The claim that there are currently 14 layers of management at Health New Zealand, raises wider issues of how we organise systems. I want to write a column about current proposals to redisorganise Health New Zealand but, frustratingly, the Coalition Government has not released evidence of its claim that the successor to the District Health…
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If you don’t understand how things work you make foolish mistakes. To explain how the government got into its cancer drugs muddle, we need to explain first how New Zealand’s pharmaceutical purchasing system works. There is a parallel between Pharmac and the Reserve Bank of New Zealand. The Government sets the monetary policy framework with…
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The Government says it will give localities more control over healthcare decisions. But how? New Zealand’s political reflex is that any problem can be resolved by further centralisation. Students will be officially banned from having cell phones at school from Term 2. The decision could have been left to individual schools. Each knows a lot…
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Note written for circulation January 2024 In 2023 the New Zealand Health System was further centralised. As usual, the reasons given for the redisorganisation were unclear, thin and unconvincing. There have been no immediate benefits evident from the new structure; experience suggests that if there are any, they will take time to manifest themselves. Downsides…
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This is an exploratory study and may be of little value. By way of background, I observed a Kings Fund study which ranked the British health system with a group of other affluent OECD countries. I thought it would be interesting to do this for New Zealand. I got deviated when I found an…
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Kaitiaki Nursing New Zealand May 25, 2022 It was surprising that Finance Minister Grant Robertson, in a pre-Budget speech, said that he thought the current health system was “incredibly inefficient”. Of course there are some inefficiencies in health-care delivery, just as there are in private enterprise: mistakes happen, some treatments could have been managed better…
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Prologue This arises from an invitation by Head and Neck Cancer Support Aotearoa to set down my recent experiences. A writer always asks, who am I writing for? It would be pointless to write for those who have already had treatment; most will have had far more rugged experiences than I had. So I am…
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Presentation to the 2021 Conference of Theatre Managers & Educators, Dunedin 5-7 May. Today I am going to discuss the governments plans for the health system. Let me begin with an admission about my perspective. Many New Zealanders are more centralist in their view of the governance of society than I am. I come from…
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Presentation to the 2021 Conference of Theatre Managers & Educators, Dunedin 5-7 May. A few weeks ago, the government announced the next health sector redisorganisation. So I have scrapped the presentations I promised, in favour of an account of what is happening and where we might be going. Today’s presentation is centred on a history…
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Centralising the Public Health System The proposed health redisorganisation seeks to markedly centralise the health system. Is this grab for power justified; will it work? The Cabinet paper’s justification of the proposed changes is sevenfold. The first two are about Maori issues. One is constitutional, arguing that the ‘public health system does not meet the…
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I have been gripped by the World Oddometer’s daily reports tracking the covid statistics. In a way it was a rejection of Stalin’s ‘one death is a tragedy; a million is a statistic’; I have watched with agony the paths of various countries. But this statistician knew that the data reflected reported deaths from covid,…
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I was writing almost weekly about the Covid Crisis during its peak of between March and June 2020. Not that I had any technical expertise in the area (in the following please allow for that) but its impact on economics areas where I had some expertise was great. Here is a list of the Pundit…
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This note is written in response to a request about the details of how to do a social cost study on alcohol (misuse). It is written by an economist who has long been involved in the area both theoretically and practically. [1] The point of this note is that it is important to understand that…
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The following are various columns on my Pundit website which involve health economics. What is the Fetal Alcohol Spectrum Disorder? (7 November 2014) The Cost of Demanding More Health Care (10 November, 2014) Prolongation of Life and the Quality of Life (28 November, 2014) Thrive: The Power of Psychological Therapy (November 2, 2015) Are we spending enough…
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Wellington School of Medicine Summer School 22 February, 2019. But, first, you may well ask, why should anyone – especially a health practitioner – care about health economics? When I was teaching health economics to sixth-year medical students, I wrote on the board so that it was there during the entire session: EITHER HEALTH PROFESSIONALS…
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A novel about an historical event reminds us of the health redisorganisation of the 1990s, raising issues remaining relevant to today. I puzzle at how politicians and advisers can make giant mistakes but are never held accountable. The notion of accountability became fashionable in the neoliberal changes of the 1980s and many people further down…
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FASD Policy and Research Forum, 9 September, 2016, as a part of the observance of International FASD Awareness Day.
N Z Med J . 2016 Aug 19;129(1440):72-83. A detailed version of paper. With, Larry Burd, Jürgen Rehm, Svetlana Popova Abstract Aim: To estimate the productivity losses due to morbidity and premature mortality of individuals with Fetal Alcohol Spectrum Disorder (FASD) in New Zealand (NZ). Methods: A demographic approach with a counterfactual scenario in which nobody in NZ…
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Brian Easton, Larry Burd, Jürgen Rehm, and Svetlana Popova Abstract Aim To estimate the productivity losses due to morbidity and premature mortality of individuals with Fetal Alcohol Spectrum Disorder (FASD) in New Zealand (NZ). Methods A demographic approach with a counterfactual scenario in which nobody in NZ is born with FASD was used. Estimates were…
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In too many areas the government is avoiding taking policy decisions. When it has to its panic measures are knee-jerk and quick-fix. Just nine years ago, John Key, then leader of the opposition, spoke to the Auckland branch of the New Zealand Contractors Federation about housing affordability which he described then as a ‘crisis reached…
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