Friday, April 22, 2022

Making it up as they go

I sent the following letter this morning to my local paper:

Two phrases bring out the cynic in me. One is “joined-up government”. The other is “wrap-around support”. Both are ideals that are more easily talked about than fulfilled.

Reading the extraordinarily vague and woolly explanation of how the new health system is supposed to work, I fully expected to see at least one of those expressions.

Sure enough, there it was: “For example, it will be easier for someone’s GP to work with their in-home care nurse and pharmacist so they receive the wrap-around care they need” (Health New Zealand “interim localities lead” Martin Hefford).

From my observation, “wrap-around care” rarely lives up to its promise. Reality usually gets in the way. But we have a generation of politicians and bureaucrats who seem to think that as long as they get the jargon right, everything else will fall into place.

All reformist politicians have an urge to re-invent the wheel and thus bestow their own legacy, but I think we should be deeply sceptical about the extravagant promises being made for the new system.

Based on what we’ve been told so far, it looks as if its creators are making it up as they go. Good luck with that, as they say.


Max Ritchie said...

It’s worse than that. The announcement of the 9 health localities and their appointed commissioners, all predominantly Maori, with Iwi mentioned first among those to be consulted, demonstrates not off the cuff but a pre-determined plan to prioritise Maori regardless of need. There are many more disadvantaged non-Maori than Maori. This is racism for political advantage. The Labour Party is about to find out that this divisive, cynical, racist approach is not only poor governance but also bad politics. The Labour Party of old has been hijacked by extremists.

Anna Mouse said...

According to Dr Lawrie Knight in his "Fact checking Māori health claims that led to the Pae Ora (Healthy Futures) Bill" it seems that for 2 decades there has been a by Maori for Maori health care provision that "have not significantly improved Māori health as hoped."

So in essence Karl your assumption that wrap around care truely never in reality works as expected.

The whole MHA and Pae Ora is a con and Dr Knights' submission proves it so.

The creation of the MHA (among other apartheid policy) is about power, control and elitism and not health in any way shape or form.

Hilary Taylor said...

Yes. We see. Closing The Gaps architect Helen Clark (I think I'm right there) is staying schtum...why does nobody ask her what she thinks of all this?

Andy Espersen said...

I am a great believer in “wrap-around care” – when and if it is needed. Let us first of all determine what this peculiar expression must stand for, must mean.

It can only mean a health system which can deal adequately with each and every eventuality which can happen to an individual person suffering from either a physical or a mental illness.

Now correct me if I am wrong, but it seems to me that as far as physical illnesses go our present system already works as perfectly as anybody can expect. I personally have benefited from it over the last few years : when my physically ill wife needed hospital care, it was available immediately – and the care extended to her from mobile nursing staff while she was at home was excellent and adequate. I would be very interested to know whether any of Karl’s commenters has ever come across incidents indicating serious problems with “wrap-around care” as far as physical illnesses are concerned.

So consequently, “wrap-around care” problems must refer exclusively to mental health conditions – must they not? Then, why does nobody openly say so?

I happen to know a fair bit about human mental problems – and their treatment. For 150 years we in New Zealand had a mental health system that was based on residential, psychiatric hospitals – just like treatment of our physical illnesses was, and still is, based on ordinary hospitals. Fact is, just as physical illnesses at times need full “wrap-around care” – so do mental illnesses.

Some mentally ill patients need “wrap-around care” all their lives, others need it only periodically – some only once in a lifetime – some never at all. Some of the most serious neuroses, e.g. the killer neurosis Anorexia Nervosa, are best treated in residential mental institutions through sustained psychotherapy, away from patients’ ordinary, usually stressful, environment. This type of care is terribly expensive. It used to be free in New Zealand – you even qualified for government sickness benefit for the whole of the period in hospital!. These days you need to go to the U.S. - where it costs a fortune.

Odysseus said...

So while the Health Minister, a former trade unionist, denies thousands of nurses their rightful backpay, and people cannot access first world drugs for cancer or conditions like cystic fibrosis because Pharmac doesn't have sufficient money, and a pandemic continues to take lives every day, millions of dollars are spent on consultants to rejig the Health System to pander to Maori separatists.

The language used by Ministers and bureaucrats to describe these "reforms" is pure fantasy. It is typical of people with university degrees who are totally detached from reality and have not the least inclination to understand it. As the Siren call of Australia beckons to ever increasing numbers of our health professionals, I predict the imminent collapse of the whole system. But this is what New Zealanders apparently voted for in overwhelming numbers only 18 months ago so they have only themselves to blame.

Richard Arlidge said...

Regrettably, Odysseus is right. I’ll wager the legacy of this reform will be that it will prove the most expensive, divisive and disastrous reform ever in New Zealand’s history - leastwise to date. Founded on fallacies and an unattainable belief that you can produce equality of outcomes for a cohort of the population that fails to take personal responsibility, as Karl rightly intimates, it now has all the hallmarks of it being concocted on the fly. Our MSM has been woeful on its coverage of this patently racist, incredibly expensive social experiment, but who can really blame it given the complexity and lack of clarity on how this is going to work (which it won’t), when we’ve already seen how well they’ve done on covering off the Three Waters rort, which is more readily tangible, if equally lacking any real transparency. Oh, there will be some winners - the consultants and the stationery printers, and that ever more-wealthy cabal sitting at the top table of Maoridom.
How or why this happening? Yet, again, it’s the decency, complacency and “she’ll be right” attitude of the average New Zealander at the root of the problem. And as proof, ask anyone you know what this reform really means? If nothing else, I suggest people have a listen to the prophetic words of the learned, David Round, who so eloquently and accurately predicted all this back in 2014. If you do nothing else, listen to Part 4 (14mins) of his presentation here: but, to put it in context, I really urge you to seek out the other 3 Parts – as for many (probably not those reading this), it will be the most informative (if not, otherwise, reminding and thought provoking) 55 mins you’ll spend on anything, if you want to appreciate the destructive forces currently at play. To paraphrase JFK – do it for both yourself and your country! (And do pass it on.)

Trev1 said...

Richard Arlidge: thanks for the link to the David Round lecture. I agree, everyone should take time to watch it. Everything he predicts is becoming real today, sadly.

Richard Arlidge said...

You're most welcome Trev1, I just hope more people take the time to gain some enlightenment, or at least think about what's happening here. I see that since that youtube video's production nearly eight years ago, it has had less than 1.5K views in a "team of 5M", and that's not forgetting it's available worldwide! How sad is that? And to top it all off, I see that "special cohort" are now going for the trifecta. Not content with, firstly, redefining our understanding of the Treaty, then it was the words racist and racism, now I see Willie Jackson (and Coffey & Mahuta et al) want to redfine our understanding of public consultation and democracy. What a truly parlous position this country has arrived at. It's well past due time for the rest of us to say "ENOUGH!", or we will all rue the day and suffer its consequences for generations to come.