DomPost Op-Ed: The bed-hopping cure
11 January 2008

It’s time to start using the empty beds available in private hospitals for publicly funded operations, writes UnitedFuture leader and Associate Health Minister Peter Dunne.

This year, the Government will spend just under $11 billion keeping our hospitals and the public health system running. That is a record amount, yet few would seriously argue that the performance of the public health system is keeping up with this record level of funding.

There are constant reports of lengthening waiting lists for elective surgery. Specialist services are being curtailed because we cannot get the professional medical and nursing staff needed to keep them running.

Recruitment of new staff and the retention of those we already have, or those completing their professional training, is a huge problem. Patients are even being sent to Australia for treatment in some cases.

And there are reports of district health boards struggling to keep afloat.

The Government faces an almost impossible challenge. Just to maintain things at their current level, funding will have to be kept at at least the current level, and more than likely increased, in the years ahead, with no assurance of any improvement in services.

To make matters worse, improvements in medical science mean that demand for new and innovative services is almost infinite, and on top of that, we are getting to the point where baby boomers are reaching an age where their consumption of health and hospital services is likely to increase.

Cutting funding is clearly not an option – just another part of an electoral suicide note. Yet things cannot go on as they are.

For years there has been talk of better integration of the public and private health sectors. The Accident Compensation Corporation (ACC) has long favoured using private surgical capacity for many of the elective procedures it funds, without obvious detriment to its clients.

So, on the face of it, the logic of extending this concept to district health boards seems logical, especially when there is excess capacity in many private surgical hospitals.

But it is not happening in practice. According to Health Ministry figures, in 2005-06 only 1 per cent of publicly funded elective surgery procedures were done in private hospitals. For 2006-07, the figure had moved only slightly upward to 3 per cent.

But even these figures do not tell the full story. Some district health boards are extremely coy about disclosing how much use they make of private facilities. Others treat the private hospital operations they fund as public hospital procedures done in a different facility. Even the Health Ministry admits to doubts about the accuracy of the figures.

Be that as it may, it is clear that a small country like ours cannot afford the luxury of two competing health systems. It is illogical to have waiting lists in one sector, and empty beds in the other. We need an integrated approach whereby the public sector uses private surgical hospitals for routine elective surgery procedures, freeing up capacity and staff in the public sector to deal with more acute and specialist cases.

The fact that the ACC already uses private hospitals shows the issue is not an ideological one. Rather, the debate is about effective resource utilisation, especially as it is going to be extremely difficult for any government to continue the public health funding increases we have seen in recent years.

Under our confidence and supply agreement with the Labour-led Government, UnitedFuture has a commitment to enabling the appropriate use of private sector hospital facilities to address waiting lists.