Cooking The Medical Books: Citizens suffer in stoical silence so National can keep taxes low.


A2KT8M portrait of sad looking old lady sitting in armchair in nursing home

FUDGING THE FIGURES is what governments do when effective policy solutions are ruled off the table. According to Radio NZ News: “New research shows nearly 40 percent of patients who need hip and knee operations in at least two district health boards are not getting them because of budget restrictions. The study, published in The New Zealand Medical Journal, which looked at Northland and Hawke’s Bay, found the drive to cut wait times has left 36 percent of patients with moderate to severe pain and disability untreated.”

Clearly, the now retired National Party Health Minister, Tony Ryall, was unable to persuade his fellow “Brat Packer”, Bill English, to appropriate sufficient funds to keep our public health service up to the job of actually serving the public.

One doesn’t imagine that English, an essentially decent politician, was very happy about this. But with his colleagues demanding lower taxes for the wealthiest New Zealanders (and some modest covering reductions for the rest of us) he was left with little choice. It would require a Labour-led government of more than usual fortitude and radicalism to institute the fiscal reforms necessary to ready the New Zealand health system for the influx of ageing Baby Boomers steadily falling prey to all the ills that flesh is heir to.

Tony Ryall’s response to his increasingly underfunded health system was, however, ethically extremely radical. According to the study published in the New Zealand Medical Journal, he simply invisiblised upwards of a third of New Zealanders in need of non-urgent surgical interventions.

Chairman of the Canterbury Charity Hospital Trust, Christchurch surgeon, Philip Bagshaw, told Radio NZ that focusing on the length of time people were waiting, rather than the length of the waiting lists themselves, was “a great way of hiding the scale of the problem”.

“It’s become smoke and mirrors”, said Mr Bagshaw. “They’ve created a self-fulfilling prophecy, so they say the waiting list is only six or four months, but that’s because they only allow that many people onto the waiting list.”

Smoke and mirrors it may have been, but the practice permitted Tony Ryall to boast that the time spent waiting for elective surgery was steadily decreasing. According to Mr Bagshaw, haemorrhoids, cataracts, hernias and varicose veins – among a host of other debilitating conditions – are simply not being treated in the public system until such time as serious complications render them acute – and costly.

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Allowing the condition of sufferers to deteriorate to the point where they are forced to seek emergency admission to public hospitals is, not surprisingly, a considerably more expensive proposition, long term, than providing treatment early. “Investing in health early on is not only humane but also makes good economic sense because to do things in a timely way is the cheapest way,” Mr Bagshaw confirmed. “If you deny people treatment … they come back later with bigger complications and cost more money.”

As scams go, however, this is a particularly clever one, because, obviously, not all of those sufferers rendered invisible will end up undergoing emergency surgery. Most will simply go on suffering, unheard and untreated.

In other words, the Government and its cash-strapped DHBs are relying upon the decency and stoicism of the average citizen to get them off the fiscal hook. Their deeply cynical – but apparently accurate – expectation has been that the voters will evince little interest in how Mr Ryall’s miracle is being achieved, just so long as the waiting period for elective surgery keeps decreasing. And so it proved. On Election Day, most people accepted without demur that John Key’s government was managing our public health system with considerable skill.

So, it’s ‘all good’ for the Government? Well, not necessarily. As the Baby Boomers find themselves relying more and more on the public health system, they are bound to flex their still massive demographic muscles to ensure that sufficient funding is appropriated to meet their growing needs. With everything to fight for in terms of free medical care, there is nothing to suggest that the ageing Boomers will not emulate the exemplary levels of electoral participation demonstrated by older voters generally. In securing their selfish health objectives, the Boomers will be aided by the short-sighted failure of so many young voters to participate in the electoral system.

The politicians of the future will respond to the medical demands of the Boomers in the way politicians always do when presented with a choice between serving the interests of citizens who vote and the needs of citizens who stay at home. If young New Zealanders want a viable public health system to still be in place when they reach their 60s and 70s, then they’d better start voting in the same proportions as their elders. Otherwise the health statistics being fudged will be their own.


  1. Running down the public health system so as to make the case for increased private health insurance. That other kind if collectivism…

    • My friend – just after a lumpectomy for breast cancer – has been put into the public health system because her insurance company only pays for one scan per 3 months and her doctors need to give her another scan as a spot on her pelvis could be cancerous. BUT private enterprise does it better -yeah right!

  2. Such a shame NZ has come down to this, cutting funding for health care, denying Kiwis treatment, through mismanagement of funds and government incompetency.

    I’m sure I don’t have to reiterate the fact that in the past, this once progressive nation led the civilised world in health, education and child welfare. However now, it seems greed and corruption in government is taking us towards third world status in these areas.

    But I guess money taken out of the public health sector, will be put to much better use, for all Kiwis to benefit from. Corporate welfare, new limos for government, $26m for referenda for a new flag, come to mind! And bugger the rest of us!

  3. All this has been known for a long time; there was a TV doco before the election in which philip bagshaw expressed these opinions.

    This in my view represents a shameful failure on the part of the Labour Party pre-election. This was an issue on which they could have gained real traction and nailed the government. This is an issue close to the hearts of all New Zealanders but the LP bottled it. I believe this one issue properly tackled could have lifted Labour over the 30%mark.

    • I couldn’t agree more.

      You only have to know a young diabetic to know the health system isn’t working and that pharmac is being starved of funds to buy the needed medicines for some.

    • OK so why was there no screaming “FOUL” from the rooftops? Where was our MSM????

      Oh, hang on…..

    • They kept quiet because elective surgery queues were longer under the previous Labour government.

      They knew it would blow back in their face so they avoided the topic.

  4. Full marks to National for pulling this fraud off but they have fooled the voters too through similar devious means that crime is down, which of course it isn’t.

    There were rumblings in the last few years that if you actually made it on to a waiting list (and that was no mean feat) you may simply end up dropping off it altogether and then a demoralising return to the start. But where was the opposition or the media??

    They have made positive differences at the shop front in ER where middle NZ voters are most likely to encounter the hospital system but the reality is underfunding will only get a hospital so far. And frankly who gives a stuff about the elderly in NZ!

    I did not see the dismantlement of the state housing coming and so its fairly easy to conclude that Ruth Richardson/Simon Upton’s long forgotten attempt at partial privatisation and partial pay as you go health system is waiting in the wings again, justified by the intentionally broken public system and sold by the soothing tones of John Key.

    Were I a health insurer, knowing what National are really like, I will have donated hugely to them and had one of those mutually profitable lunches with the PM to ensure such a policy comes to be, because I and my share holders will have struck gold! And that is what this is really all about.

  5. “In securing their selfish health objectives, the Boomers”

    Fine words from a man born in 1956. A Boomer by birth date.

    Currently the knee, hip and cataract operations are mostly being erratically supplied to an earlier generation or so. People brought up to vote. It doesn’t seem to be doing them much good.

    Our ‘wonderful’ medical ‘system’ – where so many Boomers (not sheltered by continuity of employment and income) are hard-pressed to pay for both diagnosis and treatment. And their kids – the current crop of parents, are the same.

    Of all the meaningless tropes tossed about by public writers, the one about ‘generations’ is the most useless, divisive, and misleading. As well as unbelievable. (EVERYONE born between 1945 and 62 is awash with dosh, owns multiples of properties, can look forward to a luxurious retirement – yeah, right.)

    Successive governments have had fifty-plus years to prepare for ‘the tsunami’ of ageing leeches on the strictly-rationed health system. And they’ve failed.

    There’s no point to picking on people who have paid their taxes, worked where and when they can, and have coped with the ineffectual provision of sickness amelioration offered by ‘the medical profession’. Whatever their generation.

    Clapped out ambulances at the bottom of the cliff is not a measure for a top class health protection service. You’d be dotty to think so.

    Go for the core of the problem – and it’s NOT ‘Boomers’.

    • Andrea, I agree entirely. It is hardly selfish simply to grow old, especially when much of the medicine that enables people to live longer was researched and implemented by so-called ‘baby boomers’.

  6. Sorry Chris, ….but this time I cant be bothered typing a long drawn out post , …but Ill say this….I take umbrage at the statement :

    ‘ One doesnt imagine that English , an essentially decent politician ‘….

    PIFFLE !!!!

    Let me remind you that this ‘essentially decent politicain ‘ was the man who said :

    ‘ We should be glad we have a low wage economy because it encourages overseas foreign investment ‘ !!!!!!!!!!!!!!!!!!!



  7. The pressure Mr Ryall put Health Boards under through ‘his little list of goals’ was incredible. These health targets- as you point out – having less to with health and more with headlines. It is not surprising that there has been cheating to fudge the figures – DHBs were finacially penalized if they did not meet these targets. So does anyone know what coshy job Mr Ryall is now doing?

  8. The entire Public Health system needs an overhaul. I was shocked to read that the Southern Districts Hospital Board (SDHB), needing about a million dollars to do some urgent repairs to the ageing buildings, will have to borrow money from the private banks to effect the repairs. What is the point of a non-profit organisation borrowing money as though it were a private profit-making concern?

  9. Ah God . I really wasn’t going to write this . I tried to avoid it by walking my dog to the river after swinging by the pub for a bottle of Brain Dead Chardonnay . I must , after all , make sure I die of something quick before my joints wear out and I have to wait for God in a hot , stuffy , rotavirus infested departure lounge full of others smelling of brussell sprouts and piss while in pain with no merciful death within reasonable sight .

    Look . I know , I’ve written this before . I know that you , and your colleagues , must be getting more than vaguely irritated by what I’m about to write . Again . But honestly ? I’ve seen nothing coming from your erudite self , or Selwyn , or Martyn to open up the essential discourse necessary to expose The Great New Zealand Institutionalised Lie . Yes folks . T.G.N.Z.I.L . Or T’gnzel if you prefer .

    Before I start , I’d like to say ; indeed must say , how uniquely bizarre it is , to read all the growed up adults like yourself talk about NZ’s economy , or of the lack of it as is the case here . I read Keith Rankin also . He talks about finance and economy in a very intellectual way which has given me huge insights into the vast chambers and vaults that is the cranium of the average financier . All that is terribly interesting to someone I’m sure . But not to me . To me , it’s like watching a re run of Shortland Street on a wet Sunday afternoon to help heal a broken heart . A rope , a rafter . you get my drift .

    Can you p.l.e.a.s.e. explain to me just where you think our money comes from Chris ?

    If you need help , do not call Keith Rankin because I can tell you now , he has either no idea , or he prefers to skirt around that uncomfortable question and just blatantly fudges it , as-do-you-all .

    You all talk about government expenditure as if there was some kind of goose popping a certain number of golden eggs out to be carefully rationed amongst the needy and the employed .

    Pardon me while I become trite and sarcastic .

    Get in your car . Drive away from the Lattes and behold ! ? What do you see ? Do you see ‘ Countryside ‘ ? You do ? And what do you think … happens , on that countryside ? Yes , rabbits do indeed fuck like rabbits ; do . Birdies fly , yes . The air moves , yes . That is ‘ wind ‘ . Those odd , steamy things are clouds and they sometimes drop water . Yes . As R.A.I.N. And what else do you think might ‘ happen ‘ out there . On all that countryside ? Or Land . Do you think there may be humans out there too ? I know , I know ! As preposterous as that may sound , people do indeed live out there with the fucking rabbits and the flying birdies do indeed fly in the movey , movey air with the fog monsters who pee on you now and then .

    And what do you think they may be doing out there ? Those humans ? I know , they do dress funny and they sound funny and they smell funny and they think funny thoughts … you may not believe me when I say this but they are the same as us . I know ! Outrageous ! What a thought ? It’s like finally discovering vaguely intelligent life on a planet close enough to communicate with . Amazing when one thinks about it .
    You might reasonably ask ?
    Do they fling their faeces at one another ? Yes , sometimes they do . Do they feel pain like we do ? Yes , I believe so . Do they have babies , you know , the normal way ? Yes . I’ve seen it happen . The mother , once dropping her human-ling turns around quickly to make sure there are no predators ( Banks ) before licking her new-born clean and dry . She then bites through the umbilical cord while the father is getting pissed at the pub while in a trance like state from staring at posters of rugby players .
    What else do you think they may do . Of a summers day ? No , not fuck like rabbits , fly like birdies , swirling in the movey , movey air then turn into fog monsters and pee on the first thing they see . Well , some do that last thing after many , many beer-drinks . But mostly no . They do not .
    They make farmer-things like ‘ food ‘ and ‘ clothing materials ‘ and ‘ fruits ‘ and ‘ vegetables ‘ and ‘ grains ‘ and they manage lesser animals to themselves to thrive and grow larger who are then transported to places of butchery to be murdered and sliced into polite pieces for us to add heat to , then once rendered unrecognisable to the animal it came off , is eaten , digested , then shit into a sewer where it’s cooked further until that animal part is sped into the ocean to be eaten by fishes or just settles on the bottom until the next time the Earth rebirths .

    Sad , but true .

    ( When next you’re in line for reincarnation and someone asks ” What d’ya want t’ be this time mate ? ” Do not say ” Cow . Fuck it . I’ll go cow . Just this once . To see what it’s like to have a decent pair of tits , or balls ! Man ! Have you seen those cow balls ? Huge ! ” If you go for French goose , you’re really fucked . )

    Ok . Back on track .

    So , we’ve established that there are human-farmer types on the land and they make food and meat happen . I know ! Magic is real .

    What else do they do ?

    They make money . For us . Yes . For us . Because most of what ‘ farmer-oids ‘ ( Think muddy haemorrhoids in blue polyester overalls ) make and do is surplus to our immediate requirements so that ‘ stuff ‘ is then sold to others , just like us who live on Lands far , far away who , just like is , need to consume in the front and shit out the back . ( And the reasons for that are yet to be determined )

    Here’s where it gets significantly more complicated .

    We ‘ New Zealanders ‘ ( For the want of a better name ) number about 4.3 million souls . ( Apart from the members of the entire National Government and their supporters who have no souls . )

    Yes . 4.3 million people who survived the umbilical cord gnawing , vulture circling , swirling birdie , rabbit fuck-a-thons of birth to get to where we are today . In Deep Shitsville .

    4.3 million people . Humans . Mammalian bipeds . We are clothed and polite . We’re still eating the dead heated flesh of our fellow sentient beings but we’re getting there . ( I’m as equally to blame . Damn it . Other animals ARE delicious )

    4.3 million .

    Lets ask the question ; how many are ‘city people’ … and how many are ‘ country people ‘ ?

    What’s your guess ?

    Let me tell you . Courtesy of Dept of Sats .

    53 thousand people make money selling off surplus agrarian product .

    4.250 million do not .

    So , here’s a question begging to be asked .

    ( I actually know the answer to this )
    What the fuck is Labour doing NOT courting the farmer away from National ? Why is Labour not actively charming the NZ farmer into the protective nature of numbers versus tyrants . That is a very , very basic rule of engagement . The art of war says so .

    Warning ! I might get sweary . I hope not I must say , but I might . I feel very passionate about this so I might get carried away . My apologies in advance for any swearing but I’m fucked if I’ll apologise for that which makes/allows me get carried away .
    ( Ever been carried ? It’s oddly reassuring and fun actually . It’s the bleeding and the moaning that’s a bit iffy . )

    So , where were we ?

    Oh yes .

    53 thousand people and 4.250 million people .

    It’s hard to get your head around isn’t it ? Auckland is a largish city . As is Hamilton , Wellington , Christchurch , Dunedin . Even Invercargill has a city-ish feel about it .

    NZ = 4.3 million . People . 4.3 million . That’s a shade less that Melbourne . Sydney has about 4.7 . Million . People .

    New Zealand has 53 thousand people making all that export derived money and yet there are 4.250 million people who need to survive and flourish .

    That begs many questions . One of the questions that it begs of me is why the fuck you The Daily Bloggers haven’t yet dealt with that conundrum ? Why are you so hell bent on ignoring the obvious ? Are you duplicitous ? What is it ?

    NZ is a farming Nation . We are a Nation of Farmers . That is why National has Farmers by the cow balls . National lie to farmers , swindle farmers , use farmers , in debt farmers to control farmers and generally , hypocritically use farmers for no other reason than for the money they make us from our fellow humans who like us , need to eat who live over the seas …

    You cap off this madness , this is what I have to say . ( OMG ! The Brain Death Chardonnay is kicking in finally )

    Labour and National are the same fucking deal . Mana and Kim Dotcom are also the same fucking deal . NZ First ( Little bit of sick ) is the same fucking deal . Screw Ball Colin Craig and his God Bothering Bull Shit band of Blathering Brethren is the same fucking deal . The Maori Party are the same fucking deal . ( You know , you’d sell your grannies head stone for a dollar so don’t give me your whanau shit ) It’s all the same fucking deal man . Janis Joplin knew a thing or two .

    And all you fine and fancy few . You , with your pretty feathers and your plump buttocks . Your silly cars and your deep knowledge . You have nothing . And you know fuck all . When your belly’s empty and you’re cold and afraid and you think your pets look delicious actually . ( Ooo ! I scare me with that stuff . )
    The siege of Leningrad was lifted on 27 January 1944 . After people ate each other , but not their pets . That was seventy years and three months ago .

    And yet here we are . Fucking around with the very heart of ourselves and our country and it’s barely worth a mention from any of you .

    National and Labour squabble over who gets the most from a fleeting yet plentiful supply of that which is most essential while we fuck about like fools to the slaughter . We’re less than animals . Poor little creatures know no better .

    To Nutshell it all from my humble perspective and sorry for the sweary words and anger but honsetly , I’m so tired . I’m tired off it all . New Zealand is an amazing and wondrous place . You only need to travel etc etc .

    And yet we’re throwing it all away . We’re losing our beautiful few little islands to soulless , faceless corporates and that saddens me to tears .

    We need to bring the Farmer into the picture , so to speak . The NZ Farmer is our economy . The NZ farmer is our livelihood . They are the ones who earn our money . Jonky well knows that . His predosseors knew that well also . We must . MUST engage the farmer and offer them security and safety within our city societies , they must be drawn to where the human numbers are . Any well meaning politician who can engage the farmer and steal them away from the clammy grip of the Nationals will save New Zealand .

    • “it’s all the same fucking day, man.”
      pono and thanks for that Janis Joplin.
      DHB’s are just another brick in the corporate wall.

      oh and by the way I would never sell my Nani’s headstone,
      but I might/could sell the one next to her’s,
      when all the weeds and roots are gone.

      A pre war song adapted into a Siege of Leningrad nursery rhyme,
      “A dystrophic walked along
      With a dull look
      In a basket he carried a corpse’s arse.
      I’m having human flesh for lunch,
      This piece will do!
      Ugh, hungry sorrow!
      And for supper, clearly
      I’ll need a little baby.
      I’ll take the neighbours’,
      Steal him out of his cradle.”
      thanks wiki

    • Countryboy, the money for public goods *should* come from taxes, but, from Roger Douglas (cursed be his name) onwards, the tax system has been altered to benefit the wealthy, relying on the mythical ‘trickle down’ effect to sort everything out. Anyone with a brain realises very little ever trickles past the pockets of the rich, and the current government isn’t even trying, giving them tax cuts and landing the rest of us with increased GST. Until we get back to a sensible and humane progressive tax system, things will only get worse. People with plenty of money should be *pleased* to pay more tax for the benefit of the country as a whole, but, sadly, they’ve been brainwashed by the pushers of neo-liberal doctrine to see this as theft.

      • I agree completely .
        douglas and his cronies understood well the historical implications of having farmers tied up in knots of complex debt and tax implications . All they then needed to do was leverage up the OCR and cause a drying up of off shore funds derived from farming activities and behold ! Huge on-farm debt burdeons thus total control of the entire farming sector .

    • 55,000 v 3,450,000 people, I think you may have just a described a nation of NOT farmers, and you could also have perfectly illustrated how all industry is more and more not needing people at all. And we all know how these big corporations contribute so much by way of taxes that can be put to good use in the health system, don’t we?

  10. Countryboy: Whilst I greatly enjoyed your post, I think you’re a bit off the mark as regards where the money is actually made.

    Whilst most of our major exports are indeed derived from agricultural sources, more value is added in the downstream chain of manufacturing than is achieved by the farmer. Sure you can make milk & mutton. But that’s not the same as lamb racks on a plate in a swanky London restaurant. That milk wouldn’t be much use but for the efforts of the milk tanker driver, the engineers who designed the truck and the plant, the people that operate the plant, the fancy folk who designed the label, the label makers and all others in the chain of supply (apologies to anyone I missed out).

    Personally I would like to keep farmers out of the decision making as much as possible. I’ve seen what they do when they’re appointed to boards. Ruddy faces, bad haircuts and no imagination beyond the farm gate.

    • @ Andrew . I’m glad that I’m at least of some use to you as your entertainer .
      And you are partly correct in saying what you say . Or write , as is the case here .
      Our most insidious and dangerous politicians were once farmers . douglas was a pig ‘ farmer ‘ . bolger was / is a farmer . english is a farmer .
      Who better the Trojan horses to deceive and turn traitor on their own kind ?
      I’m a farmer . I come from ancient farming roots . I don’t regard myself as deficit in imagination . As for hairstyle ? When I had hair I cut quite the figure I can tell you . My hair stylist , my first bona fide Gay man-friend for more than thirty years , made sure I didn’t look like a Irish Bogman with a dead ferret under his cap .
      Farming is a difficult business and a difficult lifestyle . It’s very lonely and very isolating and we all know the side effects of listening too long to the sounds of ones own mind @ Andrew .

      @ Chris Trotter . Thank you for posting my comments . I’m grateful , surprised and impressed .

  11. Meanwhile, back at the ranch…

    No nation can provide unlimited access to ‘free’ medical services.

    In the last few decades both the number and cost of possible procedures and drugs has expanded beyond the imagination of those well-intentioned folk who started our current medical schemes.

    The result is that there has to be some rationing, somewhere. We have to chose the ‘best bang for our (collective) buck’.

    It’s a job I wouldn’t want: Only King Solomon need apply.

    I suppose we’re best applying more effort to primary healthcare to try and prevent stupid people from killing themselves and their children with sugar and alcohol.

    That said, I know of a person who is about to receive a hip replacement at age 101 years (Given those circumstances I think I would rather take the red pill…) so nobody can claim our health professionals aren’t trying!

    • @ Andrew . Ok . You’re starting to piss me off .

      ” No nation can provide unlimited access to ‘free’ medical services. ”

      No ? But they can provide an ANZ ‘ executive with $11,000.00 a day and that’s ok with you ?
      And in your urbane and erudite enlightenment you should also know what those other parasites are now getting paid , for ‘ heading up ‘ what were once NZ’s public resources ? Your simplistic and bigoted opinions no longer interest me .
      Take the red pill . You’ve become boring .

  12. This is a very sensitive and delicate topic. We have “elective surgery”, and some of it is actually very necessary and must be done and paid for by the health system. But there are also still some cases of “elective” surgery, that maybe offered in some better financed DHBs, which may not be so high priority as they seem to be for some individuals.

    A mate of mine was up for one, but it was a minor operation, and it was after all not causing much distress, even seemed to cause less irritations than months earlier. It was an operation not necessarily deemed totally essential, but it was offered. He withdrew from an operation, as things seemed to get better, and perhaps even healed by itself.

    In any case, this may have freed up an opportunity for a more worthy case to be treated.

    But as a whole, we are definitely getting figures that do not seem to match with reality. Even my mate had to wait well over half a year, and had to go through endless checks and balances, before anything was finally decided.

    The elderly and seriously sick and injured or disabled deserve absolute priority, and it is time to get the government held to account for misrepresenting to us, what really goes on.

    Annette King has been good at asking questions before, but she had shortcomings herself, when health minister. Nevertheless, I hope she has learned, and will keep holding this lot to account, as she has done before. Like or not, she is a valuable MP in the House.

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