Budget 2025 - What Vote Health Needs Just To Stay Afloat
"Year on year specialists in our public hospitals are being asked to do more and more," says ASMS policy director Harriet Wild.
"If we do not see this level of investment as a minimum it just means the Government is choosing to dig their own hole that much deeper. Again in 12-months' time they will gamble on the future of our public health system again, knowing they have made the odds that much worse."
Two billion dollars is the increase required to meet health cost pressures (which run higher than general inflation) including changes in pricing, volumes, and inflation, as well as the increased need created by a growing and ageing population.
New Zealand's population is growing by 1.3% annually.
New Zealand's population is also ageing. Almost three-quarters of total life-long healthcare costs occur in the last three years of life. Census data shows 1 in 6 people were aged 65 and older in 2023, this is projected to be 1 in 5 by 2033.
The need for hospital-based acute care is also increasing. Acute discharges in public hospital increased by 28% between 2014 and 2023. Almost 1.3 million people attended an Emergency Department in 2022/23, a 22.5% increase since 2013/14. Over the same period, the population increased by 16%.
Two billion dollars will not remedy decades of underfunding of New Zealand's health system. New Zealand's total health expenditure (public and private) as a proportion of GDP has remained well below comparable countries for many years. Prior to Covid-19, New Zealand spent 9% of GDP on health, while countries including Australia, Canada, The Netherlands and Sweden spent an average 10.7%.
The New Zealand Health Survey shows significant volume of unmet health need also remains in our community, with 1.86 million adults experiencing an unmet need for dental care due to cost. 464,000 adults have an unmet need for mental health or addiction services - an increase of 3.3% since 2023.
While investing in primary care will make people healthier overall, it will also generate more cost for our hospitals as unmet need for secondary care is identified by those primary care providers.
$1.43 billion was allocated to meet health sector cost pressures (demographic changes, price and wage increases) in the 2023-4 Budget. However, when appearing before health select committee during Scrutiny Week in March 2024, Te Whatu Ora officials acknowledged this fell short of what was required.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
NZ Herald
14 minutes ago
- NZ Herald
Middle ground needed in healthcare dispute for the sake of public
Health NZ and the Government are certainly aware of this, but reaching a solution is not as simple as agreeing to the demands of the Association of Salaried Medical Specialists (ASMS) and the New Zealand Nurses Organisation (NZNO). Across the Government's Budget, Health NZ is competing with the funding needs of housing, education, transport and more, all amid a cost-of-living crisis for the average Kiwi. Health NZ offered nurses a 3% pay rise over 27 months, plus two lump sum payments of $325. The NZNO sought a 5% pay rise over two years, along with $2000 flat rate increases for senior positions. The union also sought to restore a tikanga Māori allowance. ASMS executive director Sarah Dalton earlier told the Herald hospital specialists sought a 12% pay rise but were being offered an increase of less than 1% per year. Health NZ has described its offers to nurses and senior medical staff as 'fair'. Dalton acknowledged at the time that 12% may not be achievable but said the dispute may not be settled without a better offer. There is room for Health NZ to manoeuvre between 1% and 12%. Dalton's acknowledgment shows that compromise, at least where ASMS is concerned, is not impossible. Health Minister Simeon Brown estimated 4300 procedures, such as hip and knee operations, were delayed because of the 24-hour strike on May 1. Wait times for elective surgeries have already ballooned since the Covid pandemic, and the wait for specialist appointments and operations has continued to grow in many regions. In February, the Herald reported all of the country's hospital emergency departments were failing to assess patients with 'imminently' or 'potentially' life-threatening conditions on time. Striking doctors and nurses have rightfully pointed out staffing issues, with Health NZ recognising another 4100 nurses were needed in the next decade, on top of 2250 nursing vacancies, despite half of nursing graduates not getting job offers from Health NZ last year. Another 3450 doctors were needed in the next decade to keep up with demand. Concessions are needed from both Health NZ and its striking staff. Sign up to the Daily H, a free newsletter curated by our editors and delivered straight to your inbox every weekday.
RNZ News
2 days ago
- RNZ News
Bonuses promised for doctors in short-staffed areas, union says existing allowances aren't being paid
Photo: RNZ Health NZ is promising bonus payments to senior doctors who work in hard-to-staff areas, although the union is accusing it of failing to consistently pay allowances now. The Association of Salaried Medical Specialists, which represents 5500 senior hospital doctors and dentists, has criticised Te Whatu Ora's new offer to its members as amounting to "an effective pay cut" for 90 percent of them. Union head Sarah Dalton was also sceptical of Health NZ's proposal to ring-fence $32 million over two years for an incentive to doctors to work in areas or specialities with particular shortages . The agency was already paying $384m a year on contingency staffing which was "driving people out of salaried into locum work and temporary gigs", and current systems for paying allowances were ad hoc and "shambolic", she said. However, Health NZ's industrial relations lead, Robyn Shearer, said incentive funding showed the agency was listening to what the union had to say about the need to retain staff in those areas. Specific details on how to allocate that money were yet to be agreed, she said. "We need to get round the table and work ... through that in the bargaining process. "Our intention is to work on that together with the union, so we are keen as part of proposed settlement to have it in agreement." Association of Salaried Medical Specialists's Sarah Dalton. Photo: RNZ / Jimmy Ellingham Shearer agreed there was work to do on consistently applying allowances that had already been agreed, including the extra ED allowance that came out of the previous bargaining round. "We are definitely keen to work on better consistency - there's a big piece of work around application of allowances up and down the country, and we're keen to work with the union on that." Health NZ would "much rather" employ permanent staff than have to find locums, she said. "But there are good reasons for employing locums, including covering staff sickness and unfilled posts. They have an important role to play while we seek permanent long-term solutions." Health NZ's industrial relations lead, Robyn Shearer. Photo: RNZ Insight/Karen Brown Should Health NZ's offer be accepted, first-year specialists would get an extra $17,000 in their pay packets over the 21-month term, and second year specialists more than $11,000. "Senior doctors at the top of the pay scale would receive an increase to base pay of more than $9000 to more than $277,000 over the course of the proposed settlement. We think that's a very fair pay offer." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
Otago Daily Times
2 days ago
- Otago Daily Times
Social worker suspended over dodgy Covid vaccine exemption
A Dunedin-based social worker who issued a shonky Covid-19 vaccine exemption has been suspended for a year. Dr Jacquelyn Elkington's case came before the Social Workers Complaints and Disciplinary Tribunal yesterday — but she did not. Elderly pay price for Covid 'complacency' The woman, who is listed on the University of Otago's website as a senior lecturer hauora Māori, failed to show up for the hearing and was promptly found guilty of professional misconduct after tribunal chairman Winston McCarthy found her behaviour was likely to bring discredit to the profession. It was the first time a social worker has been taken to task over a Covid-19 issue and co-counsel for the professional conduct committee (PCC) Becca Boles said the only appropriate penalty was deregistration. But the tribunal opted to suspend Dr Elkington for 12 months, censuring her and ordering her to pay costs of more than $13,000. In November 2021, during the height of the Covid-19 pandemic, the government introduced legislation narrowing the grounds for a vaccine exemption. Only a suitably qualified health practitioner could make the assessment and it had to be verified by the country's director-general of health. A month later, Dr Elkington — who was working in Auckland at the time — issued such an exemption for a "vulnerable" client. "She's not a medical practitioner, she's a social worker," PCC co-counsel Elena Mok said. "Her conduct took her outside the scope of her practice." A day later, the man used the exemption in a bid to gain entry to a recreational facility. A staff member subsequently raised suspicions and referred the matter to the health and disability commissioner (HDC). Ms Mok said Dr Elkington's conduct "snowballed" from that point, Dr Elkington thwarting the resulting investigations against her by repeatedly failing to provide information. In June 2022, the woman made an online application to renew her practising certificate with the Social Workers Registration Board. Dr Elkington falsely indicated she was not subject to any inquiry and when she was pulled up on her lie, she claimed she thought the HDC inquiry had closed. But a couple of months later she resubmitted the online application, again declaring she was free of any scrutiny. Dr Elkington's behaviour was "at least misleading, if not outright false", Ms Mok said. The social worker went on to claim she felt "harassed and threatened" by the probe into her conduct, and that it was "borderline bullying". Many requests for information — about client notes or records on how many vaccine exemptions she had issued — throughout 2024, after the file was passed on to the PCC, were met with silence. At other points, Dr Elkington said she could not provide the documentation as she did not have the consent of her clients. She occasionally claimed to have already submitted the requested information and also made references to the Bill of Rights Act and various international treaties. On one occasion Dr Elkington referred to the River of Lies documentary — which bills itself as revealing the truth behind the "New Zealand scamdemic" — produced by the controversial Billy Te Kahika. Her lack of engagement in the process showed a disrespect for the process and an ongoing lack of remorse and insight, reinforced by her non-attendance at yesterday's hearing, the PCC argued. "The vaccine exemption appears to have been issued because of Dr Elkington's personal beliefs about the safety of the vaccine and her views on the Covid pandemic," Ms Mok said. "Dr Elkington's attempt to justify her approach is an example of her effectively allowing these personal beliefs to influence her social work practice unduly." The University of Otago refused to answer questions about the woman's employment at the institution. In 2022, Dr Elkington ran for the Whakatāne mayoralty and posted online at the time her various theories, which included that the Covid-19 vaccination caused monkeypox. She came sixth out of seven candidates. Dr Elkington did not respond to requests for comment. The tribunal ordered that if the social worker returned to practice she must undertake monthly supervision for a year.
