A false narrative is a commonly held belief that is based on incorrect or incomplete information. Often, false narratives refer to incorrect knowledge passed throughout a community or society.
Sometimes false narratives are because the narrators believe the truth feels unsafe. The truth might lead to detrimental repercussions from being shamed to physical harm.
Andrew Little’s verticalisation of the health system inevitably led to an enhanced command-and-control leadership culture
In health systems false narratives often come into play when the leadership culture is, directly or indirectly, command and control.
Under former health minister Andrew Little Aotearoa New Zealand’s health system became highly verticalised; a prerequisite for the strengthening of a top-down command-and control leadership culture.
This culture is conducive to arbitrary decision-making which, in turn, is conducive to decision-making errors. False narratives come into play to prevent the truth from being known. They are not inadvertent.
It can also lead to health system leaders disingenuously covering up the already known or predictable negative consequences of a particular decision with a false narrative. This was definitely not inadvertent.
A false narrative of this type is the bedfellow of ‘spin doctoring’ which I discussed in a recent blog (10 August): Stop the spin doctoring.
Disingenuous false narrative
It is a disingenuous false narrative that is used to rationalise Health New Zealand (Te Whatu Ora) being required to find $1.4 billion in savings by mid-2025.
Commissioner Lester Levy started his position with an overarching false narrative
Newly appointed Commissioner Lester Levy asserts, without providing any substantiating evidence, that this cost cutting will not affect patient care. He argues that they will only effect so-called ‘back office’ functions.
On the other hand, health professionals say the opposite. They know from their own hands-on practical experience and expertise how integrated these demonised ‘back-office’ functions are with frontline clinical work.
Further, they know from their own experience of earlier recent ‘back-office’ downsizing within Health New Zealand that the clinical frontline was compromised despite bureaucratic utterances to the contrary.
Stuff journalist Bridie Witton: thank goodness for good journalism
Good journalism brings out the truth
Thank goodness Aotearoa New Zealand has some very good journalism. Stuffpolitical journalist Bridie Witton is a case in point.
While she is now covers politics, previously she was an enquiring health reporter for Stuff. However, health is intertwined with politics.
A more specific false narrative: HNZ Chief Executive Margie Apa claims redundancies won’t affect health services
Within the context of cost-cutting $1.4 billion, Witton focused on Health New Zealand’s claim that planned redundancies would not negative effect health services (30 August): Surgeons warn Health NZ redundancies will slow down surgeries.
Witton draws upon Dr Ros Ponchin who chairs the New Zealand national committee of the Royal Australian College of Surgeons.
Ponchin cites her own surgical experience. Usually she does 30 neck surgeries a year at Nelson Hospital. This year she has only done five.
Surgeon Ros Ponchin exposes false narrative
In her words:
Everything is grinding to a halt and it is not just the elective surgeries – even surgeries for cancer are taking too long… it’s not just a shortage of clinicians, including nurses and anaesthetists, or available beds. A lack of support staff – non-clinical roles such as clerks who book clinics – are also having an effect.
Further, the redundancies will have a:
… knock-on effect that will impact the ability to utilise lists and clinics effectively. Redundancy implies these jobs are redundant – they are not.
Ponchin reports the view of her professional college that:
… the loss of non-clinical roles – such as those opened up for redundancy – will effect the frontline because they make it harder for clinicians to do their jobs. This leads to longer wait times for patients, which could have serious consequences – even if someone was waiting for an elective surgery.
Giving another example the surgeon said she had performed three surgeries to fix a person’s hernia this year. Normally these are non-acute procedures.
But, in this case, all three were acute because the patient had waited so long and as a result had to have parts of their bowel taken out.
In response to Health New Zealand’s extraordinary claim that public hospitals had too many nurses, Ponchin retorted:
I am not seeing that. I don’t have enough nurses to operate with, I don’t have enough nurses on the ward.
Political fall guy set up
Previously, when health professionals directly or through their representatives raised concerns about the impact on patients of Health New Zealand’s earlier restructuring and underfunding, Health Minister Dr Shane Reti had a standard response.
This was that Health New Zealand had advised him that this was not happening. As simple and non-enquiring as that.
Health Minister Shane Reti set up to be political fall guy
Now, in response to the same concerns about the new cost-cutting restructuring announced by Lester Levy, Minister Reti has slightly tweaked this standard response.
The response now is that Commissioner Levy has advised him that this restructuring will not affect the clinical frontline; it will not happen. Spot the difference!
The problem is that it is already happening. The College of Surgeons is but one of the reputable bodies saying this.
This false narrative of denying what is happening or obviously predictable has virtually no credibility within the health system.
There will come a time when it will also have no public credibility as well. This will come sooner rather than later.
When this eventuates it will be Minister Reti rather than Commissioner Levy who takes the flak. He will the one who faces the media scrum.
In other words, the Minister will be the political fall guy.
Ian Powell was Executive Director of the Association of Salaried Medical Specialists, the professional union representing senior doctors and dentists in New Zealand, for over 30 years, until December 2019. He is now a health systems, labour market, and political commentator living in the small river estuary community of Otaihanga (the place by the tide). First published at Otaihanga Second Opinion
My father was actively involved in the Mental Health Department here in NZ when Roger the Rat Douglas dismantled the Mental Health System and Reconstructed Mental Health and closed a number of Mental Health Institutions, he was absolutely filthy as he had worked numerous decades in the Mental Health System and set up a number of Programes with patients in the Oral Health Sector. I believe it sent him to an early grave. The problem with Neoliberal Ideology is they Restructure for the sake of Restructuring with a Know All Mentality, however lacking the necessary skills to make rational, educated and critical decisions. What did Roger the Rat know about Mental Health, likewise what does Toy Boy David Seymore our future Deputy PM know about Education ??? Charters Schools are they the answer to NZ’s Education System ???
Digressing here, we already have charter schools but they are called integrated start schools. We have one in Whanganui and it’s called Whanganui Collegiate.
The State pays all the staff costs and day to day operation costs. The parents then pay a hefty fee on top of for the extras such as full time tutors, sports coaches, flash buildings and grounds.
State subsidy for the rich.
Various groups with various political and economic ideologies vying to change stuff but the driver is not to make improvements but bureaucrats, consultants, change agents, lobby mates, rebranders seeking a ticket clip on change. Centralise, decentralise, top down, bottom up, vertical integration, horizontal organization, amalgamation, devolution, national, local, public, private, form, reform. The results are pretty much not different for the consumer but it’s always a very profitable change ‘process’.
Levy, Reti and Luxon have blood on their hands…
https://www.stuff.co.nz/nz-news/350409108/patient-dies-ed-waiting-room-rotorua-hospital
It is tragic that we have to have serious negative health outcomes impacting on the wealthy before anything will be done to alleviate this deceitful underfunding (ironically under the auspice of over spending!). But the fact is that the wealthy have the luxury of private care to turn to, or even heading overseas, for solutions that either don’t occur here or are so scarce that the wait for attention would be deleterious to ones health.
This problem is worsened by the fact that the Fourth Estate has been seriously undermined in the last 10 years or so around the world (thanks to Trump and his sycophant supporters) and more recently in Aotearoa (thanks to the demise of TV3 and radio). This negative development has been endured at the same time that social media goes from strength to strength as eco-chambers regurgitate false narrative without any form of reality filter. The outcome of the fall of traditional journalism and the rise of social media “false news” (thanks Mr Trump) has created the ‘perfect storm’ in which truth and accuracy are less important to the populace than presentation, appearance and populism.
The fact that the health system has been systematically under-resourced for the last 40 years (or possibly more) has been superseded by the governments solution to unpleasant truths – lies and deception masquerading as truth. All this government have really done to date is to undo much of the great work done by the previous government around worker rights, health, and other evidenced based approaches. This has been replaced by government ministers rejecting formal advice based on their own instinctual feel for the situation supported by anecdotal support for their perspectives (nearly always by avid supporters). Health is under the cosh now, but transport (e.g. Ferry’s debacle), infrastructure (massive preference of road and public transport over rail despite current issues with gridlock), fiscal (lack of fairness in taxation system, i.e. need for CGT to correct the skewed nature of who actually shares the burden of the tax ‘take’) and monetary (focus on inflation at the expense of employment) policy are all up for more vandalism by this government – not to mention race relations being in crisis mode due to the mindless policy being insisted upon by the ACT party.
However serious Tax Cuts for the wealthy, I get an extra $15.00 per week which is f**king peanuts????
ACT trying to promulgate a Race War here in NZ by the kupapa David Seymour’s.
Scientists are learning more about the cognitive function of our brains.
Cognitive error: Faith, believing without evidence.
Cognitive exaggeration: Believing own expertise. Dunning Kruger Effect.
Cognitive dissonance: Believing in contradictions.
Cognitive wall: Closing the mind to unwanted facts. The Ostrich syndrome.
when I have had surgery recently it was not the surgeon that made the appointment .In fact the surgeon had no idea when my op would take place ,some time in the next 4 months maybe .was his reply .The back office were the ones that arranged the op and were in contact with me as to when it would happen .With out the back office the hospital would not function at all .It is the same with the GPs as it is back office there that make appointments and attend to the mundane stuff .
Brilliant and factual post Bob.
Ian – the gag order to prevent the truth coming out by NZ Health is telling.
sorry chaps but pr/comms and most of hr could be axed to morrow morning with no ill effects…
has anyone wondered why dhbs have to employ professional liars? which is the real function of pr/comms
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This coalition government is one big false narrative.
Reti has made himself the fall guy. He allowed himself to be overtaken by the tobacco lobby and was blackmailed by Seymour over cancer drugs. He allowed Willis to defund the health system for tax cuts. He criticized and politicized the covid response every step of the way not for any medical reasons. He is a doctor who lied about a document that didn’t exist. Doctors who lie should be struck off. He could have been a hero and refuse to implement the redundancy’s and told Te Whatau Ora to get stuffed and told them to cancel the hiring freeze. He rode illegally on ambulances jut for political gain ,he lied about suicide stats.
i’m not sure if he’s thick or evil but it’s one of the 2