Saturday 10 November 2007

The Wellington solution

Stephen Franks refers to the recent DomPost front page "on hospital cynicism and chaotic management" in Wellington Hospital and the Capital and Coast DHB -- he identifies a "general air of discouragement" within medical professionals. "It must be wearing," he says, "to work in a spiritless atmosphere - hating management but being cynical about all solutions." Giving a talk to the Auckland Medico-Legal Association, he was told afterwards that
hospital productivity had probably dropped 20% as many medical professionals had given up going the extra mile to cover for system deficiencies.
And all this while govt spending on the govt's die-while-you-wait health system has rocketed. The answer is clearly not more money, since all major health indicators have either held steady or declined as waiting lists have continued to climb, and new solutions to rearrange the deck chairs on the sinking ship are greeted with the cynicism they no doubt deserve.

It's time to sell the deck chairs and refloat the ship, says Libertarianz' Dr Richard McGrath, starting with the place where the rot is greatest. "Radical measures now need to be taken if Wellington Hospital is to be salvaged," says McGrath. "The loss of another specialist from Capital & Coast DHB is a further indication of the dysfunction and chaos that is inevitable under the Marxist paradigm of rationed health care," he added.
"The new health minister, the 'socialist who can count', may have done a tally of the current number of paediatric oncologists in Wellington Hospital - a big fat zero. In a free market capitalist system, the supply of oncologists would tend to match demand and there would be downward pressure on the price of services as the number of specialists in a given locality increased."

"Under the current pseudo-corporate public hospital structure, there is no relationship between demand and supply. Provision of services is crippled by the massive army of self-serving make-work bureaucrats both within our public hospitals and in the health ministry, most of whom would be redundant in the context of a free health care market."

"If Wellington Hospital is to be saved from total collapse, urgent measures are needed. Firstly, begin the privatization by telling the current board and chief executive to clear their desks, and appointing interim board members from the private sector who would in turn appoint a new temporary CEO."

"Secondly, distribute shares in Wellington Hospital to the people of the greater Wellington area, so that they can hold them as an investment, sell them on for cash, or pool them with others to form shareholder pressure groups."

"Thirdly, allow medical, nursing and other groups from the private sector to rent space in Wellington Hospital for provision of the care that is obviously needed."

"People are dying on public hospital waiting lists in our capital city, and children have to be flown across the country for cancer treatment - the situation is intolerable," McGrath said.
That's the solution to cure cynicism and to fix the dying system, one hospital at a time. It's enough to make you vote Libertarianz!

10 comments:

Anonymous said...

And the thing that really pisses me off is after all that money has been poured into the "health" system we now have full page adds in the DomPost begging for money to keep the child cancer service going.

Give me a break people surely the extra billions could cover it, oh no that is right they are paying the bureaucrats wages.

Berend de Boer said...

Shares in the hospital must be the daftest idea the libz has. Everyone would sell their shares immediately of course and nothing would change. The result? The clamour for the government to step in would be deafening, and of course, they would step in again.

Maybe the libz should think a bit about going from a to b.

Anonymous said...

So Berend says to hell with allowing the people the choice to decide what they want to do with "their" assets....typical socialist.

Anonymous said...

Berend

If you are supporting the idea that the government should operate hospitals and healthcare systems then you are a socialist. James is correct.

BTW if the medical and surgical system were privatised in this country, I would be setting up a healthcare company or buying shares in hospitals and medical practices. So much for your silly idea that "everyone would sell their shares immediately". Fact is there are many who would invest. Just because you are silly, that does not make everyone else silly as well.

LGM

Anonymous said...

Fuck you people are predictable, Berend presumptuously dares to point out what would actually probably end up happening and you guys call him a socialist, God how depressing.

Libz = Zero fucking understanding of human nature.

Anonymous said...

I tend to agree soft cock. IT seems to me that Berend is more concerned that a bad reform will further entrench the stasis quo rather than relieve it. Which we must all surely want. It is knee jerk to label him as a socialist.

Having said that, I don't find his argument particularly persuasive. Presumably people that sell their shares sell them to people that want them (why else would they buy them!). Such an interested group would appoint a board to then maximise the potential return on there investment. Looks like a positive change to me.

Sean

Anonymous said...

Well Softy,

A state run medical/surgical system IS socialist. Had you considered that?

You are a fool.

LGM

Anonymous said...

On two separate occasions this year, Wgtn Hospital announced its being at 'Code Red' status, because it was ... 98% full. That's right, 98%.

It was at crisis point because it was NEARLY full.

Any private hospital or nursing home would love to be at 98% occupancy *all* the time. That equates to more patients receiving treatment, requiring more staff, meaning more turnover.

But you'd rather see us *all* paying for only *some* receiving treatment, Berend, after waiting God knows how long for the state to get its ass into gear. (And after the bureaucrats pay themselves, first, of course).

You'd rather that people were treated like political footballs with certain conditions being given precedence over others. "Your situation's not so bad, so you can wait, you bastard!" Or, "we want the South Auckland vote, so here's another x-squillion for diabetes". Gee, how caring.

Health (and education) are services, nothing more, nothing less. They are important, certainly - but no more so than the food supply or undertaking.

Just imagine if undertaking was in the hands of the state. Fuck! The bodies would be piling up because there'd be a waiting list for disposal! Good time to be in the freezer market, eh! :)

Oh, and Softy: go back to your lefty blogs, sweet pea. You'll feel so much more at home!

Peter Cresswell said...

BEREND: "Shares in the hospital must be the daftest idea the libz has. Everyone would sell their shares immediately of course and nothing would change."

And allow me to point out this must be one of your daftest objections yet, Berend. You seem to overlook the fairly obvious point that if "everyone" sold their shares then "everyone" must have found a buyer -- which means, even in the unlikely event that "everyone" were to sell, then 1) the hospitals would still have ended up in the hands of shareholders who value the hospitals the most, and 2) those who have some sort of stake in their local hospital and who have paid for the damn thing over several years will have had a their property returned and (if they wished) made some money on it.

You also appear to have overlooked that this was one of the common and relatively straightforward forms of privatisation in the post-Soviet transformation of Eastern Europe.

The point here, if I may quote myself, from the same policy in being used to return schools to their rightful owners:

"The new owners of these schools and tertiary institutions - the parents, teachers and trustees - would have just been handed a valuable tradeable asset: if they need any transitional funding they will be able to sell equity, take on debt, or enter into whatever lease-back deals they can negotiate. They will be left free to sell all or parts thereof; to run whatever curriculum at whatever hours they think will bring in customers; and to hire, fire or retire any or all staff. They will be left free to profit from their new schools in whatever way they wish."

And, of course, free to sell if they wish.

That's the point. The hospitals are removed from govt hands by distributing shares; those who value them hold on to them, those who don't, don't.

Meanwhile, the new owners can get on with turning the die-while you wait monolith into something like Auckland's Ascot Hospital, staff can look forward to being paid what they're worth, and patients can begin adding months if not years to their life expectancy.

Everybody wins except the grey ones.

Anonymous said...

Berend: not all the general public have shares in our privately owned supermarkets - which by the way seem to be providing a pretty good service - yet I don't hear rumblings from the proletariat for supermarkets to be nationalised.

When you say "nothing would change" I think you are mistaken.
Service would improve with privatisation of state hospitals, and waiting lists would drop to days/weeks, because unlike the state sector the private sector is sensitive and responds rapidly to consumer demand.

There is no natural right to make someone else pay for you to have state of the art health care, or put another way there should be no obligation on anyone to fund the healthcare of other people. That model of funding is immoral because it relies on extortion and theft, which years ago my mummy and daddy told me is wrong.