Caygill speaks out over Gibbs report)

Press, 30 April 1988, Page 8

Caygill speaks out over Gibbs report)

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PIETER LUKE,

■ ■ I , political reporter )

The Minister of Health, Mr Caygill, nit out at one of the Gibbs task force’s strongest advocates ? last evening when he described as ‘Jnonsense” the view that the task force recommendations would end waiting lists. ! • i

In an address in Christchurch, Mr Caygill fouhd flaws in three of the arguments of either the task | force or its advocates. i But he reserved nis most scathing: words for the immediate, vice-presi-dent of the Medilcal Association, Dr Michael Cooper. | ! ’ I 1 Dr Cooper said last week that $lOO i million would be "wasted” in the [ State hospital) system) in ■ the two months of public debate. I J “Not content with mis particular piece of hyperbole, he went on to proclaim Alan Gibbs as a soul brother | to Mickey Savage, shortly before winding up with the extraordinary assertion that the Gibbs recommendations would spell ) the bnd of surgical waiting lists,” Mr Caygill said. ) “This is nonsense,” said Mr Caygill. ) Dr Cooper [was the immediate target, but Mr Caygill’s comments were his. strongest; yet in the “Gibbs debate” and came closest to attacking ) the task force chairman, Mr Alan Gibbs. ! | , I Like Dr )Cooper, Mr Gibbs this week [attacked the two-month public debate, saying that a total of $l2O million would be wasted in this time. One of the ' strongest

emotional features! both of the task force report and; Mr) Gibbs’s subsequent speeches, Is the image of his recommendations | ending hospital waiting Ijists. i '• i ) Mr Caygill’s rejection of this claim has been made before. But he yesterday pointed to a comment in the report which appears to contradict a later Speech tjy Mr Gibbs. | “In sprite of its , proponents' extravagant! claims to the contrary, the Gibbs report itself acknowledges that ‘frpe health care without/ queueing (is impossible.) Governments cannot do everything for everyone," Mr. Caygill said. ) "Yet one of these proponents ) has been Mr Gibbs himself, who said on April 20,’ ’I do not accept the logic of those who say that because treatment is) free there will always be a waiting list like)there will always be an England',” said Mr Caygill. ) Mr Caygill argued yesterday [that the 50,000name hospital waiting lists were the most visible evidence of the demand for health services exceeding the supply. But there were many other groups and individuals also waiting for attention from health services.

As examples he gave severely disturbed psychiatric *pa)tients, updiagnosed diabetics, children with v acute ear infections, and carriers of hepatitis B- J ■ “As a community we have to decide (which waiting list we wil| have to attend [to first. Tpere is a limited amount of money available to (spend on health. "But we have a) virtually unlimited demand for health services,” he said. Mr Caygill yesterday repeated; his belief that the priority of Government planning had) to be on primary care apd jhat hospital services were just one) element bf the total care system. ) He had earlier strongly suggested that management efficiencies within the; area health boards would be sought in the next two ) years, rather than the more radical Gibbs recommendations.) In his address yesterday, Mr (Caygill po nted to two' further reservations he had about the task force report. j The seductive prospect of. savings had been “tantalisingly dangled' by the report, but a large proportion of! the up io $6OO million ) of) savings would come from closing small hospitals and reducing the

time patients spent in hospital beds, he said. ) I ) Mr Caygill asked whether this would simply transfer the burden! ( of care, and expenditure, from the hospital system into the community. I ) Mr Caygill also |said . that Mr Gibbs seemed to have misunderstood how hospital funds were allocated. A key problem identified by the report is that hospitals were paid) according to their costs. But Mr Caygill said I that boards -..were not reimbursed for what ! they spent. Instead, the existing population-based funding was related to the [de-’ mands a particular board’s population [ “{vas likely to make. ) Boards, such as Canterbury’s, which [were deemed to be "underfunded,” had to advance a case for “additiopal” funds, and this was judged on its merits and ) [the availability of surplus funds, Mr Caygill said..! Funding entitlements were an indicator ; qnly, and were not necessarily translated into ! hard cash. Money for the so-Jcalled underfunded boards |had to be reallocated front the so-called overfunded boards, Mr Caygill said.