10 August: Unhealthy Health Cuts

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In a repeat of health cuts in the late 1990s, National’s latest round of health cuts are starting to bite, and communities are fighting back.

See: Claim many burned out by health sector reforms (21 December 1996)

See: CHE job cuts impel nurses to eye Britain    (19 April 1997)

See: Cuts to hospital services expected (8 August 1997)

See: GP hits out at health reforms  (3 February 1998)

See: Widow says little improvement seem   (3 April 1999)

Despite assurances given after the May budget this year, National is cutting deep into the health budget, whilst raising user-pays charges. As Dear Leader said on 15 May,

“… low income earners should not be worried about the higher price of prescriptions because they too will benefit from improvements to other parts of the health service.”

See: PM says low income earners will benefit from health improvements

Tony Ryall added,

“Despite tight financial times and what will be a zero Budget on 24 May, health will receive a big funding boost, which will come from savings within health and across the Government’s accounts.”

See: Prescription charges to increase

Well, we know how such assurances from National usually turn out.  Quite badly for us, unfortunately.

As is always the case, National’s “reforms” (aka, budget cuts)  impact on low-income families and individuals first – and  eventually creep up the socio-economic ladder  to affect the middle classes.  That is when we’ll see some real screaming from the public.

The cuts to Vote: Health have already started to affect our communities.  As District Health Boards are allocated either less money, or insufficient money to make up for inflation, local health initiatives begin to suffer.

One very clear example of cuts to local health programmes is  the Capital & Coast District Health Board (CCDHB) cutting funding for the Newtown Union Health Service,

“   Coordinator Debbie Leyland says Newtown Union Health Service, which works with some of the most vulnerable people in the region, will lose $274,000 this year and expects to face more significant cuts in the year ahead.

“The DHB has indicated the 7.9% funding reduction to NUHS is required to help the DHB save $20 million this year. It has been indicated that the DHB needs to save an additional $20 million over the next two years which will have a serious impact on primary health care.”.

Leyland says the cuts will have serious impacts on patients who have no other option but to access low-cost primary health care, such as NUHS.”

See:  Scoop.co.nz: New community group protests at hospital against funding cuts

Since the Newtown Union Health Service serves mostly  low-income/fixed income families and individuals, these cuts to to the NUHS’s budget will go mostly unnoticed by the middle class. But these cuts will mimpact on those at the bottom of the socio-economic ‘pile’.

As Debbie Leyland said,

“Newtown Union Health is a low cost primary health service that provides vital services to some of the most vulnerable people in Wellington. The funding cuts are dire for the service. Services such as the diabetes program are likely to be cut. There are nurses and doctors volunteering to work for free to keep services going. Wellington Hospital’s A&E will become increasingly cluttered and there will be less ability for accurate assessment of A&E patients due to the extra pressure.”

Leyland says the Government is ultimately responsible for the cuts, and says Health Minister Tony Ryall has refused to meet with community representatives.

“The Government is using a sharp razor to cut services that are vital to the lives of many vulnerable people. We would like to discuss the implications of these cuts with the Minister of Health Tony Ryall so he understands the impacts. Minister Ryall’s office is refusing to meet with us and has told us that he does not meet with members of the community. This shows he is deeply out of touch”.

See:  Scoop.co.nz: New community group protests at hospital against funding cuts

It is hardly surprising that Health Minister, Tony Ryall, refuses to meet with Ms Leyland. That would be… embarressing.

To show the community’s displeasure at cuts to their health service, a newly formed group, the United Community Action Newtown (UCAN) organised a public display of opposition, as well as meeting with the District Health Board at one of their many meetings.

The public health-cuts protest took place on the morning (8.45am, for about an hour) on 10 August.  Approximately 60 people from the Newtown community, and the Greater Wellington region,  took part,

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The picket was peaceful, subdued, and well-mannered. The lone policeman keeping watch may have  wondered what burglaries needed his attention, instead of wasting valuable police resources doing nothing except enjoying the brisk  morning air and sunshine,

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The banner of the newly formed United Community Action Newtown (UCAN) fluttered in the slight breeze of a cool Wellington morning,

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As the picket progressed, the Westpac Emergency helicopter took of from it’s landing-pad atop one of the Hospital buildings.

Whilst it’s refreshing to see this marvel of modern technology employed to save lives – another struggle to help people and save lives is carried out on in the streets below. Cuts to community-based healthcare can prove as harmful to human  beings as the critical injuries suffered by patients saved by this machine and it’s heroic crew,

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This gentleman had obviously put a great deal of thought into the content of his placard, and wanted to get a clear message across,

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UCAN organisor, Katie, addressing the crowd. She thanked Ken, the musician; the Maritime Union for their support; and the people who turned out to support the campaign to ratain full funding for community health services.

I later asked Katie a few questions,

Hi Katie, what do you hope to get out of this?

“We just want to have a really strong and effective primary health system that cares for all people. Those particularly most vulnerable in our society, those who don’t have the money or the ability to travel to the doctor regularly. They need healthcare  that they can access because they’re the ones who’ve been  shown to  get sicker more often. So we need a health system that looks after them.”

Where do you see the health service going if they keep cutting and cutting?

“Well of course, these clinics won’t be able to function. Their services have already been drastically reduced. They’ve already had to cut lots of  really good, effective services that they’ve provided in the past. So of course if the cuts keep happening they’re just will fall over and not be able to exist anymore.”

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The crowd, listening to Katie,

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Labour MP and spokesperson for ACC, Andrew Little, being interviewed by TV3 (below) and another journalist (further below),

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TV3 news team wandering through the crowd. Unless this blogger missed it, there was no coverage that evening of this event,

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A month ago, on  18 July, Whitirea journalist, Vomle Springford reported  a previous, similar event held by UCAN, where organisor Debbie Leyland said,

” Outreach clinics, asthma education, midwifery, and sexual health services are likely to go if the funding cut is finalised.

Ms Leyland says if services like the Strathmore outreach clinic are lost, vulnerable people will be less likely to seek primary health care and end up in hospital.

“For example, if you live in Strathmore and are on a low wage, with a sick child, and English isn’t your first language, it’s more of a challenge to get to Newtown. It’s the little things, these services are vital, crucial stuff “. “

It was unhelpful for CCDHB communications advisor, Lindsay Davis, to then  suggest that  cuts did not mean  people would be unable to get the help they need,

“If the Newtown service stops their outreach clinic to council flats, people will still be able to access health services, but they will have to come into the Newtown clinic.”

See: Newtown group wants answers over health cuts

For many people, especially immigrants, an Outreach Clinic that comes to their council flats is their only contact with health services.  This is notr about “laziness”, it’s about society being proactive before a medical condition worsens to a degree that requires more expensive intervention.

” Dr Ben Gray, a senior lecturer in Primary Health Care and General Practice at the University of Otago Wellington and former NUHS doctor, told the board in his submission  the funding cut does not make sense to him because research clearly shows primary care is much more cost effective at improving health status than secondary care.

“They (funding cuts) will lead to increased costs for the hospital in the way of increased emergency department visits, higher hospital admission rates and the risk of collapse of our obstetric (midwifery) service”. “

See: Newtown group wants answers over health cuts

Attending to an outbreak of disease at the start is more financially sensible than waiting for infection to spread, thereby compounding  the problem.

It is also the right thing to do in any fair-minded  society .

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A month later, things have not gotten better, and UCAN is still having to deliver it’s message to the CCDHB that funding cuts to the NUHS will impace unfairly on an already disadvantaged, low-income community,

“ UCAN Coordinator Debbie Leyland says Newtown Union Health Service, which works with some of the most vulnerable people in the region, will lose $274,000 this year and expects to face more significant cuts in the year ahead.

“The DHB has indicated the 7.9% funding reduction to NUHS is required to help the DHB save $20 million this year. It has been indicated that the DHB needs to save an additional $20 million over the next two years which will have a serious impact on primary health care.”.

Leyland says the cuts will have serious impacts on patients who have no other option but to access low-cost primary health care, such as NUHS.

“Newtown Union Health is a low cost primary health service that provides vital services to some of the most vulnerable people in Wellington. The funding cuts are dire for the service. Services such as the diabetes program are likely to be cut. There are nurses and doctors volunteering to work for free to keep services going. Wellington Hospital’s A&E will become increasingly cluttered and there will be less ability for accurate assessment of A&E patients due to the extra pressure.”

Leyland says the Government is ultimately responsible for the cuts, and says Health Minister Tony Ryall has refused to meet with community representatives.

“The Government is using a sharp razor to cut services that are vital to the lives of many vulnerable people. We would like to discuss the implications of these cuts with the Minister of Health Tony Ryall so he understands the impacts. Minister Ryall’s office is refusing to meet with us and has told us that he does not meet with members of the community. This shows he is deeply out of touch”.”

Ms Leyland  explained the obvious end-conclusion to health budget cuts,

” Several dollars are saved in other parts of the health system for every one dollar put into primary health care. These cuts will cost tax payers millions in the long run. The Government should be putting a fence at the top of the cliff, not simply relying on an ambulance at the bottom. “

Scoop: New community group protests at hospital against funding cuts

This is fairly basic, common-sense, stuff.

The only reason that a National health-minister would disregard basic common sense and long-term health outcomes is for short-term accounting purposes.  After two tax cuts and various subsidies for businesses, National finds itself with a massive budget deficit.

See: Government’s 2010 tax cuts costing $2 billion and counting

See: Budget deficit keeps getting worse

Unfortunately, we are the ones who end up paying for National’s mistakes.

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Musician, Ken, entertained the crowd with a steady selection of R&B and other fine music,

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Two representatives from the Service & Food Workers Union. Cuts to healthcare don’t just impact on the services that the community can access – but also to jobs and workers’ pay and conditions.

As services are wound back; jobs are cut; unemployment grows; serious medical conditions eventually demand more expensive medical interventions, it is apparent that budget cuts are a false economy.  (But try telling that to bean-counters in the National Party.)

Budget cuts affect every aspect of society and the economy.

Unions aren’t just advocating on behalf of their members – they are looking out for society as a whole.

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Representatives of the NZ Maritime Union were thanked for supporting the picket, and assisting with the ‘UCAN’ t-shirts for the organisers,

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This woman stood by the roadside – her placards eliciting a noisy barrage of supportive toots from passing traffic,

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Robin, a member of the Newtown Union Health Service. He was emphatic in his belief that funding should not be cut,

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Retired trade unionist, Pat Bolster, gave his support to  community anger at cutbacks,

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Debbie Leyland, co-founder of UCAN, then took the microphone to address the gathering. A little later, I chatted with Debbie and asked her about her meeting with the Board,

“We went to see the members of the district health board, Mary Bonner, and the other members. We went to discuss the cuts in the Union health service funding which is over a quarter of a million dollars.

I presented them with a game of ‘Jenga’ which I explained is our model of  Newtown Union health.  Because if you start taking blocks away , Newtown Union [Health Service]  will fall. We asked them to respond with their plan of health cuts and how they’re going to cope. Where are the people that are going to be affected by these health cuts going to go?

They said to me that they’d take on board what we’ve said and they will have a robust discussion behind their closed doors in that part of the meeting.  

I asked for transparency and open discussion on the public arena and that was denied.  So I then said that we had people wanting answers. They said they would have a robust discussion and they would come back to us in a week. “

I asked Debbie Leyland if  the CCDHB gave any indication why they were cutting the budget?

“Because Tony Ryall has ordered $129 million [cut] out of the Health budget.  A lot of that is to come out of primary healthcare. There’s $40 million this year coming out, $40 million next year.

But the thing is, healthcuts don’t heal people. They cost lots of money at the end of the road. For every dollar, you put in primary healthcare, you save several [dollars] in the secondary, which is going to the hospitals. So it’s a financial nonsense.”

With these healthcuts the government has promised not to cut front line services, but it almost seems inevitable that they will be, I suggested.

Ms Leyland replied,

“The funding’s already been cut. They’re not renewing  contracts like the diabetes contracts; midwives;  Strathmore mobile clinic, is probably going to go. They are cutting it. They said that this was a one-off cut last year, and here they are back again for another cut.

If they come back in the next year [with another cut] I doubt whether  the Newtown Union [Health Service] will ever be opened. “

This almost seems like a re-run of the 1990s health cuts?

“Well doesn’t it? And what’s very ironic about that statement is that that was the reason why Newtown union Health Service was set up in the first place/. It was set up by the Unions to provide honest, affordable healthcare for their members and for the most vulnerable in the community. So it is quite ironic that we find outselves here, and also what’s more ironic is today is the same day that the PHO building across the road was opened five years ago. “

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Rev. Richard Noble, one of the group of a dozen people,  making a representation to the CCDHB opposing damaging  cuts to  community healthcare. He was joined by Dr Ben Gray and Prof Don Matheson.

Rev Noble, standing alongside another member of the picket,

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Two local Newtown residents, Ariana and Bronwyn.  Browyn expressed her disgust at having “a posh cafe with $6 sandwiches within the hospital” complex, and suggested  that “maybe we need a soup kitchen instead?”

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This blogger also had an opportunity to discuss the issue with  Linda Hobman, UCAN chairperson and a member of the Wellington City Council Accessibility Advisory Committee. I started by asking Ms Hobman what happened when she appeared before the CCDHB.

Ms Hobman replied,

“We did public participation. We did that at the June Board meeting, and they asked the officers to do a report, which is on the Agenda today but it’s in “Public Excluded”. So we gave public participation again today asking them to reconsider the cuts…

… They [said they] would let us know in a week. I’m a bit confused as to why they have to wait a week to let us know the decision, if they make the decision today.”

Ms Hobman then confirmed that the Board had cut the NUHS funding by $274,000. I asked Ms Hobman what services might be cut with their  funding slashed.  She replied,

“Well that is the decision that the Newtown Union have to make. The reality is that services will be cut. That 7.8% of the budget, and so services will be cut.”

Ms Hobson continued, thather group pointed out to the CCDHB,

“We just really emphasised the point that we’re dealing with a lot people enrolled at the  Newtown [Union Service]  that have high and complex needs. We have a high proportion of refugees.

We have a high proportion of mental health consumers.

And many of the mental health consumers would have traditonally been treated at secondary, that’s in hospital, but because  Newtown Union works the way it does , these people can be living in the community and receiving the care they need. The reality is  we won’t be able to take on any new patients.”

I suggested to Ms Hobman that if patients were going to receive more  secondary [hospital in-patient] care, that this would impact on the hospital itself.

Ms Hobman replied,

“Yes absolutely. But they didn’t respond, they just listened.

It’s very important that people take a stand… The reality is it’s our  most vulnerable people that are being affected by the health cuts. And it’s  our most vulnerable people in New Zealand that this government doesn’t give a darn about.”

Ms Hobman then stated she would be returning to the Board meeting whilst it was still in open public-mode.

The protest picket disbanded peacefully, and without incident, a short time later.

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Addendum

To gather more information  relating to funding for the NUHS, I have emailed a request to CCDHB CEO, Mary Bonner, seeking  clarification on budgetary  matters. They responded,

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This blogger will keep you posted on this issue.

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Copyright (c)  Notice

All images are freely available to be used, with following provisos,

•     Use must be for non-commercial purposes.

•     Where purpose of  use is  commercial, a donation to Child Poverty Action Group is requested.

•     For non-commercial use, images may be used only in context, and not to denigrate individuals.

•     Acknowledgement of source is requested.

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Additional

CCDHB Annual Report: 2009

CCDHB Annual Report: 2010

CCDHB Annual Report: 2011

NZ Herald: Health cuts costly in long term, warns union

NZ Herald: Divided Auckland: Overcrowding a hotbed for infections

NZ Herald: Pressure leads to health cut predictions

Fairfax Media: Whooping cough is rampant in capital

Fairfax Media: Prescription charges to increase

Radio NZ: PM says low income earners will benefit from health improvements

Fairfax Media: Maori children suffer health treatment inequalities: study

Scoop: New community group protests at hospital against funding cuts

Newswire: Newtown group wants answers over health cuts

Facebook: United Community Action Newtown

Media coverage

NZ Herald: Protest against cuts to health funds

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