May 15, 2020

The Royal Australasian College of Physicians (RACP) welcomes the Government’s announcement of a funding package for the Aotearoa NZ health system, noting that applying an equity and Te Tiriti-centred lens to decision-making would support equitable health outcomes.

The major components of the Government’s investment - $3.92b over four years for District Health Boards (DHBs), and the one-off $282.5m funding to address the backlog of elective procedures and hospital appointments – present opportunities to place equity at the heart of the health system.

“It is essential that equity and the principles of Te Tiriti o Waitangi shape our new normal in our hospitals and health services”, said Dr George Laking, a medical oncologist in Auckland and the RACP’s Aotearoa NZ President.

“Without this lens, health inequities will be exacerbated. This means reduced wellbeing and quality of life, and potentially acute, invasive procedures and long hospital stays”.

There is a high risk that people who were waiting to see specialists or receive elective treatments will have experienced worsening symptoms from their health conditions, with an estimated 20,000 elective surgeries and 60,000 specialist appointments being delayed during the lockdown period.

“As we come out of Levels 4 and 3 of lockdown, hospitals will be looking to reschedule these procedures and appointments. The one-off funding to address the elective backlog is positive, but we need to make sure we are apportioning resources in a way that is equitable, and not compounding unmet health needs”.

The delays to appointments for the management of chronic conditions, medical and surgical procedures, and cancer screenings could have significant impacts for Māori and Pasifika people, who are disproportionately represented in rates of chronic illness. Māori and Pasifika also fare worse as a result of prognostication and health rationing algorithms, due to the prevalence of co-morbid conditions.

There was also concern that the impacts of the pandemic would echo through the lives of our youngest citizens, creating health and economic inequities in its wake.

“Our members are reporting that the all-important health checks and immunisations for our pēpi and tamariki are being deferred. It is imperative to get health care optimised for our babies and children, to ensure they don’t bear the brunt of this disruption to healthcare throughout their lives”.

“The Government has committed to the Child and Youth Wellbeing Strategy. We must ensure that the impacts of the pandemic don’t contribute to increasing whānau poverty, and poorer education outcomes”.

“The Government continues to show leadership in reversing inequity, but this needs to be sustained through successive years.”

Dr Laking says the findings and recommendations from Hauora, the Report on Stage One of the WAI 2575 Inquiry, and the anticipated final report from the Health and Disability System Review will provide the platform for systemic change.

“Systemic change was well overdue before COVID-19 – every major review into the health, disability or social system has found an overstretched and run-down system which is tasked to do more and more with fewer resources. This means that our most vulnerable whānau – many of whom have significant health needs – are continually left to flounder on their own”.

While long-term underinvestment in health cannot be fixed in one election cycle, Dr Laking said he was heartened by greater societal recognition of a well-funded, universal health system as a public good.

“Right now, health policy is economic policy, it’s social policy and fiscal policy. The investment we make in health as a country will support our social, economic, physical and environmental wellbeing, as Aotearoa recovers and rebuilds through the COVID-19 pandemic”.