National will offer training for rural GPs. Photo / Getty Images
Decentralisation of health services, a Minister for Mental Health, and no more Māori Health Authority, said National MP Dr Shane Reti today in Levin. He said his mantra is “timely access to quality care.”
Cost of Living, Ō2NL, crime and health are the big issues in Horowhenua, said National candidate for the Ōtaki electorate Tim Costley, who had invited Reti to Horowhenua, again.
Dr Shane Reti bring an impressive CV to his job as MP, and according to Tim Costley he will be the next Minister of Health. He still works as a GP every now and then and has done stints on ambulances across the country, “to observe what works and what doesn’t,” he told an audience of 100 faithful in Levin on Thursday, August 24.
He described Costley as his eyes and ears in our electorate and said Costley was already part of his team. He said he chose to be a practising doctor during summer recesses, “to maintain my credibility”. He said officials in Wellington make policy from behind a desk. “I try to find out how much of what they come up with really works.”
He takes this so seriously he has a medical kit on hand in Parliament, just in case. “I almost had to use it once.”
He said he had his health manifesto ready last December but is only allowed to drip-feed pieces of it. He said he stands for women’s health, and preventative medicine and has proposed a change in the eligibility for breast screening.
“The bonding of nurses and midwives is next. We promise them loan relief if they work in their profession for five years after graduating.” The motivation for that is the fact that a third of trainee nurses throw in the towel during training. “They cannot afford the living expenses,” Reti said. The party’s third big health announcement this year was in relation to the plan to set up a third medical school, in Waikato.
“Why not give the job to the Auckland and Otago medical schools, which each can only cater for 50 students? Well, they have to overhaul their facilities, their training plans, and then must obtain accreditation for those plans, which is a three-year process.”
He said the Waikato facility will train 120 students each year and it will be graduate school. “They will do four years of clinical training like they do in the USA, Canada, and Australia and the school will focus on training general practitioners and rural health professionals.”
His grand plan means students will travel to Hamilton two days a week for training, from the regions where they are working. “One day a week they will work in a large medical centre or aged care facility, and for two days a week the trainers will go to them, wherever they might be.”
Those plans mean, he said, that by 2030, 220 medical professionals will be trained and moved into the workplace each year. He said there still is a role for overseas-trained doctors, but we must work on finding people within the country to take on these roles.
In terms of retaining medical professionals, he said pay parity is still an issue but an even bigger problem is terms and conditions. “Salaries offered by Australian hospitals will always be a risk for us. I do not think we will ever be able to match those.”
He said he would also vary the ratio of nurses per patient depending on how much physical work they have to do throughout the day. “Orthopaedic nurses need more staff per patient, than some others, as a lot of lifting on rolling over of patients is tough on the body.”
He would like to be able to offer nurses a life-long career. “As most nurses are women we may need to think about flexible schedules and perhaps we need early childhood centres in or near hospitals to allow them to keep working.”
He said the ongoing strikes of nurses, junior doctors, and now even senior doctors, something he said he had never seen before, show clearly the fragmentation and unhappiness within the sector.
Reti said a National-led Government will fund a lot more cancer meds. “All those funded by Australia are proven. The Cancer Control Agency had identified 28 treatments that work but are not funded. Thirteen of those are still unfunded. We will fund those, as we already know these meds are of great benefit to cancer patients.”
He said so far only treatments for solid cancer are on the list, not those termed blood cancers. “That is because the agency has not yet done any work on those and I will make sure they do. You do not have six months if you have cancer. We should give the clinicians what they need.”
He promised a lot more great policies in the lead-up to the general election. He promised that National will have a Minister for Mental Health.
He took a bemused stab at the Labour Government regarding their 2017 health reform promises: a mental health inquiry was promised, and their second most important issue was cannabis reform, and no more targets for anyone, they said.
“I am big on targets, that is a great way to hold everyone accountable.” He said big issues for him were the ever-growing waiting lists, more cancer treatments, and vaccinations. He said he was a lot more worried about measles than about Covid-19. “The measles are six times more infectious and we had a mini epidemic of measles in 2019. That was our trial for Covid-19 but we learned nothing. We made the same mistakes over and over again.
“The biggest issue with getting pharmacies to do vaccinations was the IT system for billing. That happened with the measles epidemic and again with Covid-19.”
He said the National team had an expert in mental health in Matt Doocey. “He will be our Minister for Mental Health.
“I know that health staff are working understaffed and that they are tired. We are great at building buildings, and roads, now we need to be great at doing that with people. Social connectedness needs to be rebuilt.
“I am the only one who can say no more Māori Health Authority and I say that as someone who has done plenty of free marae-based clinics during my career. I believe the system they set up is failing and if it fails no one will do something for Māori ever again. The ideology has been pushed too far.
“They have a serious conflict of interest. One of its key roles is the monitoring of inequities across the sector, but they are also a provider. That is what happens if you centralised everything in Wellington. The Māori Health Authority took any Māori from other health sections, not the ones with the skills they needed.”
He said the board was dysfunctional as it began meddling in operational affairs when they felt operations weren’t doing them. In February in the briefing to the new minister Reti finally found out how much staff the authority had: 400 full-time equivalent. “That is twice as many as Pharmac on half its budget.” He had been trying to get that number out of the minister for a long time.
He said the reporting on their work had changed from monthly to quarterly. “The last one came in March and the next one will be on October 30, after the election. They are hiding the evidence.”
“We must go back to the regions, to iwi, hapū, to patients, where they will get much better results. I am big on outcomes.
“I am still committed to outcomes for Māori: immunisations for one. Every Māori person who came to the committee said their number one priority for the first year in the health reforms would be a big increase in immunisations.”
He said a report had been done by Ernst and Young on the functioning of the Māori Health Authority and it was terrible. “I had to go to the Ombudsman to get it released. The minister said releasing the report was not in the public interest, but released it as soon as the Ombudsman became involved.”
He also pointed out that the infamous clause 72, giving the Māori Health Authority a veto, has gone.
“We must admit we have a health crisis. That shows we understand the problem and brings urgency to the case.”
He said he predicts the Waikato DHB will be the first one to break and MidCentral won’t be far behind. “I did a few nightshifts on ambulances across the country and saw the situation in Waikato Hospital firsthand. We couldn’t move patients from ambulances into the ED, stretchers were all along the corridors. You could barely move. How on Earth can you shut an emergency department during the weekend, like they did in Oamaru?
“Working on the frontline helps you understand what is going on and what works.”
He said taking away the no-prescription charge from those who can afford to pay for them will make available $350 million for more cancer treatments. “That’s how we will pay for all the extra cancer treatments.”
He said New Zealand does not make it easy for overseas-trained doctors to work here. There are plenty who have done all the extra work to get registered here but are driving taxis, buses, or delivering mail instead because they cannot get training positions in New Zealand hospitals, which claim to be understaffed.
He said the bureaucratic layers are ever increasing and a lot of people do not know what their lines of communication are now. “All sorts of weird jobs are invented, such as boundary spanners. What on Earth is that?”
He plans to restart vocational training for nurses. “They do not need to go to university.” He said he was a big fan of autonomy when one of the people present asked why nurses couldn’t have more responsibilities.
He said one of the biggest hurdles in health is the lack of AT, or anaesthetic technicians, who are the ones operating the complex machinery used to do anaesthetics. “We are very short of those people. They used to be trained in the Bay of Plenty for a year, now they go at AUT for a three-year degree.”
Reti promised a lot more exciting policy announcements including those to do with kids and good health, and how to get good healthcare to them. “The first 1000 days in a child’s life a crucial.”
