OPINION
I was talking to a senior medical specialist a couple of weeks back and he was lamenting the state of the health system. So far, not so unusual.
He was telling me about the
Catching up on surgery waitlists seems impossible when there are not enough staff. Photo / NZME
OPINION
I was talking to a senior medical specialist a couple of weeks back and he was lamenting the state of the health system. So far, not so unusual.
He was telling me about the delays in everything from tests to test results, the over-full operating theatres, and the fact the public system is so busy that it is buying up all the spare time in private facilities, to process public patients who can’t wait for surgery.
But it was his thoughts on the cause of this pressure that got me thinking. Yes, we have a shortage of medical staff and facilities, and yes, the so-called health reforms are rapidly turning out to be an expensive rearrangement and expansion of the deckchairs in the health bureaucracy. But his concern was more prosaic. You can’t cancel months and months of surgeries and then expect the sector to simply speed up and absorb those cancellations. No health sector is built with that sort of spare capacity. Particularly in a time of pandemic-induced staff shortages.
His pragmatic view was that with clear precautions, needed surgery could have continued through much of the Covid pandemic lockdowns, particularly the second Auckland one, and that the decision to leave hospitals almost completely empty for long periods was appalling, with predictable consequences.
It all makes sense. If you lose, say, five months of surgery time in a year, with the best will in the world you are not going to make that up over the next two years. Even if you squeeze an extra month’s work somehow in every year, it will be five years before you have completely caught up. That adds up to a lot of pain and suffering for the ill, and a lot of waiting around.
The state of our health system is of course not the only current political issue able to be traced back to the decisions of the Covid era. Inflation and the high cost of living are a direct consequence of a relatively obvious over-priming of the fiscal and monetary pump from the government and Governor of the day, combined with that of several other governments around the world, notably the US. A failure to change course soon enough means we are dealing with that long economic tail today.
Education, too, struggles in the long shadow of Covid decisions. A whole cohort of young people are less adequately prepared for life than they would have been without Covid coming along. Their schooling was disrupted and in many cases truncated. Some of that was unavoidable, but there was precious little attempt to balance the obvious risks. Schools were closed at the drop of a hat for very long periods, and the tendency to close schools quickly for a variety of reasons has continued.
As well as coping with the ongoing problems of poor school attendance and a damaged tertiary sector, we are still dealing with the collateral damage in terms of the actions of some young people who are clearly disaffected and disconnected from society. There is little doubt the current crime wave is in part caused by that marginalisation of so many young people.
Much has been made of the state of our infrastructure and cost-overruns in big transport projects in recent times and rightly so. But the cost overruns were inevitable once huge and complex construction sites were closed down for months on end. To me that made no sense, when we trust such sites to manage the health and safety of their workers every day, except during Covid. Months and months of road maintenance was also lost, which left us in a poor state when the skies opened at the start of this year.
I would add a few extra items to this huge post-Covid hangover. The simultaneous increase of the number of conspiracy theorists and the desire of governments to label and crack down on “disinformation” are both children of the lockdowns and vaccine mandates, albeit abetted by social media. If you demonise people for their understandable, if possibly irrational, fears, then you are going to get more people placing themselves on the opposite side of what they see as an overbearing authority. And if you get too used to having your way with “one source of truth”, then you can come to see any disagreement as “disinformation”.
We also see a Government that in the wake of Covid has become addicted to what amounts to publicly-funded propaganda. Agencies have been flat-out advertising their policy views on radio and television, in a blitz of commercials that became de rigueur during the pandemic but would have been seen as a scandalous waste of money beforehand. Even now every ad break on every station seems to contain two or three messages about staying home if sick, the merits of lower speed limits, government-mandated e-invoicing, and even introductions to individual staff at government research organisations, who are helping you and the country succeed, bless them. Poorly labelled advertorial content is also prevalent. A banning of government advertising that serves little practical purpose is sorely needed.
There is a huge range of decisions, large and small, which could have been made differently during the pandemic and lessened the post-pandemic malaise we are now living through, while still saving lives. Some will say they are only obvious with the benefit of 20/20 hindsight, but in many if not most cases, the likely consequences of decisions were highlighted by some at the time.
Even now the chief protagonists have few regrets. As he removed the final Covid restrictions last week, the Prime Minister did allow that the second Auckland lockdown may have gone on a bit too long (you think?). An interview with the former director general of health revealed he wouldn’t do anything substantive differently.
That’s what the Covid Royal Commission is for, of course. Rather than allowing the decision-makers to mark their own work, it has been set up to have an objective look at what could have been done better. However, so far it has been disappointing and pretty much invisible. A look on its website suggests it has been having polite behind-the-scenes chats with some of the key “stakeholders”, including Ashley Bloomfield.
The commission needs to up its game. The pandemic may be over and already half-forgotten, but much of what ails us now can be directly tied back to pandemic decisions. As a country we owe ourselves a robust public debrief, which includes the views of the dissenters. It is not clear whether we will get one.
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