The record $1.9 billion Mental Health package includes a new $445 million universal frontline mental health service; $200 million extra for new and existing mental health and addiction facilities; an expansion of the nurses in schools programme to decile 5 secondary schools;  $128.3 million for Department of Corrections to spend on mental health and addiction services; $197 million to tackle homelessness through Housing First; and funding for the Te Ara Oranga programme in Northland to help up to 500 people a year who are addicted to methamphetamine.

The Government is also investing $40 million over four years into suicide prevention services, to give people at risk intensive support. This includes better recognition and support for people who have self-harmed or experienced suicidal distress.

Health initiatives for Māori and Pacific peoples were also a priority in yesterday’s Budget, with $12 million provided to fund rheumatic fever programmes to reduce the incidence rate among Māori and Pacific peoples and support better management of the illness.

Associate Health Minister Jenny Salesa says this investment will support the development and implementation of innovative, community-led rheumatic fever interventions.

In addition, the Budget will invest $1 million to research how a whānau-centred approach to primary healthcare could improve outcomes for Māori and Pacific peoples.

There will also be increased investment of $9.8 million over four years in developing innovative Pacific community initiatives, including initiatives to share evidence-based Pacific models of care.

And $14.3 million over four years has been allocated for a strengthened Pacific training pathway, with a focus on increasing the number of Pacific nurses and midwives.

Another winner, road ambulance services receive a one-off funding injection. Government also committed an extra $17.2m over four years to top-up operational funding in addition to the $190m of funding year-to-year.

Primary care receives a major boost of $331 million in the Budget, a 25 percent increase on last year, and Pharmac gets an extra $40 million a year for the next four years.

However, National’s Health spokesperson Michael Woodhouse says District Health Boards have missed out in this year’s Budget.

“The sea of red ink we’ve seen our nation’s District Health Boards sink deeper into won’t be fixed and the $569 million allocated for DHB cost pressures will hardly be enough to even keep the lights on,” he says.

Lyndon Keene, Director of Policy and Research for the Association of Salaried Medical Specialists (ASMS) agrees district health boards will be disappointed with yesterday’s Budget, estimating a funding shortfall of around $300 million.

“More money has been directed at community-based services, including an additional $61 million for National Mental Health Services, which is managed by the Ministry of Health.

“However, the estimated shortfall in DHB funding means many hospital services will continue to struggle with increasing demand, and current unmet need for services is unlikely to be addressed.

“Targeting more funding for community services is much-needed,” he says, “but doing so at the expense of other services that are already under sustained pressure is highly disappointing.”

Keene says the bulk of mental health funding which is ring-fenced and allocated to DHBs to cover services for people with the most severe needs has increased from $1,478 million in 2018/19 to $1,531 million “or just 3.6%, amounting to a nil increase when demographic changes and cost increases are taken into account”.

Alongside DHB funding, Woodhouse identifies the following as “underfunded initiatives and broken promises”:  “No money for independent midwives; no remedy for the broken promise on GP fees reductions for all New Zealanders; a measly 1% increase in medicines funding that won’t keep pace with population growth and demand pressure; no free health check for senior New Zealanders.”

Yesterday’s Budget has done little for the wellbeing of the thousands of New Zealanders waiting for elective surgery, says the President of the NZ Private Surgical Hospitals Association, Richard Whitney.

He believes the government has missed “a perfect opportunity to address the concerning waiting list situation by failing to have DHBs collaborate with private surgical hospitals around the country to provide much-needed surgical services”.

More than 350,000 New Zealanders 18 years and over have some form of elective surgery each year, says Whitney. An additional 280,000 have been told they need elective surgery but only 110,000 of those are on waiting lists.

“The private hospitals sector has significant capacity, with experience and expertise, to address much of this demand.

“Our member hospital facilities already provide more than 50 percent of all elective surgery performed in New Zealand. We can partner with government to provide a significant number of additional elective surgeries.”

Whitney says outsourcing a portion of this surgical workload, as part of a collaborative and strategic relationship between public hospitals and private providers, would help to meet the unmet demand and enhance patient outcomes, while relieving the load on DHBs, enhancing efficiencies and reducing government capital expenditure requirements.

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