seen for a long time and it came from that member."

Stuff's political editor Luke Malpass said that on the shortest day of the year and as a cold snap hit the country, it wasn't surprising the government seemed to have a case of the winter blues.

"While Covid-19 may have retreated from the front pages, what we are seeing now is the consequences of the government's Covid-19 policies during 2020 and 2021," he said.

"Politically, it gets tougher from here. The victories of Covid-19 management are now well behind the government.

"But the deferred challenges as a result of the response to Covid are here now. And that's without worrying about a resurgent opposition.

"Winter is here for the government."

There was one happy occasion amid the gloom. Parliament's grounds were re-opened, restored to pristine condition after being wrecked by the protest.

*Peter Wilson is a life member of Parliament's press gallery, 22 years as NZPA's political editor and seven as parliamentary bureau chief for NZ Newswire.

RNZ