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Not holding my breath for Budget

HamishHi, my name is Hamish Hutchinson. I’m a registered nurse, an NZNO delegate and I work at Waitakere Hospital in Auckland.

We’re coming up to the Budget, which is when the Government prioritises its spending for the next year. Will they prioritise health? I’m not holding my breath.

The Council of Trade Unions calculated we are well over a billion dollars short for the health system just to stand still. I can’t really comprehend what a billion dollars looks like, but I can tell you what underfunding looks like to me, every day.

I’ve been working as a nurse for 5 years. I chose nursing because it’s the sort of profession where you can use your own humanity to help others. This is still why I want to be a nurse.

I work in an Emergency Department (ED), so we are used to it being busy. We have a great team that responds well in a crisis. But it’s not always trauma and lights and sirens – another part of the ED is about doing screening for family violence and asking about how things are for people in the home. When it’s busy – and it’s getting more and more busy all the time – this stuff – the social stuff, the time spent listening to people gets pushed aside. That worries me.

ED nursesWe always say that the Emergency Department is for emergencies only. I’ve lost count of the times I have heard people saying that they couldn’t get into their GP for 3-4 days or couldn’t pay for after-hours clinics or couldn’t get into a GP because they work two jobs and have kids. Inevitably they come to ED – where else will they go?

Just as an example, I saw one man who had an infected wound. He had put off seeing the GP because of cost and because he couldn’t take a sick day from work. When he finally arrived in the ED his wound had gotten really bad. Something that probably could have been managed by a GP a few days ago ended up needing surgery and a hospital stay. It was worse for the patient and it cost so much more than it needed to as well, in equipment, bed space, and staff time. This doesn’t need to happen.

Some days the Emergency Department feels like a game of musical beds. When the hospital is full it’s just one big balancing act. I’m amazed it works and I think that’s down to the tireless work of nurses and other hospital staff.  But the reality is this is not a game, this is people’s lives.

Good health is vital for a good society and if I got to make the big decisions, I would make health and wellbeing a bigger priority than it is now. Everyone needs to be able to get health care in their own communities. We need more hospital staff for sure – but keeping people out of hospital is cheaper in the long run.

ED nurse talking with patientWhat this would look like for me?  It would mean having enough time to talk to people to find out what brought them to ED and how we can stop it happening again. You can’t do that when it’s too busy, when there’s people in corridors, and it’s the really important stuff like this that falls away with underfunding and understaffing.

Other things that would make a big difference, in my opinion are:

Free GP visits for everyone and clinic hours extended to suit working families. People should be able to see a GP on the same day and have flexibility if they are workers.

Improving the ‘social determinants of health’- the things that should keep people well in the first place, like housing, welfare, education and employment. We would have more time available for the unavoidably sick if preventable causes of disease were reduced or removed.

In particular, outside of the hospital, there has to be more emergency housing, and this is an issue that’s needs to have been resolved yesterday! There’s nowhere in West Auckland to go if you are homeless, only sleeping rough or paying for a motel which might not be an option for lots of people.  Addressing the human right to safe shelter is an absolute must and would ultimately improve the health of people in hardship. If nothing is done on this issue, I will be worried for the future, because it’s bad enough now. On Thursday, I hope the Government prioritises health and the people in our communities. And that means housing, welfare, education and employment as well. They could do it if they had the will. They could fix this all if they wanted. That’s something we are all holding our breath for.

Hamish footer

 

 


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What we want for health

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The Government’s 2016 Budget will be announced in a couple of weeks so we thought we’d set out now what NZNO wants for health. Here’s hoping that is what the Government delivers.

What we want is a health system where everybody can access the health care they need, where and when they need it.

It’s not an outrageous ask, and we’ve never met anyone who disagrees. So, let’s unpick it and see what lies beneath the words.

  • We want a health system that is funded to provide equitable and universal health care.
  • We need the right people to make it happen; nurses, doctors, kaimahi hauora, kaiāwhina, administrators, cooks, cleaners and clinical leaders.
  • Those people must be trained and paid appropriately and be provided with safe work environments.

Last years’ Budget does not provide enough funding to meet the health needs of New Zealanders. Nor did the Budget the year before, or the year before that… In fact economist Bill Rosenberg estimated last year that the funding allocated for health was at least $260 million short. This year will be worse. Rosenberg says that in the eight months to February 2016, District Health Boards were already $27.9 million in deficit.

Funding for the primary health services we so desperately need are being squeezed and cut and services are closing. It just doesn’t make sense – primary care is the way to make our vision for a healthy New Zealand happen. Attacking small services as they begin to make headway into our communities is completely counter-intuitive.

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The Minister of Health is famous for saying “We must live within our means” – implying that health funding is a finite pool. It’s not. This Government could prioritise health if it wanted to.

The Government could say, for example, it’s worth spending more on health for the next 10 years until the massive benefits of focusing on primary care start showing in the system. It could say, more spending now means spending less in future.

If there was a plan, we would know how many nurses to train and we’d be able to support and mentor them after graduation appropriately.

It would be recognised that short term “savings” often don’t yield long term rewards, for people or for budgets.

Nurses, midwives, caregivers and other health care workers tell us they are stretched to the limit. Some are having to sacrifice tea and lunch breaks and working unpaid overtime just to keep up with the care they need to give to ensure needs of patients are met. Support for training and development is decreasing. Stress levels are rising and morale is low.

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A healthy health system would train and employ the right number and skill mix of staff so that people aren’t burning out and/or making mistakes and/or rationing care.

So, that’s what we want in the Budget. New Zealanders deserve it and, as the largest health workforce, we expect to be heard. We are putting it out there that we will fight for it, for all New Zealanders.

A healthy health system should be a top priority for any Government. We want a health system where everybody can access the health care they need, where and when they need it.