Copenhagenizing Christchurch

bikeAn excellent post on Public Address explaining why it’s a no-brainer to give the bike a fair go when the rebuild finally gets going.

$130 million dollars of cost savings, better health, better air, less congestion. It’s a no-brainer.

The Copehagenization of Christchurch would bring very significant economic savings to the economy (in the ballpark of $131,000,000 per year, according to my calculations). But, as Copenhagen has proven, we will need to build the cycle infrastructure first, and use this as the ‘bait’ to encourage commuting by bicycle so that we can reap the economic benefits. One thing that we have already conclusively proven in Christchurch is that poor cycling infrastructure will never persuade our citizens to get on their bikes.

Read the full story right here.

Herceptin’s only the tip of the iceberg

Tui Allen
Good luck Tui. I hope it's going well.

Before the 2008 election, TV3’s Campbell Live looked at Tui Allen’s battle with breast cancer . They concentrated on the fact that there was an almost $40,000 annual cost saving for Tui to fly monthly to Palmerston North for the half hour treatment than to have the same procedure carried out at Auckland Hospital.

The cost differential was put down to different cost structures in the two centres. While it’s obvious that some costs will be higher in Central Auckland, it’s difficult to believe that such a huge difference is justified. I wonder how the bureaucracy ratio compares between Auckland and Palmerston North.

Tui is an obviously brave and positive woman. She and her husband have spent their savings on her Herceptin treatments and raised a loan to boot. I hope and pray that she and her family successfully beat this challenge. Tui’s problem could easily be yours and mine. It’s not just relative costs between two centres. It’s not just about Herceptin and the many other things we can’t afford. It’s not even just about health.

Why don’t we have a decent railway permanent way? First World broadband? Cheap power for the oldies? Why are 20% of New Zealanders living overseas? Why is it necessary for Tui to pay anything at all for treatments which are freely available in many of the countries with which—as Michael Cullen continually reminded us—we like to compare ourselves?

It’s necessary because, as a nation, we don’t have enough cash in the till to pay for everything that’s available and desirable to help people like Tui.

It’s necessary because we don’t earn enough. We aren’t cutting the mustard. We have too many people being paid to produce nothing.

New Zealand vs Luxembourg GDP graph. We're not doing well.Consider Luxembourg“

Luxembourg?” I hear you cry. “Who cares about Luxembourg?”

The good people of Luxembourg, a country not much more than twice the size of Greater Auckland, with 500,000 population, earn more than 2½ times what New Zealanders earn.

For every hour of paid work in 2006 New Zealanders produced US$28.30.

For every hour of paid work in 2006 Luxembourgers produced US$72.20.

Luxembourg has next to zero natural resources. One thing they do have is a bunch of people who work effectively. Even more pertinent to our sad situation: a high percentage of those people work in jobs which give a high return on investment.

You work it out.

Next time a politician knocks on your door, ask them why this is so and ask them why they’ve done nothing about it, ask them what they intend to do about it now. Write to a few of them and give them a rev-up. If they bother to reply they’ll lie in their teeth but if enough of us hold their feet to the fire they’ll get the message.

We need to make a noise about this. The answers lie in many areas. Here are just a few:

  • increasing R & D by business and government;
  • creating a climate which encourages innovation and providing training to enable entrepreneurs to develop and market their ideas;
  • reducing the cost of doing business;
  • making it easier to employ people and for employers to get rid of those who wouldn’t work in an iron lung;
  • improving our education performance;
  • providing meaningful work for the employable unemployed:
    • Our forests are full of pests and noxious weeds;
    • huge areas of land in need of afforestation;
    • thousand of miles of coastline and roadsides need cleaning up;
    • The work has not all been done so why are we paying people not to work?
  • Reducing bureaucracy…
  • introducing a capital gains tax;
  • increasing the New Zealand Superannuation age of entitlement;
  • and a thousand other things that we’ll address in coming weeks…

PS

If you think Luxembourgers are doing well. Wait till you hear about Liechtenstein.

It’s enough to make you weep.

A media hatchet job

Roman Hasil isn’t the chief guilty party in yet another DHB fiascoRoman Hasil

Watching the news media hounding Dr Roman Hasil has been disturbing to me. Anyone who has experienced depression or lived with a victim would have immediately recognised the outward symptoms.

Watching the way TVNZ’s trusty news team pounced on an obviously distraught Hasil and his female friend in Australia was very disturbing. It wasn’t news reporting, it was akin to ambulance chasing. It was cruel.

The 8 unfortunate women whose lives have been affected by this flawed man’s botched sterilization operations and problems with the bottle would have gained little comfort from the exercise in persecution. Hasil is as much a victim as they are.

Who is really to blame here?

OK, Dr Hasil is not blameless, his behaviour was disgraceful and probably criminal, but what about:

  • the decision makers at Whanganui District Health Board and Whanganui Hospital who failed to carry out the most basic background checks when hiring Dr Hasil. They didn’t even contact his last employer.
  • the recruitment company who held back a damning reference from one of two referees (yes, just two) listed in Dr Hasil’s CV.
  • the string of employers who failed to address Hasil’s obvious health problems.
  • the Medical Council, who could have done more to obtain information from their Australian counterparts.
  • the whole unwieldy New Zealand health edifice which has left the Whanganui Hospital so short of medical staff that they find it necessary to cut corners. Too many administrators – not enough doctors and nurses. Overworked staff. A vicious circle of destruction echoed around the country.
  • our pathetic per capita GDP which ensures that we can’t afford to rectify the shortages.
  • the Royal Australasian College of Surgeons who should have a one stop shop database of information about their members.

Who will pay when the lawyers start on the compensation hunt?

We all know who will pay. It’ll be the long-suffering taxpayers and ratepayers when the District Health Board is sued. It’ll be the patients whose care will suffer because of funds diverted to the battle and staff diverted by the process.

Who should pay?

  • The recruitment agency.
  • The individuals at the DHB who failed in their duty. Not the organizations to which they belong.

Every time an MP, a Minister, a council, a cop, or a raft of other perpetrators does something stupid which results in litigation the taxpayer pays the costs and the damages.

It’s time the individuals shouldered the responsibility for their actions. Maybe we could then look forward to a little more care being exercised before decisions are made or libelous statements uttered.

Responsibility

And after all this, and various other fiascoes, the DHB Chief Executive, Memo Musa, still has his job.

Curious.

Throwing good money after bad

It’s about time the New Zealand taxpayer saw some action on the dreadful state of the tottering health edifice. We can’t afford to pay medical staff enough to keep them in this country, but we can shell out tens of millions (hundreds?) on exponentially increasing health bureaucracy.

It’s crazy.

We need answers, results and accountability. Information Technology is supposed to make life easier for bureaucrats, instead it just produces more and more paper which nobody reads and an increasing spiral of administrative complexity. More and more managers of managers. Less and less doctors and nurses. It’s a sorry state of affairs when we’re spending more money on health than ever before, but our health services seem to be in an ever-decreasing spiral of effectiveness.

The problem isn’t what we’re spending, it’s how we’re spending it. What has changed in the system that requires vastly increased expenditure on non-medical staff and services? If those changes haven’t resulted in improved services and cost effectiveness why were they made and, more importantly, why are we stuck with them?

Michael, I suspect you got it right for once

Can’t be wrong all the time.

Wanganui mayor, Michael Laws, had this to say a while back regarding the Whanganui DHB:

“My initial inclination is that one administrative entity that looked after the west coast of the North Island – from Levin to New Plymouth and included both Wanganui and Palmerston North – would be preferable to the current hodgepodge.”

Sounds good to me. Now all he has to do is stop abusing his fellow DHB members, get them to co-operate and start getting stuff done as he did with the City Council; at least during his first term. Maybe he can’t cope with not being numero uno on the Board.

There is no need for Whanganui Hospital to provide full services if a combined alternative could, as it should, result in more bang for the buck. If you’re living in Greater Auckland you may well have to travel far greater distances (and through worse traffic) to receive treatment than you would if you were to travel from Wanganui to Palmerston North.

Case in point

John de Waal A few years ago I cut off the end my thumb by guillotining it in a folding trailer towbar. Yes, it hurt. At the time I was living in Whangaparaoa on the Hibiscus Coast. The nearest hospital was North Shore, but the nearest place where I’d have received full treatment was Middlemore in Otahuhu. By the time I got there and waited a day or two for treatment my thumb would have been dog tucker. Maybe literally.

By amazing good fortune, I hit the jackpot at my Red Beach local medical centre. A plastic surgeon, Dr John de Waal, was visiting to provide staff training. That’s John on the right. Give him a ring if you need a half-life refit. A lateral thinker and a nice bloke. Thanks John :o)

He sewed my thumb back together as a practical demo for the staff. Clever work – drilled holes in the reinserted thumbnail to serve as a splint to sew the mangled flesh back together. Ten years on it’s almost as good as new. If it hadn’t been for that happy coincidence I’d have been unable to carry on working as a marine engineer. I’d have been another ACC statistic on a permanent disability benefit.

So what’s your point I hear you cry?

With our present setup, unless you live very close to a major hospital you can’t expect close-to-home Rolls-Royce treatment in any area of medicine anywhere in this country. If something bad happens to you you can’t expect treatment around the corner or a helicopter in 5 minutes. The cookie jar is not bottomless. Unless we rebuild the whole tottering edifice from the ground up, you can’t expect satisfactory treatment anywhere. Waiting lists for emergency treatment are, on many occasions, as unsatisfactory as waiting lists for surgery. Yet again we need to start with a clean slate. This time with more input from the medical folk, less from the bean-counters and the pedlars of high tech baubles. It’s a bloody mess.