Our guest blogger this week is a registered nurse working in Auckland. Her concerns about the politics of health spurred her to start a blog: http://politicsofhealthnz.wordpress.com/ and we’re pleased that she’s allowed us to cross-post her inaugural post.

The Auckland DHB’s leaked email, which reveals the management team’s readiness to further ramp up the pressure on staff and services in order to balance the books, will come as no surprise to clinicians who have become accustomed to working within an under-resourced system.

The DHB appears  willing to enforce the National-led government’s agenda, that of demanding more for less from the entire public service.  The government describes this as “cutting the fat”, but those who work in health  are acutely aware that this phrase, with its unpleasant connotations of butchery, is an ugly euphemism for renouncing its responsibility to ensure all NZers have equitable access to healthcare.

The day-to-day reality for clinicians is one of attempting to provide care in an environment which increasingly compromises their ability to do so safely and effectively.  CEO Ailsa Claire’s statement that “staff costs must be reduced” implies a lack of awareness of the depths to which staff morale has sunk.

Ms Claire describes “the danger of the Board or and (sic) external people determining how we resolve this issue.  Not good for the organisation”.  If Ms Claire’s fears were realised, it might well be damning for the Auckland DHB’s current management.  However,  it could be very positive for clinicians and their clients/consumers/patients if the intolerable stresses within the service became publicised as a consequence, and led to the necessary resources being provided.

The services provided by a district health board do not constitute a business, and the failure of those services to function within an inadequate budget cannot be defined as a financial “loss”.

Healthcare for all is a public good which must be properly funded by government, and effectively and compassionately administered and provided by health boards and their  employees..  When the means for the latter to do their work is absent, the solution is not to order them to “cut costs” and “control overspending”, it is to pass the responsibility back to those with the power to do something about it, namely, the government.