Health changes ‘necessary’

Press, 17 November 1987, Page 49

Health changes ‘necessary’

PA Wellington Public health care as it is now known would probably not exist in 10 years unless the system’s efficiency problems were urgently addressed, said the Otago Hospital Board’s chairman, Mr Michael Cooper. As an example, no-one could defend the continuation of the present structure of 26 different hospital boards, three area health boards and 18 district health offices for 3.3 million people, Professor Cooper said, in an editorial in the latest New Zealand hospital magazine. Structural changes might not be enough but they were a necessary and overdue first step in coping with the increasing demands for accountability being made on the system. Dr Cooper said it seemed inevitable that with scientific progress, rising consumer expecta-

tions and an ageing population, health care would continue to absorb an increasing amount of the national income. But that would not be achieved without overcoming strong resistance. “Whereas rising expenditures on, say, videos, stereos or home computers are hailed as manifestations of economic success and progresssimilar increases in the health care industry are considered to be problems calling for more stringent controls,” Dr Cooper said. “The difference lies, of course, in the fact that while we pay for our own videos, 80 per cent of the cost of health care is shared with others.” Politicians seemed convinced that the public were more and more unwilling to pay in tax for the health care they often demanded as patients. If true, that was likely to reflect the public’s view of the tax system

and their mistaken belief that they were being asked to carry the burden of other people’s illness. Professor Cooper said the main barrier to expanding health care was the belief that the health care industry was abnor- > mally inefficient and the taxpayer was not getting value for money. That led to challenges to the whole basis of public funded and provided health care. While increased privatisation was seen by some as a solution to the problems, the scope for such change was limited. “Private insurance and user-pays are only different, and less equitable, pipes off the same well and the bulk of what we do in the name of health care, some 70 per cent, does not lend itself to the market place, involving as it does the vulnerable, dependent, terrified or unconscious,” he said.