Specialist Surgeon, Dr Hylton Le Grice (CNZM, OBE), who did his post-graduate surgical education in London & USA, worked in both public & private sectors in NZ and was on the Board of Southern Cross Healthcare (NZ's leading non-for-profit private health insurer) for 17 years, serving as Chairman for seven of these, writes for us today as follows.
"I believe that Rob Campbell as (former) Chair of Health NZ had several good ideas to improve the State Health system and these should be taken note of. They include:
1). Savagely reducing the increasing numbers of costly inefficient bureaucrats employed in the State Health monolith, with the money saved being used to expedite improvements in the system - especially on the clinical side.
2). Have one separate entity providing and maintaining infrastructure, and another separate entity to provide clinical needs and other related demands. This would allow clinical managers to much better concentrate on over-riding clinical needs. In years gone by, the major hospitals had medically trained doctors as Medical Superintendents who were in total charge of the clinical needs of those hospitals. This worked so well.
3). There needs to be more recognition of the contribution of the private sector of medicine in NZ - and there should be more co-operation between the Public and Private sectors - if it was not for the majority of Elective (non-urgent) Surgery now done in the Private Sector, the whole Health Service would collapse. As it is now the Public sector 'contracts out' to the Private Sector for elective surgery, but the politicians and bureaucrats won't talk about that.
4). One other point to take cognizance of, is that from the very beginning of the Public Health Service established in 1937-38 by the first Labour Government, they allowed Private Health Insurance to be a tax deductible item. That stayed so until 1987 when this was abolished, with also a ' Fringe Benefit Tax' placed on health insurance premiums paid by Employers for their employees. As a result, the numbers with Health Insurance in NZ plummeted. Over the subsequent 35 years numbers have gradually increased - but frequent requests by health insurers, senior citizens, and many individuals, to have this ' tax detectability' restored, has fallen on deaf ears of both sides of the political spectrum. This seems very strange, as every procedure carried out in private is one less burden for the constantly overburdened state health system - now in crisis !
5). With that point in mind, it needs to be understood that the constant adequate financing of an all embracing state health service is an almost impossible task. Ten percent of GDP spent on health services is a ' bench mark' number - but because of scientific advancements in healthcare with new procedures, drugs being invented every year and people living much longer, the financial demands are nearly endless. That is why it MUST be agreed that the public & private sectors should work in harmony to improve the overall healthcare system".
.. which raises the question: was Rob Campbell fired for having ideas about health reform that were not ideologically aligned with Labour?