One man's poll: In sickness and in health ...

By SIMON COLLINS

If you wonder why the Labour Government is considering a new health tax, just ask the public. After every extra billion dollars sunk into the health system, they keep asking for more.

Health has become an issue modern Governments can never win, at least while spending remains near the present level.

All any Government can hope to do is "neutralise" it by making voters think that, although things are not perfect, they are about as good as we can afford.

On the evidence of the 600 people interviewed for this series, Helen Clark's Labour Government may have scored some points, but health is still a massive negative as it enters the final run-up to the election.

Of the 125 people who mentioned health when asked about the state of the country, only nine made what could be called "positive" comments.

"It [the state of the country] is okay, I suppose, but health is only just okay," said Marlisa de Winter, 37, an Auckland advertising manager.

Shelley Bennet, a retired Greymouth bushman who still mows 10 lawns a week and makes children's toys at the age of 79, had to wait three years for an eye operation a few years ago. When he needed a similar operation this year, he waited only six months.

"It must be election year!" he laughed.

The other 116 people who mentioned health all complained. Of these, 41 simply listed it as a concern, usually with other worries.

Kaitaia painter Darrel Hopkins was typical: "There are a lot of problems with education, health, the Labour Government in general."

That left 75 people with more specific concerns - most often inadequate financing (23) and hospital waiting lists (19). Many were in real anguish.

Waitakere widow Patricia Maxwell agonised about the plight of a man with such bad cataracts and glaucoma that he cannot drive or watch television.

"They told him he had to wait two years for an operation. He's been waiting a year now. He got up the other morning and he couldn't see at all. He went into the hospital, but they told him, 'No queue-hopping'."

Retired Hastings drainlayer N.D. Coley said his wife had been in hospital nine days waiting for an angioplasty. "The whole thing stinks!" he said. "It's a good country. It's the people that's running it!"

In Christchurch, social worker Robyn Liddall, 50, was waiting for an operation because of the shortage of anaesthetists.

In Runanga on the West Coast, invalid beneficiary Peter Clements, 55, said: "It's criminal! I know a lot of people waiting for hip replacements who have been put back and put back. A lady in Runanga has just been put off another six months - this has been going on for three years."

In Invercargill, accountant Yvonne Hansford said: "Our health system down here is appalling. Southland Hospital should be renamed the 'Band-Aid Station', the waiting lists are so long."

A friend with her knew of someone who waited seven years for an operation.

"I think they do need more money in the police force, education and health," summed up Kaitaia motelier Sally McPhee. "Those are the three priorities as far as I'm concerned."

Six people worried about medical staff shortages, especially in rural areas, and three thought nurses were underpaid.

"In Southland and Otago we can't get rural GPs," said Jamie Mackay, of Gore radio station Hokonui Gold. "They are overworked. It's not a money issue. Doctors don't want to work seven days a week."

Invalid beneficiary Debbie Drew said that when she moved from Christchurch to Greymouth, she lost the ability to get medicine at weekends and had to go to the hospital instead of having doctors come to her.

"We don't even have an advocate here to go to with complaints."

Four people were upset about cuts at Kaitaia Hospital, which has axed after-hours surgery and forbidden its three surgeons to do caesareans.

When Bronwyn Pomare's aunt was ill, they sent a plane to fly her to Whangarei. But she died before she got there.

"She was old, so you can accept it," said Bronwyn's husband, Toma. "But it could have been a younger person."

Mental health was cited by six people.

"They can't retain staff. There is so much movement because their working conditions are lousy," said Judy McKay, an Auckland mother who has an adult daughter with schizophrenia.

She said the nurses worked double shifts and there were not enough psychiatrists.

"Their workloads are huge. We are going to have disasters."

Community support workers, she said, "sound good, but they might only visit for five minutes a week. It's very hard to talk to them because they are always changing."

In Christchurch, a man with mental problems in the family shared her concerns.

"Mental health I think is disastrous. All sorts of things are out of control. They are under-resourced for the problems that are around. It's only because there are agencies doing things with donated money that there is even some lid on it."



Christchurch shop assistant Kirsten Smith pointed to the 18-month wait for drug addicts to get into the Hillmorton addiction unit. "That's pretty poor just to get treatment for something they want to get off."

Perhaps surprisingly, only five people complained about the costs of primary healthcare such as doctor's visits and prescriptions.

Napier secretary Lenore Johnson noted that you can go to the doctor free in Australia.

Four people were concerned about care for the elderly or resented the asset test, which makes old people run down their assets before the state pays for resthome care.

"They work all their lives and end up in homes and have to use all their money before people will look after them. I think that's totally unfair," said a Te Atatu grandmother.

Only one person complained about Pharmac's restrictions on free medicines. Shirley, of Manurewa, said her husband took part in a trial of a new German drug for his heart condition a few years ago which had an "unbelievable" effect. "It was just like a new burst of energy.

"But what happened is they said it cost too much and that's it." Her husband went back to the less-effective drugs.

One mother, Jennifer Ross, of Aongatete near Katikati, complained about the cutback in school dental clinics from two visits a year to one.

Other complaints mentioned money wasted in the health system, health insurance, inadequate safety regulations and the "shambolic" state of hospital facilities.

Seven people offered constructive ideas. Five of them suggested diverting money to healthcare from hospital management, Maori TV, Treaty of Waitangi claims, unnecessary roadworks and the arts.

Only Denise Hansen, from Karamea on the West Coast, was prepared to pay "maybe a little bit of extra tax - but not too much because no one's got much to go round".

The seventh constructive suggestion came from Dean Johnston, a Hastings truckdriver who supported Act's policy of compulsory health insurance.

"At least you can be guaranteed to get into the hospital. Now you are not. I pay that hospital a tax every week and still have to sit on a waiting list. Give me my taxes back."

International data suggests that when healthcare is put in individuals' hands, they are willing to spend more than any New Zealand Government has spent collectively.

New Zealand's total health spending, 6.4 per cent of the national income spent by the state plus 1.6 per cent spent by individuals, is right on the 8 per cent average of developed countries. Australia's figure is 8.3.

But in the United States, where private insurance dominates, people spend 13 per cent of the national income on health.

In his Budget in May, Finance Minister Michael Cullen said New Zealand's chances of becoming richer "will not be assisted by excessive growth in expenditure which squeezes out opportunities for contributing directly to economic development".

He planned only a modest rise in public health spending to 6.8 per cent of the national income by 2004-05.

But this Herald survey and the US figures suggest that there is still a large unsatisfied demand for healthcare.

Satisfying it would be counted as "economic development" if new hospitals were built by a private company such as Southern Cross, but evidently not if they were built by the state.

A health tax, which Cullen says Labour will "examine" in its next term, would be designed to make state spending more politically acceptable. He has promised it would not mean any overall rise in income taxes.

So far, the polls show that most voters are content with Labour, despite their health worries.

But of the 88 people in this survey who were both worried about health and sure of whom to vote for, 43 per cent planned to vote Labour and 32 per cent National - a much narrower margin than the 51-22 per cent split among all 600 people surveyed.

In such a small sample, this difference can only be a hint of a political effect, and it may be working the other way - people who have already decided to vote National may be looking for negatives to quote against the Government.

But it is a hint that, at current levels of health spending, health worries may contribute to the natural erosion of support that all Governments experience eventually.

It is a warning that, for the future, Labour may well take to heart.

THE COLLINS REPORT

Herald reporter Simon Collins spent two weeks travelling New Zealand from Kaitaia to Invercargill. He asked 604 people for their detailed views on the state of the country and the issues that mattered to them in the light of the coming election.

The results of his one-man poll have been running in the Herald since Saturday.

The earlier articles are:

Saturday, July 6: Voices of the people (overview).


Monday, July 8: Race question opens up minefield (Pakeha views).


Tuesday, July 9: Maori in the new millennium (Maori views).


Wednesday, July 10: New life as a second-class citizen (the views of immigrants).


Thursday, July 11: Debt, poverty and the brain drain (education and jobs).

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