With the public health sector coming under pressure, the private health sector is increasingly intervening to catch up. Some say that increases inequality.
Public hospitals have faced increased demand from Covid-19 and are now facing a winter flu peak, at a time when waiting lists for elective surgery have soared because of the pandemic. The challenges come amid staff shortages due to vacancies, illness and isolation requirements.
Professor Robin Gauldsays the director of the Center for Health Systems at the University of Otago, the private sector is benefiting from the pressure in the public system.
“The private sector always does better when the public sector cannot deliver,” he says. “I suspect there will be an increasing number of people seeking private treatment because of the public sector’s inability to treat them, or because of concerns about the ability to be treated in the public sector.”
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Southern Cross health insurance, which accounts for about two-thirds of the health insurance markethas gained 20,000 additional members in the past 12 months, bringing the total to just over 908,000, according to Chief Sales and Marketing Officer Kerry Boielle.
That’s the sixth consecutive year of growth, and an acceleration of the additional 8,500 members it gained in the year to June 30, 2021†
“We can largely attribute this growth to a greater focus by New Zealanders on their health and well-being, seeking assurance that they are covered for unexpected events – which is the critical role health insurance plays,” says Boielle. “We’re also seeing strong demand from companies investing in health insurance for their people.”
Breakfast
From July 1, 2022, all 20 DHBs were deleted and two new entities took over the health care system.
Gauld of Otago University is concerned about the trend towards private health care, saying it is “deeply unjust.”
“I don’t think that’s what New Zealanders want,” he says. “We are a country that strives for a good public health care system that treats everyone, regardless of income.
“There is a human rights issue here. Why should some people get the care they need to keep them out of misery, to keep them working, because they can pay, where other people live in misery and can’t work effectively and live a good life because they can’t? pay and do not have access to the care they need.
“The more you see the private sector being strengthened, the more that goal of justice and solidarity and ‘we do it all together’ is undermined.
“It is nothing short of a national scandal that we have made these arrangements.”
Delivered
Professor Robin Gauld, director of the Center for Health Systems at the University of Otago, says a trend towards private health care is “deeply unjust”.
Instead of spending more money on public health, Gauld would like to narrow the gap between public and private by introducing a social insurance model that didn’t know where the services came from.
“It means that the least fortunate people have the same opportunities to be treated as the best-off people who can just afford it,” says Gauld. “You will still have equality issues, but they would be seriously reduced by opening the public and private sectors to patients funded through social insurance.”
Private hospital group Evolution Healthcarewhich, in partnership with Southern Cross, operates Wakefield and Bowen Hospitals in Wellington, Royston Hospital in Hawke’s Bay and Grace Hospital in Tauranga in partnership with Southern Cross, has worked closely with the public sector during the pandemic and helped the to ease pressure on public hospitals, according to CEO Sue Channon.
“We take on quite a few patients for the public sector,” Channon says. “We continued our relationship with them, which was really well developed during the early stages of the Covid pandemic.
“We are in almost daily contact to take on additional work for the public sector, and that is in all our hospitals.”
The group has added public patients to its own operating lists where it has additional capacity, and has also leased entire operating rooms to the public sector, under a ‘wet lease’ model with Evolution providing staff, equipment and consumables and the public sector providing surgeons and anesthetists for a full list of public patients.
“We work side by side and complement each other well,” Channon says.
Evolution has opened 11 operating rooms this year and plans to expand further next year as it identifies a capacity shortage and appears to be meeting the need.
“The private sector plays a very important role in providing health services to New Zealanders,” Channon said.
“We see that with the extra workload that comes with the pandemic, and now the flu, the elective surgery is postponedand the waiting lists are growing. The outcomes for patients are worse if they don’t get access to the healthcare they need when they need it. I think everyone knows that and we are working very hard together to make sure we can give New Zealanders and patients access to those services.”
Still, she acknowledged that the private sector faced its own limitations, similar to the public sector, with operating rooms sometimes closing due to staff illness, and surgery cancellations when patients became unwell or exposed to Covid-19.
“It affects us all.”