Latest news with #AnushaBradley
Otago Daily Times
25-05-2025
- Health
- Otago Daily Times
HNZ warns outsourcing surgeries will hurt doctor training
By Anusha Bradley of RNZ Outsourcing more elective surgeries will limit training opportunities for future surgeons, the Health Minister has been warned. Health New Zealand aimed to perform more than 30,000 elective surgeries in the 15 months to June 2026 in a bid to reduce waitlists, including by outsourcing thousands of more straightforward cases to private hospitals. Documents obtained by RNZ under the OIA show Health Minister Simeon Brown was told in March that outsourcing more elective operations to private hospitals will worsen training opportunities. "That's because outsourced procedures are usually of lower complexity, which often makes them suitable for training," Health NZ wrote in a briefing. Some doctors agree with the ministry's warning. Hawke's Bay head and neck surgeon Christopher Kennel, who worked in both the public and private sector, said his trainees were already missing out on learning, because the public sector only had the capacity to deal with the most severe cases. Outsourcing would only make it worse, he said. "The registrars are already having a biased training towards more complex cases. I don't know how people who go through training here are going to be prepared to function privately because they're not going to have the background to do common, but less urgent cases, because the public system is under-resourced." To mitigate this, Health NZ was exploring more national agreements to train more doctors in private hospitals, starting with radiology and pathology. Health NZ said significant work was underway to get an agreement for obstetrics and gynaecology, while briefing papers said otorhinolaryngology (ear, nose and throat) and plastic surgery could also be targeted. Health NZ was also considering making training a requirement of private hospitals' outsourcing contracts. This raised ethical and practical questions, Dr Kennel said. "If trainees are helping me earn money privately, then who's paying them? "Is it fair for the public side to pay them to operate with me privately when registrars could be seeing public patients in clinic instead? "The other thing is that on any given day when I'm operating privately, I might do a public contract case, and I might treat a privately insured patient. How does the registrar know how to schedule their day? Because if they're going to be with me for like 2 hours of a public contract case, what do they do when I'm operating on just a privately insured patient?" Auckland radiologist and Auckland University Faculty of Medicine associate professor Colleen Bergin said she wants to see details and assurances on how robust training systems in private hospitals would be. "There are systems in place in the public hospital, there's a structure. Everyone on that day is involved in teaching those students. But moving to a private system, there's no details on that kind of process." Orthopedics was the only surgical speciality currently allowed to train doctors in private hospitals nationally, as much of its work was ACC related and done privately. Health New Zealand said it also had training agreements with some specialities at a local level. New Zealand Orthopedics Association chief executive Andrea Pettett said the 16-month-old scheme was "working extremely well" and a "win-win". "All parties are very happy with the system. Our trainees are employed by the public hospital and they are released for one or two private runs. They go to the private hospital often with the public surgeon. And it's entirely up to the private surgeon whether they want to train them." She saw no issue with publicly-paid trainees working in private hospitals, as private surgeons were also giving up their time to teach. "Obviously in a perfect environment, our public hospitals would be better placed if they could do the full suite of acute and elective surgery, but they can't. So this is a pragmatic way to ensure that New Zealanders get access to elective surgery." Speciality Trainees of New Zealand president Jordan Tewhaiti-Smith, an obstetrics and gynaecology registrar, was involved in setting up a training agreement between private hospitals and the Royal Australasian College of Obstetrics and Gynaecology. He expected a deal to be announced soon but there were some details that still needed to be worked through. "It's making sure we are medico-legally protected in those spaces because public registrars aren't employed by the private sector, so that's a grey area." Ultimately, allowing private hospitals to train public doctors was a "needs-must" situation, he said. "These are people that are going to be the future specialists of tomorrow and the people that are operating on you in 5-6 years time. If they aren't trained to a good standard because we've dropped the ball in the public sector then it comes at a cost to everyone. "Some people might snub their noses at the fact that we're supporting the private sector by outsourcing all these cases, but actually it's a much bigger lens that I think we should look through." The Royal Australasian College of Surgeons said it was speaking to private hospitals about training future surgeons, but ideally all training would happen in an appropriately resourced public health care system. In a statement, Health NZ said a pre-requisite of any agreement is that training in private hospitals would not compromise the public system. "We are working with the private sector towards common expectations for how medico-legal, quality and financial issues are managed, as well as with professional medical colleges and unions to build consensus," Health NZ Clinical Lead Planned Care Derek Sherwood said.
RNZ News
16-05-2025
- Entertainment
- RNZ News
Top awards for RNZ journalists at 2025 Voyager Media Awards
Anusha Bradley (left) and Dana Johannsen. Photo: RNZ RNZ journalists have scooped up major accolades at this year's Voyager Media Awards. Investigative journalist Anusha Bradley has been awarded reporter of the year, and sports correspondent Dana Johannsen has been named sports journalist of the year. RNZ had 13 finalists in the awards, the results of which were announced on Friday. Judges Isabelle Oderberg and Phil Taylor said Bradley's three pieces stood out as exceptional - "both individually and as a body of work for their newsworthiness, the importance of the public interest journalism therein and her engaging writing and thorough research, which contributed to the colour and depth of the work". Fellow judges Ben Stanley and Bernadine Oliver-Kerby said Johannsen's portfolio shone the brightest. "Underscored by deep research, strong reporting principles, and a clear storytelling style, Johannsen sets the standard for all Kiwi sports journalists to follow." RNZ's crime correspondent Sam Sherwood also won the best specialist reporting award for his work at Stuff last year. The judges - Drew Ambrose, Sam Ackerman and Zac Fleming - said Sherwood's agenda setting journalism was "well written and had monumental impact". Meanwhile Lisa Taouma won an award for best current affairs (long) or documentary with Myths & Maidens made by Coconet TV and RNZ. Charlotte Whale and Drew Ambrose said it was "a wildly original and thought provoking documentary about female identity in Pasifika society". "The producers used creative devices and structured the story in a clever way to make the subject matter compelling. "With the western gaze of artists like Paul Gauguin and the historical representation of indigenous societies now facing closer scrutiny, this documentary is an important addition to that very important cultural reckoning." RNZ's Kate Newton and Hingyi Khong were chosen as finalists in the best innovation in digital storytelling category for Smoke Signals . RNZ and Tama & George Productions' Daniella Smith, Dane Giraud, Tim Watkin, Phil Vine, Liz Garton, Ben Pierce, Daniel Hurley, Rangi Powick, Lucas Giruad, Briana Juretich-Greig, Zhenya Nagornaya, Marika Khabazi were in the running for the best original podcast or series with Uncut Diamond . Mata with Mihingarangi Forbes was a finalist for Mother of missing Marokopa children speaks in the best scoop category, and Forbes herself was also a finalist for the Te Tohu Kairangi award. RNZ and Coconet TV's Tuki Laumea, Damon Fepulea'I, Lisa Taouma, and RNZ's Justin Gregory, James Nokise, Tim Watkin, Briana Juretich-Greig, Rangi Powick, Dexter Edwards were finalists for the Le Mana Pacific award for Untold Pacific History - Season 2 and The Last Voyage of the Rainbow Warrior. RNZ itself was a finalist for the digital news provider of the year, and for the coverage of the sinking of HMNZS Manawanui in the best coverage of a major news event category. RNZ's investigative journalist Guyon Espiner was a finalist for the political journalist of the year, and executive editor of RNZ's In Depth John Hartevelt was also a finalist for the editorial leader of the year. The full results of the Voyager Media Awards can be found here . Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
Scoop
14-05-2025
- Health
- Scoop
RNZ Obtains Two OIA's - One Redacted, One Not
Analysis: The right hand not knowing what the left hand is doing can be a good thing. My colleague Anusha Bradley and I did not know we had put in similar requests for information about the outsourcing of operations from public to private hospitals. She got back a memo from Health Minister Simeon Brown with two of its four pages of details of risks and mitigations blanked out. I got the same four pages back from Health New Zealand with nothing blanked out. This itself was unusual from an agency the Ombudsman recently told off for too often taking too long to release too little. If you compare the two memos, you get a rare glimpse inside the process of deciding what the public can know and what they can't. Brown said this was "standard", to redact officials' free and frank views about risks and issues. The minister has defended from the top, the withholding of information that his officials, on the other hand, released without his knowledge in full. The outgoing Chief Ombudsman Peter Boshier in March, reflecting on how the law called the OIA (Official Information Act) was going across the public sector, summed up: "The real issues are not with the law. They centre on 'culture' and that involves trust, behaviour and leadership. Bad behaviour undermines the OIA. The Act's not the problem - it's the attitude that needs to change." He had seen far too many "taking a defensive approach to OIA requests". Ironically, given the case here of HNZ not redacting the memo about outsourcing surgeries, Boshier singled out Health NZ over delays and "its refusal to release parts or all of the requested information". But its leadership - Brown - has demonstrated in his memo where he sets the threshold for sharing information, even about fundamental shifts in health delivery of utmost importance to patients and whānau, who often protest they want to know what is going on, not just for their own operation but around everyone's access to public health care. Should they and the wider public be able to also access information about the risks and mitigations ahead, via reporters using the OIA? The unredacted memo stresses outsourcing more surgeries could have benefits - and there is no reason to delay - but points out there are risks in hurrying, and there is every reason to get the right risk mitigations in place. The unredacted memo was one of two documents released about the private hospitals outsourcing strategy. Another six documents about it were not released, on the grounds that Health NZ would "soon" make them publicly available. The same grounds for refusal were used last month when RNZ health reporter Ruth Hill asked Brown for the advice he got about putting $50 million into more operations. The advice would be released "in due course", his office said. That advice and those six documents have not been released yet. Brown's office entirely refused to release the emails Hill also asked for, on the grounds - allowed under the OIA - that this would take too much work. One way of learning more without relying on ministerial memos is to look at the experience of outsourcing elsewhere. The UK's public health service, the NHS, has rapidly expanded outsourcing since 2008 to try to cut public waitlists. It now relies on the private hospitals for some types of elective care. One peer-reviewed study last month of elective primary hip and knee replacement concluded: "The introduction of private providers into the NHS is associated with a contraction in in-house NHS provision, increasing waiting times for all patients and a two-tier system operating in favour of the rich." Another last year that surveyed 40 studies, said waiting times had been reduced "in certain contexts" and that private hospitals could provide quality care in high-volume, low-complexity cases, but with "implications" for access. Its main conclusion though was more research was urgently needed, because there had been no "comprehensive evaluation of the implications for healthcare professionals and the wider healthcare system over the longer-term", even after 20 years. "It is crucial that the ongoing debate regarding the implications ... is evidence-based rather than driven by rhetoric or politics." Will the implications in New Zealand, and the ministerial memos about those, be able to be part of the debate here?
