Social history of Aotearoa - New Zealand|
Date: Wed, 29 Oct 97 09:01:26 CST
From: email@example.com (Brian Hauk)
Subject: Worker's Death Fuels Outrage Over Cuts In New Zealand Health System
Worker's Death Fuels Outrage Over Cuts In New Zealand Health System
By Agnes Sullivan and Patrick Brown,
in the Militant
Vol. 61, no. 37 (27 October 1997)
AUCKLAND, New Zealand - "He was drowned by three top
judges and two clinicians. He drowned internally, that's how
he died." Said Jim Shortland as he described the death of his
uncle, Rau Williams, of kidney failure in the early hours of
Saturday, October 11. Shortland had helped lead a fight to
have his uncle's "death sentence" -the refusal by health
authorities to give him lifesaving treatment - lifted. The
struggle, covered day-by-day in the media, proceeded
alongside a series of protests around the country against
Williams died after he was taken off dialysis
treatment - which cleans the blood of impurities - on
September 17, by decision of doctors working for Northland
Health, the government-appointed body responsible for the
provision of health services in the north of the country.
Northland Health's decision was backed by the High Court, the
Court of Appeal, and the Human Rights Commission, each of
which turned down Williams's appeals.
Northland Health insisted that "clinical reasons" lay
behind its decision, citing his "mild dementia," and claiming
that Williams did not fit the medical criteria for either
home or hospital dialysis. Martin Searle, the head of
Middlemore Hospital's renal service, said the guidelines were
set because of limits on government funding.
Williams, aged 64, was Maori and a former freezing worker
(meatpacker). His kidney failure was associated with
diabetes, from which Maori suffer at five times the rate of
non-Maori. So far this year "Whangarei Hospital has assessed
10 patients as unsuitable for its end-stage kidney failure
treatment, with most of them Maori," according to the
Christchurch Press. With continued dialysis treatment
Williams was expected to live several more years.
After the Life Care Trust offered a dialysis machine to
treat Williams, an Australian renal specialist flew to New
Zealand to examine him to assess his suitability. Whangarei
hospital refused the doctor access. Around 200 people marched
in Whangarei on October 3 supporting Williams's right to
treatment. Williams himself took part in his wheelchair. The
somber mood of the protest was punctuated by chants in the
In the wake of the widely expressed outrage at Northland
Health's, two members of parliament in the National Party/New
Zealand First coalition government, Maori Affairs Minister
Tau Henare of New Zealand First and John Banks of the
National Party, felt compelled to protest the decision. The
National Party Minister of Health, William English, backed
Northern Health, as did Labour Party leader Helen Clark.
Impact of cuts in health service
Hospital care in New Zealand has traditionally been
provided through a public health system, and has been free.
Since the 1970s, however, government pressure to reduce
health spending has led to a deterioration in the service.
Major steps to cut hospital budgets were taken in 1983. Eight
years later the National Party government took further steps
towards a competitive, market-oriented health system. A
Ministry of Health report written last December stated that
real health spending had fallen 10 percent since 1988 - 89.
On October 11 the New Zealand Herald published a summary
of a confidential report by doctors at Waikato Hospital on
the impact of the level of funding available to hospitals in
the Waikato region from 1997 to 1999.
"Hospital funding cuts will result in early death,
blindness, deafness, undiagnosed cancer.." stated the
summary. "[F]uture patients will be denied semi-urgent and
routine surgery." Heart patients "can expect heart damage and
shortened life... There will be no coronary artery bypass
grafts, valve replacements, or congenital heart surgery...
People who would have benefited from surgery for limb
complications face amputations... There will be a reduction
in dialysis treatment."
As reported in the Herald, the report warns Health
Minister English "that it is pointless relying on private
services to fill the gap in services, because a high
proportion of children and elderly on waiting lists are from
The private health sector, however, is still in its
relative infancy in this country. After Williams was refused
dialysis, information emerged that this treatment is
available only in public facilities. Around the country,
waiting lists have lengthened in the face of inadequate funds
for surgery. Heath Minister English plans to implement a
booking system in July next year to reduce the queues,
calling this the "most honest" rationing the country has
seen. Points will be awarded to patients on the basis of
"clinical and social criteria," according to an article in
the October 12 Sunday Star Times.
The government has also recently announced a "get-tough
plan" to cut drug spending. The government advisory body, the
National Health Committee, suggests in a recent report that
"patient charges could be increased to pay for more health
care." The committee also asks, "When should we desist with
publicly-funded interventions that add to pain and suffering,
and prepare instead for a peaceful or `good' death?
More for-profit medicine
Amid the controversy, government ministers have been
urging a greater role for private, profit-making medical
ventures. Prime Minister James Bolger used a speech at the
opening of a new $25 million clinic in South Auckland on
October 8 to declare that "we must stop the nonsense that
seeks to portray public health care as good and private
health care as wrong."
The chairman of the major private health provider in New
Zealand, the Southern Cross health insurance company, Hylton
Le Grice, told the company's annual general meeting on
October 9 that the public health system would in the future
be limited to emergency services and major, expensive, or
vital surgery. Southern Cross raised premiums an average 12
percent a year over the past three years.
More than 5,000 people protested in Whakatane on October 2
against a proposal to stop non-urgent surgery at the
Whakatane hospital. Some 2,000 people also rallied in nearby
Tauranga, and a protest meeting was organized in the South
Island city of Nelson. In September, Southern Health
announced plans to stop providing services to the district of
Gore. A march to protest the decision is planned in
Invercargill in October.
Indignation over proposed cuts to public health services
in Otago drew 7,000 people to a September 19 protest march in
the southern city of Dunedin, in one of the largest protests
seen in the city in years. The demonstration was organized by
the Public Service Association, the chief union among public
employees, and the Nurses' Organisation, the main nurses'
union. In Auckland, the Nurses' Organisation scheduled a
strike ballot later in October. Contract talks broke down
after Auckland Healthcare refused base-rate pay rises.
Management's stance falls in line with a government letter
ordering hospitals to freeze pay unless they can shed staff
or slash wages elsewhere.
Meanwhile, Shortland said that Williams's medical file
should be open to the public, and vowed to help others caught
in the same predicament as his uncle. "If you're denied
dialysis contact me," he said. "I'm pretty much sure we'll
come to your aid - no one has the right to deny life."
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