Media in the middle of political skirmishes over sickness and health
Photo:
Sunday Star Times
Mediawatch
: This week the
latest Ipsos Issues Monitor survey
showed 'inflation/cost of living' was - again - the top concern of Kiwis.
No surprise there - or that 'healthcare/hospitals' was in second place.
"It continues on its upward trend, reaching its highest level of concern (43 percent) since tracking began," Ipsos said.
That - and the fact that more of those surveyed chose Labour as the party most capable of managing health - would have stood out for the government. The same is true of how the issue plays out in the media.
Under the headline
The political problem of health
Health Minister Simeon Brown told the
Sunday Star-Times
last weekend the job "matters to every New Zealander from the moment they're born to the moment they die. It's a huge responsibility, but there's also significant opportunity."
He'd just announced an opportunity for private hospitals - instructing Health NZ to make long-term deals with them for elective surgeries.
"We haven't been ideological about it, we've been focusing on pragmatic solutions to ... maximise what's delivered both in the public and private system," Brown told Newstalk ZB the same day.
The next day,
New Zealand Herald
political editor
Thomas Coughlan reported
official papers showed Treasury reckoned further cuts to health would be needed to meet the demands of the government's health delivery plan.
But that didn't come up when the prime minister appeared that day on Newstalk ZB for his regular Monday morning chat.
The host Mike Hosking said he couldn't agree more when the PM said people don't care who's doing their long awaited op when they are staring at the hospital ceiling.
But then Hosking told the prime minister about an interview last week with a Christchurch surgeon who works in both the public and the private systems.
"We need to be more flexible in public (hospitals). They even come round at one o'clock and say it looks like you'll finish after 4 or 4.30, so we won't let you do your second case," Chris Wakeman told Hosking last week.
"You wouldn't close your factory at 4 o'clock if you still had work to do," he added.
Later, Mike Hosking read out a text from an unnamed listener who claimed nurses and anaesthetic technicians insist operating stops early if it looks like it's going to go past 4pm.
The following day Mike Hosking
asked Brown
if surgeries that might overrun 4pm were routinely postponed.
"Look, there are heavily unionised contractual arrangements in the public system and so you do end up with inefficiencies throughout the system. Those issues need to be dealt with by Health New Zealand to make sure that it is more efficient," Brown replied.
"These union agreements ... drive inefficiency and a lack of productivity. These are issues that do need to be resolved as part of (Health New Zealand) negotiations with the unions."
Health Minister Simeon Brown
Photo:
RNZ / REECE BAKER
"Absolutely not. The limits are more about management decisions on staffing costs, availability of recovery beds and how to distribute operating theatres between acute and elective work," Sarah Dalton, executive director of the Association of Salaried Medical Specialists told
Mediawatch
.
"The barrier to providing more elective surgeries is a refusal to pay staff required to work longer hours ... and inability to provide sufficient staff to run our operating theatres to their maximum capacity."
"We don't have anything in place that would stand in the way of doctors opting to work in a different work pattern or longer hours. And in fact, many of them frequently do.
"Typically surgeons and anaesthetists work 10 hour days. A number of hospitals sometimes run what are sometimes called twilight theatres in the early evening or on weekends.
"I don't think the way that the discussion has been presented is entirely fair - and it is somewhat misleading.
"It is concerning to us that 'private' is seen as the answer when in fact they are already near capacity for what they can do. And we also have significant doctor shortages."
Sarah Dalton
Photo:
LDR / Stuff / Kevin Stent
Hosking [https://www.newstalkzb.co.nz/on-air/mike-hosking-breakfast/audio/richard-sullivan-health-nz-chief-clinical-officer-on-surgeries-not-being-performed-past-4pm/
returned to the issue] with Health NZ's Chief Clinical Officer Dr Richard Sullivan on Thursday.
He said the proportion of "early finishes" in theatres doing elective surgery is declining - and under the government's 'elective boost' programme they had been doing some surgeries on Saturdays and Sundays too.
"It's more than just the unions. You'd need a quite a big workforce to run full Saturday lists all the time. That's not to say we shouldn't look at that, but we need the most efficient way of getting people through our theatres," Dr Sullivan said.
Hosking told his listeners the bottom line in public hospitals was: "If it's 4:30, we're going home."
There's a bit more to it than that.
While there is some extra capacity in theatres, many more people would have to be paid for more hours to do more out-of-business-hours. They don't have all the staff to do a lot more of elective surgeries, in either public or private hospitals
And as
the Herald'
s Thomas Coughlan reported earlier this week, Treasury reckoned the Health Delivery Plan targets could mean increased spending cut targets in the year ahead. Health workforce pay increases would be limited to a degree described as "unprecedented," Treasury documents also stated.
In the
Herald
, Brown rejected Treasury's conclusions. He said government provided Health NZ
additional funding
in three successive Budgets and Treasury had not consulted the Ministry of Health or Health NZ before reaching its conclusions.
"Why do we still have 10 days' sick leave?" Hosking also asked the PM last Monday.
He said the question had been put to him by "my tech guy" working at his house.
The tech guy got a headline-making response on that from the nation's leader.
"So we had five sick days until Jacinda [Ardern] decided we needed ten for Covid. Can we agree that it's gone-ish - and therefore we might need to do something about sick leave?" Hosking asked.
"We might need to do things about pro rata and sick leave as well, because you know, people who are on part time contracts are getting full-time 10-day equivalency. Brook Van Velden is working through some of those issues," Luxon replied.
The possibility of that went straight into Newstalk ZB's news bulletins.
When the prime minister did his turn on RNZ's
Morning Report
soon after that, he was asked if he would support a cut in sick leave.
"Well, I think there's probably a need for us to look at it ... and just make sure that we've got that setting right," he replied.
ZB's political editor Jason Walls was puzzled.
"Sick leave is an entitlement that everybody has. So it's not just some beltway story. It is an interesting thing for the Prime Minister to bring up. It was just Mike's mate that was talking about it."
But Mike's mates behind the mic at Newstalk ZB were teed up to talk about sick leave all day.
"A very strong hint that 10 days of sick leave might be going the way of the dodo," was Kerre Woodham's take when she followed the
Mike Hosking Breakfast
.
"I get that it's a godsend if you are prone to infections during winter, but really spare a thought for the employers."
Employers such as perhaps Nick Mills, a hospo guy in the capital who's also the host of
Wellington Mornings
on Newstalk ZB.
"I go with the flow. But I'm in an industry where people take the absolute mickey," Mills told his listeners in the capital.
"They're just teasing it a bit at the moment on the fact that it's going to be for only part- time employees, but that's going to change," he said.
One hour later they were hearing more on this on ZB in Canterbury from the local host, John MacDonald.
When Matt Heath and Tyler Adams took the ZB mic for the full national ZB network at noon, they had a similar sense of what was common sense.
"10 days a year? Does the average person walking around need 10 sick days a year? I don't think so," Heath said.
The questions for the workplace relations minister Brooke van Velden followed.
On
ThreeNews
and
Checkpoint
she batted back questions about whether it was a gender issue. She was also taken aback that this was a talking point at all.
"The only reason we're talking about this is because Mike Hosking was talking about it this morning. There was nothing from the government side to say we had an announcement to make," she told
ThreeNews
.
In the end it will be months before all this is fully aired in Parliament, long after Mike Hosking's tech guy first put it on the agenda.
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When they left hospital they were given some Vitamin D in a little bottle, and a prescription for iron and Vitamin D. The following day Duncan went to a Manawatū pharmacy with the prescriptions. He was given the iron, but said the pharmacy refused to give the Vitamin D as the staff thought the dosage was "too high for her age and her weight". The staff said they would call the neonatal unit and follow-up. A few days later Puklowski received a call from the unit to organise a home care visit. During the call she was asked if she had any concerns, and Puklowski asked if they had been contacted about the Vitamin D. They had not, and said they would follow up and rewrite the prescription along with a prescription for phosphate. A day after the phone call, on 2 July, Duncan went to the pharmacy to collect the medication and came home with just the phosphate. Unbeknown to the parents they had been given an adult dosage of phosphate. The label on the medication directed them to dissolve one 500mg tablet of phosphate twice daily in a glass of water. That evening they gave Bellamere her first dose of the medicine in her formula water. They would give her three bottles in 24 hours as was recommended. The couple noticed in that period that her eating was off, and thought she was "extra gassy," Puklowski said. "She was still feeding fine. She just wasn't maybe going through a whole bottle compared to what she was," she recalled. Then, the day after she got her first dosage Bellamere suddenly stopped breathing. Bellamere was taken to hospital and rushed to the emergency department. Once she was stabilised she was taken to the neonatal unit where she stayed overnight before she was flown to Starship Hospital. The couple had taken a bottle of the medicine with them to Starship Hospital. She gave it to the staff who saw that they had been given an adult dose. The staff then requested the original prescription which confirmed the script had been written with the correct dosage, but somehow the pharmacy had given the wrong dosage Puklowski said. "I keep thinking about how much she ended up having and it just makes me feel sick." Tragically, Bellamere died at Starship Hospital on 19 July. On Wednesday, a Ministry of Health spokesperson told RNZ there were a number of investigations underway. "Medsafe has completed an urgent assessment and is comfortable there is no immediate patient safety issue at the pharmacy. Medsafe will continue to work with Health New Zealand and these findings which will inform the information provided to the coroner. Medsafe is also sharing information with the Pharmacy Council. "Once these reviews are completed, we will be able to look at next steps." Health Minister Simeon Brown earlier told RNZ he raised the incident with the Director-General of Health as soon as he was made aware. "She assured me that there would be an investigation undertaken by both the Ministry of Health and Health New Zealand. That investigation is underway. "I am advised that this incident has led to Medsafe undertaking an urgent assessment of the pharmacy. A further investigation is being undertaken by the Pharmacy Council, and the death is also the subject of a Coroner's inquest." Health agencies would provide information to the coroner as needed to support the inquest. "It is important that the reviews are undertaken, and that the circumstances that led to this incident are understood. I expect that these investigations may propose recommendations, and that these will be reviewed once reports are complete." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
