Hope springs eternal a year on from health reforms
The government is spending the week focused on the first signs of progress within a reformed health system with wait lists, the post-code lottery and workforce shortages on the agenda
Mōrena and welcome to The Bulletin for Tuesday, July 4, by Anna Rawhiti-Connell. Presented in partnership with Z Energy.
In today’s edition: Hipkins heads to Europe on Friday; number of borrowers struggling to meet mortgage repayment obligations continuing to rise; but first, a year on from the health sector’s new dawn, there are some signs of the reforms in action but vast challenges remain
(Image: Tina Tiller)
Cataract surgery announcement a step towards eliminating post-code lottery
Yesterday’s announcement from the government on surgical wait lists for cataract operations was heralded as significant not just because of the hope it may give those whose sight has been worsening as waiting lists have grown. As the Herald’s Nichola Jones reports, a recent study that analysed 44,000 patients referred for cataract surgery between 2014 and 2019 found more than a quarter of those who were declined surgery “did not meet the visual acuity requirement for driving a private vehicle in New Zealand”. The announcement from health minister Ayesha Verrall was held up as one of the first examples of the health reforms in action, with the introduction of a nationally standardised “scoring” system and threshold for surgery replacing disparate regional thresholds. It’s an example of the goal at the centre of the reforms to end the “post-code lottery” in health, where access to treatment has been determined by where you live.
Concerns raised about how increased number of surgeries will be resourced
The move has been welcomed but eye surgeons have already raised concerns about how the increase in the number of operations enabled by the standardisation will be resourced. “Workforce shortages” has become a kind of catch-all phrase to describe myriad staff shortages across the health sector. Speaking to Jack Tame on Q&A on Sunday about the ongoing delay in reporting on emergency department wait times, Te Whatu Ora chief executive Margie Apa managed expectations about what that data might reveal when it is released by citing that ubiquitous phrase. The Herald published an investigation from Alex Spence (paywalled) into the state of our emergency departments over the weekend and it doesn’t paint a great picture, with staff reporting unprecedented strain and compromised patient care.
More than 6,300 overseas health workers have joined New Zealand's health workforce since immigration setting changes
This morning, immigration minister Andrew Little announced that more than 6,300 overseas health workers have joined New Zealand's health workforce through the Accredited Employer Work Visa scheme and the Green List Straight to Residence pathways. Immigration settings for healthcare workers have been substantially changed and loosened over the last year. In an assessment from various healthcare workers a year on from the health reforms coming into force, safe staffing, pay and working conditions feature prominently in the list of ongoing concerns. President of the Association of Salaried Medical Specialists, Dr Julian Vyes says he’s seen “no evidence there has been significant recruitment to senior clinical staff roles.”
Does reform improve health outcomes?
It’s fair to say no one thought change would happen overnight. Expectations on the speed of change enabled by the reforms have been carefully managed since the get-go. Two academics from the University of Otago make a very fair case for giving new initiatives, in this instance Te Aka Whai Ora, the Māori Health Authority, a chance to succeed. Professor Robin Gauld has been studying health systems here and around the world for years and spoke to RNZ’s Kathryn Ryan yesterday. I recommend listening for his assessment of where things are at. Ryan asks him whether these kinds of reforms actually improve health outcomes. With so much hope vested in the future promise of what these reforms can achieve, Gauld points out that health outcomes are influenced by so much more than the system and it may be difficult to even peg future improvements on these reforms.
Celebrating extraordinary achievements by ordinary people, This is Kiwi explores the remarkable stories of incredible New Zealanders.
In this six-part series Jane Yee talks to inspirational New Zealanders to uncover their motivations, the influences that shaped their mindset and explore the concept of knowledge for better. Brought to you by Kiwibank and The Spinoff Podcast Network our first episode features Dave Letele discussing how he beat the odds.
Read more on The Spinoff now (sponsored)
The prime minister heads to Europe on Friday
Once again emphasising the importance and “bread and butter-ness” of trade, moules-frites are on the menu this week as prime minister Chris Hipkins heads to Brussels on Friday to sign a New Zealand-European Union (EU) Free Trade Agreement. Newsroom’s Sam Sachdeva reports from Brussels that “better late than never” might be an appropriate official slogan for the deal, with the signing five years in the making. Hipkins will sign the agreement with EU Executive Vice President and Trade Commissioner Vladis Dombrovskis and EU president Ursula von der Leyen. He will then head to the Nato Summit in Lithuania where a slight gear change may be required after his China trip. Our last (and first-ever formal ) address at Nato came from former prime minister Dame Jacinda Ardern last year, where she urged democratic nations to stand strong against an increasingly assertive Beijing.
Number of borrowers struggling to meet mortgage repayment obligations continues to rise
According to new Reserve Bank data, banks classed $1.2b of mortgage debt as “non-performing” in May. As the Herald’s Jenée Tibshraeny reports (paywalled), non-performing debt includes loans and advances that are 90 days past due, as well as “impaired loans”. May’s figures were up 12% on April’s and 51% up on numbers from May 2022. To put it in perspective, the May 2023 figure only made up 0.4% of banks’ mortgage book but aside from a few months in 2020, the last time New Zealand had a 0.4% non-performing housing loan ratio was in June 2015. As Tibshraeny writes, this ratio got as high as 1.2% around the time of the 2009 Global Financial Crisis and stayed as low as 0.2% from mid-2016 until the onset of Covid.
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Direct from the Great Hall of the People
The Spinoff’s editor Madeleine Chapman has just returned on the NZDF workhorse from covering Chris Hipkins' big week in China. She sat down with Toby Manhire yesterday for a bonus episode of Gone by Lunchtime to describe the scene in the Great Hall of the People, how Hipkins managed the tricky political challenges from Xi Jinping to Kiri Allan and the prime minister's suboptimal approach to snacking.
Click and Collect
The government's planned congestion charging scheme has stalled as yet another attempt to gain bipartisan consensus looks to have failed
How rate rises stack up across the country
Expect to see "something" in the next few weeks as government misses deadline on unveiling preferred option for an alternative Auckland Harbour crossing
Another tweet carrying footage from the livestream of the terrorist attacks in Christchurch was viewed 150,000 times before the account was suspended following inquiries by The Spinoff yesterday
Related: interesting interview with Joan Donovan, the head of the Technology and Social Change Project at Harvard University on the need for stronger government regulation of big tech. One of the most succinct summaries I’ve read in a while on the interplay between social media, the health of traditional media, government and democracy
Got some feedback about The Bulletin, or anything in the news? Get in touch with me at thebulletin@thespinoff.co.nz.
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Julie Hill writes that those who came into Sir James Wallace’s orbit describe a man who took what he felt he deserved. Stewart Sowman-Lund reports on Countdown supermarket being caught out mistakenly selling two items at a higher rate during its “Great Price for Winter” promotion. Sarah Aiono asks whether New Zealand really wants to go down the path of standardised testing when it’s all but vanished break times for students overseas. Red Nicholson introduces The D*List, an online magazine for disabled New Zealanders. Sam Brooks discovers another great reason to visit Wellington.
Sporting snippets
“I couldn't believe it” — Zoe Hobbs on her remarkable run and the now near-certain path to the Paris Olympics (paywalled)
“In the best cricketing tradition of behavioural etiquette, the entire occasion turned on the exact timing of a man in a hat saying the word “over”, while another man prodded a patch of manicured north London clay with a piece of wood” — The Guardian’s chief sports writer Barney Ronay on the final day of the second Ashes Test at Lord’s
Sam Harvey was at it again, running for a total of 43 hours to win another ultra-marathon yesterday, just ten days after falling just short of breaking the world record for ultra-distance running
Hi Barbie!
The Barbie movie will soon be upon us and it will be inescapable. You might be beyond excited or full of despair about that, but the mass market saturation that the film has achieved, months in advance of its release, is remarkable. It’s especially remarkable in a world where “fragmented” and “niche” are some of the most commonly used words to describe audiences these days, and the future of cinema as we’ve known it is often described as tenuous. Great New Yorker read here on why Barbie won’t be the last of Mattel’s toys to be hauled out of the toy box in Hollywood. The industry is leaning into a concept known as “pre-awareness”, where comfort, nostalgia and mass cultural understanding act as a buffer against splintering media consumption habits.
