Politics / Election 2020

National health policy promises $800m in new funding over four years, targeting Pharmac and cancer

13:44 pm on 16 September 2020

The National Party is promising record funding increases for Pharmac, a new cancer agency, faster elective surgeries and primary care 'navigators' in its health policy.

The party's health spokesperson Shane Reti says every single health target has worsened under the Labour-led government.

"Even before Covid-19's emergence we were seeing cracks in our health system. Access to quality healthcare has slid backwards under Labour," he says.

"Our health policy will deliver better care sooner, and closer to home.

"Labour have spent more, yet many outcomes are worse. For example every single one of National's health targets are worse today than when we handed them over in 2017.

"We have practical solutions that will offer tangible outcomes for generations to come."

He says the party's plan would deliver a high quality, evidence-based modern health service regardless of location or identity, costed at $800m of new funding over four years.

National would not reduce DHBs to between 8 and 12, or set up a Māori health authority, as Labour plans to do after receiving the Heather Simpson report, he says.

Cancer

  • As previously announced, a new cancer agency
  • Accelerated bowel cancer screening program rolled out to the remaining 10 DHBs in first year
  • A pilot for low dose CT scanning for lung cancer with particular benefits to Māori
  • Start building the delayed radiotherapy machines at Hawke's Bay, Taranaki, Northland DHBs in first year of office

Surgery

  • Faster elective surgeries, with funding and surgery for patients within four months
  • DHBs will outsource elective surgeries they are unable to complete themselves within that timeframe - to other DHBs or private providers at no extra cost
  • Equitable access to elective surgery by replacing the post code lottery with standard treatment levels across the country

Pharmac

  • Total Pharmac funding increase of at least $55 million per year including:
  • As previously announced, a dedicated cancer drug fund worth $50m per year
  • A rare disorder fund worth $5m per year
  • Pharmac funding increases to be tied to wider health budget: Approximately 5 percent of health funding will be Pharmac funding

Primary Care

  • A $64m fund to get a primary care social worker-type navigator in every General Practice location in New Zealand
  • Start a request for proposal process to establish a third graduate entry medical school focused on retention of General Practitioners in rural areas
  • Require DHBs to report annually on a Māori health strategy

General

  • Better protect New Zealanders from Covid-19 with a dedicated Border Protection Agency
  • Restore and update National Health Targets
  • Increase funding for the number of cochlear implants from 40 to 100

The party also announced a $30m childhood dental health policy yesterday, and has also promised to upgrade the Hawke's Bay Hospital and install air conditioning.

Dr Reti says these are just some of the health initiatives the party would deliver if elected.

"These are practical solutions that will have a tangible impact on New Zealander's lives for generations to come," he says.

"National believes the Pharmac model is the best way to ensure New Zealanders are accessing much-needed medication."

"Year on year this will be more funding for Pharmac than at any time in the past decade, and New Zealanders will have better access to more medicines.

Dr Shane Reti. Photo: RNZ / Samuel Rillstone

He says the primary care navigators have been trialled in the United Kingdom with positive outcomes. They would offer counselling, help unlock government agencies, follow up appointments and referrals and do home visits.

"General Practitioners are often under significant time pressure which can lead to longer waiting times, and leaves them little time to address anything but their patient's immediate health concerns," he says.

He says his experience working with the National Health Service in the UK has shown him that often the social worker type role they would fulfill is as important and often more important than the GP.

"When I've been in practice myself and I look out at the waiting room and my list is full, my waiting room's full and yet I have a mental health consultation coming towards me... I don't want to be the one who misses a suicide patient, I need to be the one who does a really good job with this person but look at my waiting list, look at my waiting room.

"Imagine if it could be that I did that initial triage, identified what the actions were... I need to understand better your work environment, I need to better understand your home environment, I need to understand better why government agencies have locked you out.

"It'll make a big difference, it'll help deal with that tsunami of need that's coming towards primary care."

On elective surgeries, he says 7312 surgeries promised for within four months were not delivered on time last year.

He says the party introduced a tool to measure this called the elective surgery performance flow indicators, or ESPFLI.

"But if I just pick a couple of DHBs - for Tairāwhiti, it was 23. Tairāwhiti must be able to do another 23 cases in a year. Let's go to a bigger DHB - for Capital and Coast is was 63 - surely Capital and Coast can do another 63 cases a year."

Resolving the waiting lists would take priority over an extra funding for elective surgeries, but the party would also look at where that is needed, he says.

"We think DHBs can do that and raising to the point that was raised here initially we're prepared to fund that as well."

Despite rejecting recommendations to reduce the number of DHBs and establish a Māori health authority, Dr Reti says the party would consider some aspects of the Heather Simpson report, and it was not a waste of time.

"It's an excellent data repository, some really good resources and information in that report ... and as I've indicated to you there are other suggestions in the Heather Simpson report that we would look at incorporating like the changing to adjustors in PBFF.

He says there will be a separate announcement on mental health and disability next week.

The party is also interested in exploring the possibility of a drug reuse programme, where unopened and unexpired drugs that have not been used can be returned, he says.

'An exercise in spin' - Hipkins

Health Minister Chris Hipkins says National's track record shows it is more focused on spin in healthcare rather than actually improving outcomes.

"We have to be cautious when it comes to National and targets because we know that they ultimately get manipulated.

"In their last lot of targets they said that people had to be seen for a specialist first assessment within six months of joining the waiting lists for that so they simply managed that rationing the number of people that that could join the waiting list.

"Some eye injections which would normally be done as a day procedure were transferred into a surgical setting where it costs more to deliver them because it made the elective surgery numbers look better.

"That's the type of manipulation that really does the health system no good whatsoever, it's just an exercise in spin basically."

On Dr Reti's claim that health targets have worsened under the Labour-led government, Hipkins says that's a reflection of the realities of underinvestment by the previous National government.

"I think National's track record speaks for itself, which is they generally don't fund cost pressures faced by DHBs and that's one of the reasons DHBs are in deficits at the moment is there's just so much catching up to do.

"What we're seeing is a more honest reflection of what's happening within the health system, we're not focused on manipulating targets, we're focused on trying to improve the quality of healthcare that New Zealanders get."

He says Labour has already embarked on a very large reform programme in health, which would be the party's priority for the next term of government.

"I think if you look at the record levels of investment that have gone in over the last three years we've had big increases in funding for our district health boards, we've had big increases in funding for capital investment - so upgrading our hospitals - and I think we can expect to see that level of commitment continue under a re-elected Labour government.

"We set up the cancer control agency - something that seems to have slipped National's attention ... we've got a huge programme of work in mental health that's going to require an ongoing degree of focus. We want to get our health boards back in the black, it's not sustainable for them to be running the sort of deficits that they are at the moment."

"I think anybody who follows health closely will just see more of the same from National."