Health Minister Shane Reti. Photo: Jimmy Ellingham / RNZ
Health Minister Shane Reti has told senior doctors and dentists he wants to work more closely with the private sector to cut waiting lists - but insists that is not a step towards privatisation.
There were strong signals earlier this week from Associate Health Minister David Seymour that he plans to push for more privatisation in the health system.
Following his speech to the Association of Salaried Medical Specialists conference in Wellington today, Dr Reti was asked whether the government's approach was creating a two-tiered system, "with private healthcare for the haves, and the underfunded public system for the have-nots".
"Mr Seymour says he's going to privatise health. So what are your comments on that? Is it true?" asked the union's national president, Dr Catherine Ben.
"I have the privilege of being the Health Minister and that's not my overt policy," Reti replied.
He would like to see "greater collaboration" with private facilities and private operators, particularly on the government's list targets.
However, his message to the private sector was that taxpayer money had to benefit the public, and they had had a "quid pro quo responsibility" to build capacity in the public system.
"That is the deal - this is not just Crown funding going to your balance sheet, God bless you....
"So you will see us increasing the relationship and outsourcing to the private operators - that is not at all a step toward privatisation at all, that is not my agenda.
"My agenda is to lift the capacity of the public system so it's there when we need it."
'The dead hand of Big Tobacco'
The minister faced intense questioning from delegates on a range of contentious issues, including budget cuts, workforce shortages and the influence of the tobacco industry on government policy.
There was sustained applause from delegates in response to a question referring to "the dead hand of Big Tobacco" behind the changes to tobacco excise taxes, and asking "how far should politics run ahead of medical objectivity?"
"So clearly, I don't have the delegation for Smoke Free, that's Minister [Casey] Costello," Reti said, raising his voice over the clapping.
Everyone should be pleased with the reduction in smoking rates from 8.6 to 6.8 percent, followed by a "non statistical plateauing" at 6.9 percent, he continued.
"Clearly there's more work to be done if we're going to get to SmokeFree 2025 by this time next year."
The decisions on tobacco control had been made by the Coalition government, supported by Cabinet, he said.
"The proof will be in the pudding as to whether we get there. I understand the issues clearly around SmokeFree, but there is an absolute desire to drive that rate down.
"What you're seeing from Minister Costello is a different approach to doing that."
Doctors still using faxes, pagers, pens and paper
Another delegate asked about the "rationale" for Health New Zealand's decision to disestablish its data and digital transformative strategy, which aimed to reduce operational risks.
"For context, this particular person still uses fax machines and pagers," Dr Ben added. "They're lucky - we use pens and paper."
Reti said the soon-to-be released digital and infrastructure plan would detail the future direction for Te Whatu Ora.
He noted there had been significant investment in some digital projects, including bolstering the "fragile" payroll system, the immunisation database (which was critical to meet the government's immunisation target) and the tens of millions that had gone into the Health Sector Agreements and Payments (HSAAP) programme.
"But there is a refocus on where data and digital need to go."
Some projects were being "paused while they are recalibrated" to decide how closely they aligned to the frontline and patient outcomes.
"And that's the decision making that Commissioner Levy is making his way through."
One of the projects under threat is a new AI note-taking app, which psychiatrists say could almost double the number of patients they can see.
Reti said he was "not across that detail" and the question was better directed at Mental Health Minister Matt Doocey.
"But what I can say is there is an AI workgroup inside Health New Zealand, and I can also tell you there's a lot of cross-agency support - with Minister [Judith] Collins' work in this space on digitalisation of government."