Duncan Garner: Diabetes brought me to the brink – now I'm changing my life
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
NZ Herald
2 days ago
- NZ Herald
Pharmac must shift from being a gatekeeper of cost to an enabler of health
Their tireless advocacy, amplified by journalist Rachel Smalley's sharp campaigning and the lived experiences of thousands of New Zealanders, has helped shift this conversation from the margins to the mainstream. The public mood is shifting. Pharmac, once internationally respected for its fiscal restraint, now faces growing pressure to demonstrate its relevance in a rapidly evolving healthcare environment. How Pharmac can transform into a health enabler: Cecilia Robinson writes that it's about reimagining what Pharmac is here to do. Photo / Getty Images The question is no longer whether Pharmac is doing the best it can with what it has, but whether its model is still fit for purpose. As someone who moved from Sweden, where access to modern treatments is standard, I was horrified to discover that many New Zealanders must turn to Givealittle to fund medicines available freely elsewhere. It's not just unfair. It's unthinkable. Therefore, the appointment of Natalie McMurtry as Pharmac's new chief executive comes at a critical time. While her background in Alberta's health system brings relevant experience, the task ahead is not just about leadership, it's about reimagining what Pharmac is here to do. Pharmac must shift from being a gatekeeper of cost to an enabler of health impact. Its role can no longer be confined to doing more with less. The public expects more transparency, compassion and to access medicines freely available in countries such as Australia, Ireland and Singapore. Pharmac's original model was developed in a different era, when the core challenge was controlling pharma companies, who were gaming the system, and skyrocketing costs. These issues are still important, but cost-effectiveness, particularly as measured through QALYs (Quality-Adjusted Life Years), is now too narrow a lens. It doesn't account for broader system benefits: medicines that prevent hospitalisation, help people stay in work, reduce caregiving pressure or support mental wellbeing. New Zealand's medicine gap persists despite a $604 million investment, with patient advocates urging change. Photo / 123rf We need to move towards a broader, health-impact framework. Medicines should not be viewed in isolation as a standalone budget line but as levers that can help to reduce pressure across the entire system. They reduce demand on emergency departments, improve quality of life and help address chronic conditions before they escalate. This evolution in thinking requires stronger alignment between Pharmac and Health New Zealand Te Whatu Ora. As integrated care becomes the national direction, the way we fund medicines must reflect how those medicines contribute to overall system efficiency and patient outcomes. Pharmac's current structure, operating within a ring-fenced budget, has created artificial constraints that limit innovation. While it has helped secure competitive prices, it has also locked us into a rigid, risk-averse model that can't keep pace with the demands of modern medicine. To stay relevant, Pharmac must adopt smarter, more flexible funding approaches. This includes: ● Outcomes-based pricing: linking funding to real-world results, so high-cost drugs are only paid for if they work ● 'Access equity' funding: targeted budgets for treatments that don't fit traditional metrics, such as rare disease therapies ● Public-private co-investment: partnerships to enable earlier access to emerging or breakthrough treatments These models are already in use globally. New Zealand, with its small scale and centralised health system, is well placed to adopt and lead in this space but doing so will require political will and cross-agency collaboration. One of the strongest criticisms of Pharmac is that its decision-making too often overlooks the most marginalised. Equity must not be treated as a footnote, it must be central to how decisions are made. Pharmac must evolve to meet New Zealand's healthcare needs, advocates say. Photo / Getty Images That means asking tough but necessary questions: are Māori and Pacific patients missing out? Are people in rural communities being reached? Are high-cost treatments for small groups, such as children with rare conditions, being given a fair assessment? True equity means seeing value not only in volume, but in fairness. We must move away from one-size-fits-all measures of utility and toward a model that recognises the value of treating the under-served, the isolated and the overlooked. Pharmac has made efforts to improve its equity lens, but these steps need to be embedded and expanded. This includes involving communities earlier in decision-making, co-designing criteria for assessment and setting explicit targets to reduce access gaps. If there is one thing Pharmac must urgently regain, it is public trust. Right now, too many New Zealanders feel shut out of its processes, confused by its rationale and left behind by its pace. Trust won't be rebuilt through a communications campaign. The Pharmac chair, Paula Bennett, is pushing through some important reforms which require a fundamental shift in how Pharmac relates to the people it serves. That means: ● Transparent processes that clearly explain what's funded and why ● Better engagement with patients, clinicians, researchers, and advocacy groups ● A willingness to admit when the system isn't working and to try new things The leadership of new CEO McMurtry offers an opportunity to reset that relationship. Her described strengths, quiet achievement, systems thinking, and clinical experience, will need to be paired with openness, boldness, and humility. It's encouraging to see the appointment of Dr Dale Bramley as CEO of Health New Zealand Te Whatu Ora. Bramley brings deep experience as a public health physician and former chief executive of the Waitematā District Health Board, along with a strong understanding of the health system from both clinical and leadership perspectives. Dr Dale Bramley has been appointed CEO of Health New Zealand Te Whatu Ora, bringing extensive public health and leadership experience to the role. Photo / Dean Purcell His appointment provides a valuable opportunity to strengthen alignment between Health New Zealand Te Whatu Ora and Pharmac. As the country moves towards integrated care as the national model, our approach to funding medicines must also evolve, recognising the role modern medicines play in improving patient outcomes and driving overall system efficiency. Pharmac's future must align with where the health system is heading: more integrated, more proactive, more preventive. Medicines that enable self-management, support digital care, or reduce reliance on acute services are now core to how we deliver better outcomes. Health systems globally are shifting from volume to value. New Zealand must do the same. That requires moving beyond simple funding silos and embracing joined-up thinking, where medicine access is seen as a strategic investment, not just a cost centre. Pharmac has a unique role to play in this shift. But to fulfil it, the agency must move from cautious gate keeping to confident leadership. It must be willing to challenge legacy assumptions and champion bold ideas that better serve the public good. The real test is whether it can lead to a smarter, fairer, more compassionate approach to medicine access – one that reflects the realities of modern New Zealand, embraces equity, and evolves as science and society change. The opportunity is real. With the right leadership, the right frameworks and the courage to think differently, Pharmac can become not just a funding body but a force for health transformation. But that will take more than good intentions. It will require bold decisions, structural reform and a clear commitment to doing things differently. Tinkering at the edges won't cut it. The time for real change is now. Ultimately, Pharmac's legacy won't be defined by how tightly it managed its budget. It will be judged by how well it met the health needs of its people.
RNZ News
3 days ago
- RNZ News
Doctors welcome health minister's GP training funding shake-up
Royal New Zealand College of General Practitioners president Dr Samantha Murton. Photo: Supplied Doctors are welcoming the government's move to fully fund specialist GP training. Previously, medical graduates only had their first year of specialist general practitioner training paid for, but now all three years would be covered. The government would also cover the exam costs for about 200 trainees, and full education costs for about 400 year 2 and 3 trainees each year. President of the Royal New Zealand College of General Practitioners - which delivers the 'General Practice Education Programme' - Dr Samantha Murton, said the changes brought GP training in line with all other medical training across New Zealand and Australia. "This funding will be a gamechanger for current and future trainees. This is a significant acknowledgement for the specialism of the general practice workforce and the vital role we play in healthcare being as important as those of our peers in secondary hospital settings. "Not only will this funding offer the necessary financial support our GP registrars need throughout their training, but we are optimistic that the news will encourage medical graduates who have an interest in general practice but have been put off by the financial barriers to make the step to train as a specialist GP. To them, I say welcome and you won't regret your decision." Chief executive Toby Beaglehole said the college was enthusiastic that primary care funding was heading in the right direction. "We are focused on building a sustainable workforce for the future , which starts with training and the equitability of our program costs to other specialist medical training. "This funding sends a signal to the sector that the expertise of general practice is valued as a vital part of the health system." Announcing the changes at a GP conference on Friday, Health Minister Simeon Brown said they would help improve New Zealanders' access to primary healthcare . Health Minister Simeon Brown. Photo: Calvin Samuel / RNZ He also announced the government's funding method for GP clinics, known as capitation, would be updated for the first time in more than 20 years, with changes taking effect from 1 July, 2026. "The current model is outdated and doesn't reflect the needs of patients. The revised formula will go beyond just age and sex, to also include multimorbidity, rurality , and socioeconomic deprivation," Brown said. "These changes will better distribute funding to where it's needed most, so that GP clinics with a higher needs population of enrolled patients will receive more funding to care for them." A new national health target would be developed with the primary care sector, proposing to ensure that more than 80 percent of people could see a primary care provider within one week. "People shouldn't have to wait weeks to see a doctor. Delays can lead to poorer health outcomes, more pressure on hospitals, and growing frustration for patients. We're focused on delivering timely, quality care that puts patients first." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
1News
3 days ago
- 1News
Former Black Fern fundraising after shock cancer diagnosis
Cheryl Waaka, a former Black Fern and a māmā to two teenagers, is now facing her toughest opponent yet, stage 4 bowel cancer. She was a fit and strong wāhine Māori hailing from Ngāpuhi and Ngāti Kahungunu, she's won two World Cups in the black jersey and is still dedicated to the game — but her diagnosis in June has left her stricken with sadness. "I was healthy, running around, doing my everyday job. It was King's birthday weekend. There was a Johnny Isaacs Māori tournament in Kaikohe. I was running the line, AR-ing, and three days later, I'm on the floor in excruciating pain." She remembers the day her life was changed forever. "I got my brother to get me to the GP in Kaikohe. Ambulance to Kawakawa. Ambulance to Whangārei and then that night, broke the news that I have a tumour in my bowel and I need to have emergency surgery. ADVERTISEMENT "I suppose I'm very lucky to my surgeon. He got the tumour, but unfortunately, it spread to my liver. In March, Health Minister Simeon Brown announced the National Bowel Screening Age would be lowered for all New Zealanders from 60 to 58, a step he said would save hundreds of lives. The "redirected" funding was previously set aside for a pilot programme that allowed Māori and Pacific people to access bowel cancer screening starting at age 50. While Brown said the age of eligibility for free bowel screening was projected to prevent an additional 771 bowel cancers and an additional 566 bowel cancer deaths over the next 25 years, advocates called the move "institutionalised racism" as half of bowel cancers in Māori occurred before the age of 60. Waaka, who was up to date on all her health checks, said if the screening age was lowered to 50, her diagnosis would not have been stage 4. "If it didn't happen now, would [the tumor] have been still sitting there, and by the time I got to 58, if I got to 58, it might have been too late. "You look at me, strong, fit, healthy. It can happen to anyone. And I don't want it to happen to anyone." ADVERTISEMENT (Source: Photosport) And the effect ripples to her whānau, she recalled the moment she had to break the news to her two children. "I wouldn't like to wish that on anybody. Just myself to be told, and then to actually tell the kids. "I was trying to hold myself to be strong, as we do as wāhine. So that was one of the hardest moments of my life. I wouldn't wish that." The rates of early onset colorectal cancer have risen by 26% per decade on average over the past 20 years, according to University of Otago researcher Dr Oliver Waddell. Researchers and Māori health practitioners have called for the age to be lowered to 45 as it was in many other countries. "If we had [earlier] screening, I most probably wouldn't be costing the country money. ADVERTISEMENT "That's how I'm looking at it. If I was able to get screened at a younger age, you just imagine how much money this government will be saving in health costs," Waaka said. Bowel cancer treatment costs depended on when it was found — stage 1 being the cheapest and stage 4 is the most expensive. For Waaka, her bowel cancer has got into her liver and aside from rounds of chemotherapy, the non-funded drug she needs comes at a cost of $30,000. To start her first round of treatment on August 11, she is having to fundraise to survive. But Waaka said it's a big ask to turn to the community for funds. (Source: Photosport) "Life is hard, people are struggling and for me, I feel like I'm taken from the whānau. "And everyone said, you know, you've given so much, it's our time, but deep inside you know everyone's struggling to survive out there, and I'm just so grateful that people are willing to help me to survive and for me to fight this fight... which I'm going to do." ADVERTISEMENT She wanted her off-the-field legacy to be remembered as much as her on-the-field career. "I'm never one to ask for help, but I'm always giving. So for me, my legacy will be that I've given everything that I can, and hope I've just left something that will remind people of me." By Mihingarangi Forbes of
