Armstrong on Health changes
John Armstrong writes:
It is not that long ago – only a matter of months – that the loss of 500 jobs in a crucial branch of the state sector would have been the major news story of the day. …
The same could not be said about this week’s announcement that the axe will fall on close to 500 positions in the Ministry of Health and across the country’s 21 district health boards over the next 18 months.
The media reaction was very ho-hum despite the layoffs actually being closer to 700 once 200 vacant positions in the Ministry of Health which will not be filled were included in the tally. …
Increasingly, the feeling is that the public has – to borrow from Helen Clark – moved on from the days when it could get outraged by the merest hint of slash-and-burn spending cuts or privatisation. The assumption was that National won last year’s election through John Key positioning his party more to the centre. It is clear now that a large portion of the electorate had already shifted to the right.
John is partly right here, but only partly. The public mood has shifted, but I would not call it a shift to the right. It is the same shift we have seen in the UK, where most of the public now support spending cuts.
It is not a change in political views, but a reaction to the recession. Part of it is a feeling of shared belt-tightening. If businesses and households can tighten their belts, so can the Government. And it is partly that people do understand huge deficits and massive borrowing is not sustainable.
The other aspect I would point out is that it is hard to call what Ryall is doing as slash and burn spending cuts. He has promised that Vote Health will not decrease, but the gains from the bureaucracy reduction will be transferred into frontline services. This changes things considerably.
October 24th, 2009 at 9:06 am
Trying to bring left and right in to preferences on health delivery efficiencies seems stupid. With the size of budget and challenges that health has there should be continual adjustments in spending priorities and they should be always trying to focus as much expenditure on front line services. That will sometimes result in adjusting employment levels in some parts of the structure.
I’d like to think National can base their decisions on what seems the best common sense approach rather than trying to satisfy some fantasyland test of the degree of (political) rightness.
October 24th, 2009 at 10:01 am
Pete
Its the old hole in a bucket conundrum. We all want good cover but we know it can just be a bottomless well.
you’re right people want better outcomes on the front line.
With such a small market (4m) I’ve always thought we should have one integrated system for DHb’s at all levels and it makes sense that the PHO and labs should mesh into that. Staff can easily port from one area to another as it’s all on same system.
October 24th, 2009 at 10:03 am
“It is not a change in political views, but a reaction to the recession.”
Disagree. I think it is a mix. There is certainly a level of dissatisfaction with health services. Secondary if not primary. Growing inaccessibility of services, cancelled operations, waiting times in A and E, the politicisation of maternity care , and increasing misadventure claims. The public is probably amenable to any change that might improve matters. And they are not so stupid as to think more money is the solution.
October 24th, 2009 at 10:08 am
Tony has thought long and hard on how he will implement these changes. He has studied Treasury theory closely but unless benefits CLEARLY outweigh known costs he has dropped theory in favour of something more pragmatic. I refer to the NHB sitting WITHIN the Ministry of Health. Not very long ago we would have had a new Crown Agency proposed here with much hoopla enormous set up costs and – what benefit. I am not so sure Nick Smith will achieve the same result. I do regard him as a weird person and not very suited to something that REQUIRES careful political management. He is a bit like Simon Upton – all brains but zero personality and just gets up everyone’s nose.
October 24th, 2009 at 10:14 am
P.S.I do accept Nick Smith has a tougher sell, he is afterall increasing costs and reducing entitlements. Not easy at all. But he sits there at those dreadful press conferences and my skin crawls. It did for Simon Upton as well as he wagged his little finger and said we must do this or that. Just dreadful stuff.
October 24th, 2009 at 10:24 am
Jesus!….500 jobs OVER A FIVE YEAR PERIOD is hardly slash and burn.
The interesting thing about this is that I firmly believe the loss of these jobs (which will mostly be achieved through natural attrition) is something the public do not give a toss about, to use that horrible phrase, it is a “beltway” issue.
Out in the real world we are starting to see the beginnings of a revolution, the much abused “middle class” has had enough of being financially raped the Natasha Fullers and the Philip Ure’s of this world, these same middle class simply do not care if 500 bureaucrats are laid off today, tomorrow or over a five year period.
The middle class are a strange breed, most of them suffer from the annoying Kiwi disease of chronic apathy, in good times they put up with being robbed blind by the government, they just want to get on raising their kids and paying off the mortgage.
However, when times get tough and people they know well are laid off through no fault of their own they are jolted into the real world, they start to get a bit pissed off at being told how to live their lives and start to resent bludgers sitting on their drug fucked backsides while they work 60 hours a week to bring in the same money they did two years ago when they worked no more than 40 hours per week.
The NZ middle class is beginning to rediscover personal responsibility, gone are the days of “I must have it now”, things they used to drip up on “interest free terms” are put off until they have the cash, overseas trips are forgotten about in favour of a couple of weeks at home over the summer, but most of all they start to take a serious interest in what the government is doing with their money.
The middle class bloke (brilliantly described as “Waitakere man” by Comrade Trotter) takes a lot more notice of his wage slip, in the past he only worried about the bottom line, when times are tough he looks a bit further up that pay slip and thinks “what the fuck are these bastards doing with the 1/3 of my money they steal from me ever week”.
All of this means that while Ryall and the Nat’s have made a good start by laying off these 500 bureaucrats they are missing a golden chance to do more, they are missing the best chance they have ever had to effect real change and to drastically reduce the size of the government, Waitakere man would not give a toss if the number of bureaucrats given the boot was closer to 1500, and he would care even less if these redundancies were immediate.
Over the next two years we will start to see real change in the way middle NZ think, while the Nat’s cannot take any credit for this change they would be mind numbingly stupid to pass up the chance to make those changes, Waitakere man has had enough of being taken for a ride, the Ure’s, Fullers and faceless paper shuffling bureaucrats of this country are in for a rough ride, and, I have to say, it is long overdue.
October 24th, 2009 at 10:55 am
big bruv>Jesus!….500 jobs OVER A FIVE YEAR PERIOD is hardly slash and burn.
The staff turnover in Ministry of Health IT must run close to 100% per year already. There are a few staff who have been there for years, but a larger number who leave within months. Natural attrition would easily take care of all 500 UNLESS the government puts a big redundancy package on the table, in which case people who would have resigned naturally will start hanging on in the hopes of getting a payout. The best thing the Minister could do to achieve his targets would be to announce that there will be absolutely no compulsory redundancies or payouts for voluntary redundancies.
October 24th, 2009 at 11:49 am
big bruv – if Waitakere Man is to blame for having reelcted Chris Carter in Te Atatu, dare I suggest that the battle has not yet been won
October 24th, 2009 at 5:30 pm
Only 500, come on, how about govt depts. and councils losing the same number of jobs that has been lost in private industry in proportion of course.
Am I an evil bastard, well yes I am