KEY POINTS:
We have a story today about how it is more than 20 years since Colin Marchant missed out on an operation to have varicose veins removed from his left leg, because the anaesthetist was unavailable.
We asked about your experiences. This forum debate has now closed. Here is a selection of your views on the topic.
Mary
When the CEO of the ADHB earns a salary of something in the vicinity of $440,000pa, which is obscene. Then perhaps the time has come for the government of this country to be considering where its priorities lie in regards to public health care. With this point in mind, perhaps this wasted unproductive position of CEO along with many other similar useless administrative positions in our public hospitals could be culled, as is the case with public hospital waiting lists at the moment. This way, the money the CEO along with the rest of the ineffectual team at the top of the ADHB are presently earning, can be generated into the public hospital system itself, thereby supplying actual beneficial health treatment for those who need it! It is amazing really when medical personnel are forced to take industrial action for improved pay and conditions, while at the same time the public hospital administrators greedily take home exorbitant pay packets at the expense of not only the medical staff, but also those members of the public who require surgery and other medical treatment!
Jorg Prinz
Reading the stories of people in New Zealand suffering from a non-functioning health system makes me feel sorry for the patients and angry about those who run this health system. Makes you wonder where all the money disappears that is pumped into health in this country. Is somebody creaming the system? Or are we simply employing too many "managers" of some sort in this system? Waiting lists show that there are not enough doctors to attend to the problems. Or are the working doctors not working hard enough? I dont think so. There are foreign locum doctors all over the country, working a few weeks or months for double or triple the money as a full time employed doctor would receive. Although there are about 1500 foreign trained doctors in New Zealand who are not allowed to work because they are "not good enough to work here" - as doctors, perhaps as taxi drivers. As if European trained doctors would be worse doctors than Kiwi trained doctors. This narrow-mindedness of the medical council is hard to beat. Well, it is just another point I would like to throw into the discussion. On thing is for sure: we all are taken for a ride. New Zealand medical standards are slowly slipping towards third world country standards. The arrogance of politicians, medical council, and pharmaceutical industry will fire back one day: what goes around comes around.
Tanya
I need surgery but have decided not to have it because of the risks involved and I do not feel confident in the health system anymore. The reasons for this is because a neighbour nearly died under aesthetic because of a mistake of the hospitals. He had waited too long before being taken in for surgery and his stomach acid was churning from not eating for so long. He vomited up the stomach acid and it went into his lungs. He was in intensive care for a night and recovered ok and was discharged the next day. I thought he should have stayed in for at least another day, for goodness sakes he nearly died! It was at the time just before the doctors were to go on strike last year, so I guess they were trying to push out all the patients they could out of the hospital before the strike too place. Another person I knew who had an operation ended up with a bad infection and had to go back to hospital to have it drained. I am on my own with my 16-year-old daughter. She would have had to keep a eye on me afterwards if I had the surgery. They were not too keen on that I could tell. I was not offered any home help or anything either if I had the op. I also explained to them I can not go for long periods without food as it affects my mood and my stomach gets very sore. I got the impression she will be right. No further tests or anything were done, which I thought should have been. I did not get an opportunity to talk to the anthaeiseist either. This would have been my first ever op, I was being very cautious. I was told by the surgeon that it was a teaching hospital (Dunedin) so I would expect medical students in there. I wasnt happy about that, felt like I did not have a choice. I would have preferred a more experienced surgeon do the hernia repair op. Where the hernia is near the private part of the body which I do feel uncomfortable exposing to strangers. I did not feel comfortable at all with going through with the surgery so cancelled. I am having to be careful in what I do now. At least I am alive! Excuse my spelling, have not eaten for a little while, better go eat something!
Alister
I had a friend who broke his collarbone and the break was such that it was required to be pinned. He had to wait for more than 3 weeks before he was admitted for surgery and even then, he spent 5 days in hospital and was discharged without the surgery being performed. There were not enough staff to perform the surgery and every day he would be "nil by mouth" all day until then at the end of the day, after he had been bumped of the surgery list he would be given dinner. This cycle went on for several days and then he was discharged without the surgery being done. He was admitted about a week later and the surgery was finally performed. All this time he was waiting for surgery he was on ACC. Just looking at the cost side alone that was 4 extra weeks he was unnecessarily on ACC and also 5 extra days he spent occupying a hospital bed. So this would add up to $2600 for extra ACC payments, plus 5 days in hospital at what I have been told is somewhere around $1000 per day. Just with this one instance, from the extra 4 weeks of ACC payments and extra days in hospital alone, there was well over $7000 dollars wasted. This highlights just how badly the health system is being managed. This money should be spent on providing treatment rather than funding ACC payouts and unnecessary days in hospital due to a mismanaged service. None of this includes the extra recovery time required due to the fact that he would have deteriorated over the extra 4 weeks. Also there is an extra 4 weeks of pain medication and of course the emotional stress of this whole debacle. Had this been in the private sector, no doubt the people responsible would be deemed incompetent or even negligent and would no longer have a job. The New Zealand health system is a joke, absolutely pathetic. I have no faith in New Zealands health system to the point I am looking for private health insurance as it is clear that New Zealanders can no longer rely on the state health system for even basic care. I myself have had numerous bad and unsatisfactory experiences of the health systems but this story of my friend highlights the inadequacies perfectly.
Elaine
I was lucky and my radiotherapy consisted of 25 sessions over 5 weeks. But I still received burns. These was horrific, and although I did the dressings myself, with advice & cream from the hospital, I still cried myself to sleep at night as the pain was incredible. The wait between surgery and radiotherapy is all important, and should be redressed immediately. Somehow the government always has money for non-essentials, but when it comes to health, there is no money to spare. Come on Mr. Cullen, loosen those purse strings! I guarantee if a member of your family was suffering,and you were on a regular income, then you would do all you could to help and support them in trying to beat this illness.
Mary
In 2001, I accompanied my best friend to Sydney for radiotherapy treatment as her support person, after she was diagnosed with breast cancer the same year. Prior to leaving NZ for a private Sydney hospital, I contacted the then Minister of Health Annette King and asked her how long this situation of sending cancer patients overseas is expected to continue. The Ministers response was that the reason patients were being sent to Australia for radiotherapy, was the result of the previous National governments health cost cutting, which included reducing the radiation student intake for training in this field! Ms King also reassured me that at that time, the Labour government had increased the quota of radiation students for radiotherapy training, and the result of this would be more qualified staff becoming available in three years time to administer radiotherapy treatment. This was in 2001! It is now 2007, and the situation seems to be exactly the same as it was six years ago, with absolutely no improvement to services whatsoever! Wonder what the governments excuse is this time!
Lee
I think it is about time that refugees, prison inmates and members of parliament be put on the same waiting list as me.
Peter "Not another health debate" I thought to myself as I read the headings today. However, the irony is that my father in law is currently housed in a Hawkes Bay hospital with a broken leg and waiting for surgery for over a week. He fell while at home and has in a holding pattern for some time. Although his heart condition places him at high risk, there still is not a positive answer to when it will be fixed and a promise broken yesterday when the nurse informed him the surgery will be delayed. Meanwhile he faces daily illusions and what could only be classified as mental torture due to the drugs being used to control the pain. Now, not only does he have to survive the fall, but every day he has to survive the building collapsing, shadows lurking or parts of his body falling of is some sort of twisted dimensional anxiety.
Tim Spooner
This delay just goes to show how outdated surgery is in NZ. The procedure to close up varicose veins is now a simple 45-minute laser procedure, done under local anesthetic. One hour and the patient goes back to work. Get with it.There is no need at all for major operations for this easy repair.
S Mohanakrishnan
I am really puzzled as to why these surgeries are called "elective surgeries". No one elects to have a surgery unless it is plastic surgery to improve ones features. All other surgeries are forced upon people because of their medical/sick conditions and they all should get treatment immediately. Otherwise what is the health system there for? It appears that they are practising some sort of "selective surgery", making people wait till they cant bear the pain of their ailment or till they become life-threatening. Not a healthy state of affairs. I understand it is all because of lack of enough medical practitioners, surgeons, nurses, hospital facilities, etc. But the long-term solution for that would be to promote medical education more widely and if necessary to start few more Universities devoted to medicine and nursing education. I am sure the private sector and even overseas educational institutions would welcome such an investment opportunity. Which incidentally may also divert funds from the residential housing sector, which the Reserve Bank is trying to cool down.
Jeremy
I was on the waiting list for 18 months, waiting to have a colonoscopy done, since I have had pain and problems, which could suggest a problem in the region. I have family history too, with both my parents and my older brother having had pre-cancerous polyps removed. One of my grandmothers perished from bowel cancer. So what did the Govt do? They took me off the waiting list saying my case did not merit the test – "not enough evidence of a condition". Duh, that is what the test is for. I guess they want me to pay the $1400 myself. Well, I suppose I could. However, why! I pay taxes, my wife pays taxes. Why, when I need some assistance from the Govt, do I get nothing? It is very frustrating. In Australia, I understand that everyone can have the test and the nominal charge is $100. No wonder our cancer rate is so much higher than Australia when they treat us like this. Kicking people off the waiting list for legitimate procedures is penny-pinching and wrong. Is it so we can sink more money in Cullens share portfolio?
And he is still waiting.
Christina
I am seeking help for my incontinence problem since 1999. Our GP sent me, back then, to see a Gynecologist, who then transferred me to see the urologist for Urodynamics studies. His receptionist rung me and asked me if I wanted to take part in a double blind study for treatment of incontinence. I declined, as I am working fulltime in our business and wanted treatment! I live and work nearly 50km from the clinic and it takes me about 45 minutes to get there. I really dont have the time to travel 3 times a week and have the risk of being the "double blind" patient who gets only a placebo treatment. I wanted help for my health problem. The receptionist further on asked me if I wanted to pay for the study (around $1000) or "go public". I confirmed that I could only afford the public variety - and I never heard of them again.
Because our GP mentioned to me that I probably would only get a surgical help if I first tried to learn pelvic floor exercises and have specialist Physiotherapy, I did that. I can not remember how many hundred dollars I spent there, but it did not remedy my problem of stress incontinence. After this my problem actually got worse. My first two deliveries were caesarian and only my last delivery was normal, but with a large incision and further tissue damage, which left me with bad scarring. While the incontinence grew to a hardly managable problem, I felt that the scar tissue started to hurt badly and break. Controlling gas and bowel motion became very difficult. When I described the pain and the growing problems to our GP he found a large rectocele which is now protruding into the vagina and he referred me again to Dr. Speed, the gynaecologist. By then it was 2004. To get some relief I decided to try if a bit of weight loss might help and reduced my weight from 61kg to 55kg, I am 163cm. But it did not work and I will try to loose more weight. The doctor confirmed the rectocele and again referred me to the Urologist. As you can imagine, the incontinence, having spread now from urine also to gas and bowelmotion, has a become a growing obstacle in the management of my daily life. While in the 1990th it "only" prevented me from running, riding my horse and my motorbike, I also always had to stop and "squeeze" (twist my legs) when I felt I had to cough or sneeze.
For some years now I am really handicapped at work too. Being an automotive technician and Warrant of Fitness Inspector in our own business means dealing with the public all the times and also having colleagues around.
Besides the permanent pain, whenever I move I have to worry that there might be gas escaping or I might leak otherwise. Maybe you can feel a bit how depressing such a situation is. I do not want and can not afford to abandon my work and my business because of that. That is why I decided that I would pay myself this time for the Urodynamic Studies and this time I was able to get an appointment already a few days after I rung. He found my pelvic floor muscles amazingly well trained. Which showed that surgery was the right remedy for my prolapses. So the doctor enrolled me on the surgical waiting list for Tauranga Hospital. He mentioned that there is a 6month wait to have this operation. I was on this list for about 10 month when I received a call from the Hospital, enquiring about if my health problem was still there or had disappeared. But I had to let the lady know that it had actually gotten worse and I was often in severe pain. The side of the scar was hurting permanently and I am walking with a limp, as I can hardly put any weight on this side of the pelvic. She advised me to get back to my GP and Dr if I felt I had gotten worse. I contacted both of them and finally was invited for an Outpatient appointment in Tauranga Hospital in January. As I was told, "this is the final examination about one week before having the surgery", I was glad to be "nearly there" where a normal life can begin again. I also organized my family and help for my business in expectation of the surgery. I just have to add here, that each time I go to any of those appointments, I also have to leave my business and technicians behind for about 3 hours at a time and so you can understand my disbelief and frustration, when the doctor told me when I entered his rooms (again) that he does not know who I am and why I am here and what my problem is! He had no file about me and the previous tests and visits. To safe a bit of sense I tried to explain and describe my health problem and previous tests and appointments, but the only result was that he now wanted to refer me to another specialist, for another costly and delaying test. I suspect when I describe my growing desperation and how depressing this health problem is he will refer me to have a psychiatric assessment. It is now 8 years that I try to get help. I must admit that I have lost all trust in this system and the medical professionals I have been dealing with so far. I have been insured with AI for years for "Hospital and Specialist Cover", but the insurance has declined to cover, as they see this as a "pre-existing condition". (Means any woman who has had children will not be covered for any gynecological problems) I also think its advisable for any woman who wants to have children to have them by cesarean delivery. This way she is a lot safer from those problems. Otherwise I recommend better to have no children at all in NZ as we females are left alone with the resulting health problems or have to pay dearly to get it fixed. My plans now are to seek help privately and to pay for surgery myself. I'll have to use a bank loan to pay to get a life back.
Otherwise I risk loosing all my dignity and sanity with this embarrassing condition. I am quite sure that my experience will be one of many sad ones
Our health system is a mess, we are twice as likely to die on our roads as our neigbours across the ditch because we are stuck with out-moded roading systems, our internet cant meet the requirements of the systems most other nations have already surpassed, our kids education is regressing, and the lack of adequate public housing at the bottom of the market has put so much pressure on the private housing market that owning a home is an impossible feat for most young New Zealanders. These are problems that cant be fixed by playing around the edges with "efficiencies" or whatever. They can only be addressed if NZ citizens get fair dinkum about what living in a community is and understand that government expenditure is not wasting money, or taxation theft, or any of those other furphys put out by rich greedheads and the silly un-rich who chase after them, it is an investment for all of us, one that will provide returns for all of us; if it is allowed to.
Johanna
I am far better off than many people on waiting lists, but I am still quite annoyed with the whole thing. Went on the waiting list in October 2004 to have a sleep test done for snoring and sleep apnoea. Got the test done in March 206, that is a year ago. Since then, four appointments with a specialist have been cancelled and I am now waiting for the fifth. I might as well take the test all over. I wake up from the sleep apnoea almost every night, I am always tired, wake up tired, have little energy, do not get much done - all this to a moderate level. Again, some people are far worse; they do not sleep much, fall asleep behind the steering wheel. I am not there yet. But I still would like my appointment and get something done!
Colin
A while ago my mother died, she had a heart condition, but she never scored high enough to have it operated on, over 6 years she declined in health, and the scoring system kept raising the bar, in the end she did have the operation, as by then she was very unwell. She passed away 6 weeks after the operation as she no longer had the health to make a good recovery. well done, NZ Goverment. My father in law died due to bowel cancer, they knew he had it but being in a smaller town did not have the resources to deal with it, he did not receive any real treatment at all, other than pain relief in the last few days. So for all you people who think the NZ Govt will look after you, you are very misguided.
Kristina
I do not think it is just the waiting lists that are the problem – it is the waiting to hear back as to what is going to happen full-stop! I followed up an appointment I had had with a doctor (for my hearing) at the Waikato hospital who had passed my information to a surgeon for review. It took over 2 months and numerous phone calls for the folder to be opened and another appointment made to discuss getting the operation. Then about a month after that, I get a letter with a form to fill out asking me whether or not I still needed the operation and if I did not send back the form they would assume I did not need it. What if the form had been lost in the mail? I am automatically crossed off the list. I then get a letter saying yes, I have been put on a waiting list and they could say that I would be able to have surgery some time in the next 6 months. Dont doctors schedule? "Some time in the next 6 months" is rather vague. I have nearly reached the end of 6 months and have not heard anything at all from the hospital. Have I fallen through the cracks? Have I been sent a letter that didn't arrive advising me of a date for surgery? Did they update my details as requested? There are no answers, like mushrooms we are kept in the dark and fed cow dung.
Kaumatua
First, Ray, the majority of immigrants pay taxes in NZ so them accessing health care over so-called kiwis should not be an issue. The problems are multifaceted. Government has not planned for the increase in the burden of disease so people suffer. Also since we promote outdoor activity and sports so much that we are bound to get wear and tear in our bodies therefore increasing the need for treatment and surgery. As we grow older we need surgery to renew parts of the body. All this is the consequence of wanting to live longer in the best way possible...so there will always be some losers and some winners in accessing health care.
Paul B
Dropping people off the waiting lists makes our (un)health(ly) system a total farce. Do the powers that be think that if the numbers on the list stay small we will be fooled into thinking all is ok?
Andy
The Public Health system in New Zealand has been in decline for some time. Waiting lists growing longer and being "creatively" dealt with is not a new situation. Responsible New Zealanders protect themselves by taking out insurance to cover surgery, these people do not appear on waiting list statistics as they have direct access to the private system. Yet these New Zealanders have the same proportion of their tax dollars spent on a public system that they will never call on. If the Government is serious about dealing with waiting lists they should look at tax rebates on medical insurance premiums. This will encourage more people to take out private medical insurance, and whilst not impacting on people already on the waiting lists, it will reduce the number of people being put onto the lists and that will eventually flow onto to a real reduction in the number of people waiting for surgery.
Andrew Atkin
The government goes on about the increases in health costs due to increased service sophistication. Ok, but are we over-investing in quality (sophistication) at the expense of quantity? Maybe it would be better to have slightly a less state-of-the-art service for the sake of people not having to wait forever to be treated? It boils down to ultimate optimisation, and I the get the feeling that the government may be running on a state-of-the-art as opposed to optimum total service ideology.
Raj Subramanian
We all know that communism failed totally in the last few decades. World over, Labour Governments normally reflect communist ideologies of State providing inefficient services from Tax revenue. They believe efficient/timely service delivery is not important rather name-sake schemes are important. Unfortunately in New Zealand even National party has also adopted major Labour ideologies to get more votes. We go to a private Doctor and ask for a treatment, he quotes a figure. If we pay that amount he will tell us what date he will undertake that treatment and he is bound by all professional ethics created by professional bodies and government.
Same way we as a nation collectively pay taxes(rather Govt.takes it from our salary without even our consent) to Government to cover many services including Medicals. Even if one member of our nation doesnt get the services in a timely/efficient manner, the Government should take complete responsibility and pay the patient damages apart from providing service. They cant hide behind policies of removing us completely from a waiting list to show their might. It is a shame on the successive governments. If they cannot undertake operations in hospitals then dissolve the complete health system and hand it over to private sector. Cut 10 per cent of taxes. We can then utilise that amount for health insurance premium. As a temporary measure Govt. can subsidise private health insurance premium by tax rebate/reductions on them -one major hurdle- oisurance companies normally dont cover existing health conditions. Therefore Govt. should insist that the tax rebates will be available for insurance premium only if the policy is without any exclusions. Otherwise the cream of good health people will be in private health insurance scheme while the whole sick list will be in Govt. Health systems making the waiting lists longer.
Matthew
New Zealand healthcare is in such a bad state simply because there are simply no more brains to drain.
Steve
I am growing increasingly tired (I dare not say sicker!) of this incompetent Governments insane focus on politics and statistics when it comes to the health system. Taking thousands of people who need health care off the system for political gain by manipulating statistics should no longer be tolerated by the good folk of this country. We need to speak up and tell this socialist government of ours that we will not be blinded by lies and skewed statistics. A high-quality national health system is supposed to ensure that the citizens of this country get full and timely access to health services and operations when they need them. What we have currently is a no-quality non-health system run by bureaucrats and politicians acting like the emperor wearing his new (no) clothes.
Charles
Who is a Kiwi and a "non-Kiwi"? A new immigrant/Permanent resident who has come through the proper channels ie. application etc has all the rights where medical treatment is concerned. As far as how long one should wait, no one should be made to wait that long, treatment should be made available as soon as possible to all who need it.
David
It staggers me that someone can be on a waiting list for 20 years due to a staff illness 20 years ago. Where does all the money the government puts into health care go. Surely surgical procedures and clearing waiting lists should be a priority not something you do if there is some money left over.Compulsory savings is one step in the right direction but what about compulsory health insurance. If to only cover surgery. As a previous correspondent said how is that the Australian health system can treat NZs as well as their own citizens. My family gets no free health care in NZ because we are in the fortunate position to earn too much and can afford health insurance. My children have had operations when they need them as we can afford with the help of our health insurer to have these done privately. My son required an operation as a toddler. If placed on the waiting list we were told he would get the operation when he was 13 or 14 (he was 2 at the time). At that age the operation would have been quite traumatic. Luckily he was able to have it done privately without the trauma. I have also experienced the free healthcare in Australia which was far superior to my experiences with public healthcare in NZ. Lets hope the new National led Government will address this issue once it wins the next election.
Phil Sinclair
Many of those arguing that our health service is in dire straits also demand tax cuts. The two points of view are incompatible. While there may be some changes which can be made to reduce costs and make this sector more efficient (eg stop specialists from running a "closed shop" so that demand for their services always outstrips supply)in the end we will only get the Health Service we are prepared to pay for. The fact that NZ governments of whatever stripe are reluctant to pay for adequate infrastructure for anything ,leads me to believe that unless a fundamental change occurs within our community, the health-care system is going to get much worse before it gets any better. People are always eager to blame "the government" for the appalling state of our health services, yet this reluctance to invest in infrastructure didn't originate within governments, it is a direct result of what has happened to previous governments who have been silly or idealistic enough to spend on building up our country's assets.They always get tipped out at the soonest possible opportunity.
One only has to look at the last election to see this. After nearly 50 years of marginal economic growth NZ finally seemed to be clambering out of the pit. We had a considerable surplus in the government accounts and citizens were employed and earning at a far greater rate than any previous time in our citizens lives. Surely this would be an ideal opportunity for us to begin making up for the decades of under-investment in transport, communications, education, health and public housing infrastructure. "No way" cried the citizens whose short term thinking was only out-stripped by their greed. We want tax cuts now! Never mind that the amounts many get in tax cuts would be a pittance compared with the increased costs that would arise out of letting our nations systems languish. Forget the fact that every cent spent on these projects would continue to slosh around the economy enriching us all, as well as modernising our nation.No! We wanted the money and we wanted it now.
New Immigrant
I agree with one of the Herald readers view that kiwis to be offered health care/operations first over new immigrants etc., but only if, new immigrants etc. are taxed at a lower tax rate than kiwis. Well it is all history now, the tax cuts did not eventuate, we could not possibly afford meaningful cuts, but neither did the development NZ needed happen either.
Ray Carter
We need to ensure Kiwis are offered health care/operations first over new immigrants etc. On spending two weeks in both Auckland and Middlemore hospital supporting my father after a heart attack I was astounded to see the vast number of non-kiwi patients needing operations and care, the ratio approx 10:1 (1 being Kiwi).
Michael Draper
How is that Australia has the competency to not only provide its citizens with a proper health service but also has the capacity to treat New Zealanders as well? It cannot be lack of money - the New Zealand government is well prepared to provide its tax payer dollars by the hundred millions to provide facillites so that we can all go and watch men playing ball. So what is the reason? Can we not employ Australians, at least in the short term, to show us how it is done?
Carl Forster
There should be no waiting time if you require an operation.. but under this Labour government it grows longer and with the number of people dying before they get their operation. I would suggest the following calculation: when this gLabour government and its MPs admit they are wrong and accept responsibility. Won't happen so the list and times get longer.
Richard Wallis
The Governments requirement that people be dropped off the waiting lists before they will provide further funding is merely political blackmail. They obviously want to make it seem that the waiting lists have reduced, and are prepared to don the mask
