A bad moon rising

Sorry JF, I just had to use your song title (please don’t sue; it’s all in a good cause).

I have recently had cause to see close up and personally what sort of society we have been building in New Zealand and how it is planning to look after our older folks. From my perspective ‘older folks’ really are older folks, but I am not alone. There are a whole truckload of us ‘baby boomers’ who will soon be seriously old folks unless the Government has us all euthanized first.

The problem that I have found is that despite having known since the baby boom after WWII that there would be a huge increase in the number of old folks from about the year 2000 onwards, fuck all has been done to plan for it. By the early seventies it must have been abundantly clear that there were not going to be enough young people to keep the economy going, yet nothing was done.

Successive governments have re-acted to things as they have arisen, but there has been sod-all forward momentum and now we find ourselves in a situation where those agencies charged with providing, health, welfare and pastoral care and assistance for the oldies are hopelessly under-resourced and under-funded.

That is bad enough; but they are also hopelessly under-trained. The bottom line is that planning for the care for older folk has been left until the last minute (presumably in the hopes that many would fall off their respective perches first and save the agencies the trouble of looking after them).

During that time their only ‘solution’ has been to raise the age of eligibility for National Superannuation so that fewer will qualify for it, and this of course is a continuing course of action that most of the current crop of parties seem keen to pursue. Presumably the thinking is that older people have absolutely no desire to retire and would far rather die ‘in harness’ and on the minimum wage. I’m not feeling a lot of love around that idea (or gratitude). It’s like the late Rodney Dangerfield used to say ‘they ain’t got no respect”.

It doesn’t occur to them that after 40 to 50 years of flogging their guts out and paying taxes of every size and shape some people might like a break – some down time where they can enjoy their Grandkids and whatever meagre spoils they have managed to accrue before the reaper calls.

So what we now find is that the Health System (I won’t glorify it with the name ‘service’) is being run like a corporation where bottom lines rule. They have budgets which the government dishes out to them (with a pair of suitably small tweezers) and they have to stick to them. This results in clinical decisions being made for all the wrong reasons. This affects all health ‘consumers’ (don’t you just hate that stupid word? Whatever happened to patients, eh?). However its biggest impact is felt upon the old folks whose needs are often greater and who are already vulnerable because they are becoming increasingly aware of their mortality and the possibility that every day could be their last whether they are healthy or not.

The result is that hospitals do their level best not to ever admit anyone and if they can’t avoid doing so they muster all of their resources to ensure they can discharge them again as soon as possible. Now in theory that could be good – that is if the reason for discharge is that the hospital has actually effected some kind of major improvement in the health of the patient and it is viable to send them home. However these days the emphasis is on getting rid at any cost.

As you have probably guessed this blog is based upon bitter recent personal experiences and not idle theory or speculation. Over the last several weeks I have seen one of my nearest and dearest misdiagnosed, discharged twice before a satisfactory state of health was achieved and then bullied by staff because I had the temerity to complain. Rest assured there is much more to be done about that!

However it was abundantly clear to me then and also at a seminar held by Age Concern where functionaries from the DHB appeared that the budget is an all powerful and revered thing. I expect the health bureaucrats prostrate themselves before a graven idol of this mythical beast every morning.

Now some of you might be thinking that a budget is important and no organisation can really function without one. And I would have to agree with that. After all there needs to be a watch on how the money is spent to avoid foolish waste (why do I keep seeing a picture of a load of very well paid DHB CEO’s when I say that?). However we have to get a bit real here for a moment. This is a budget for a Public Hospital not for a normal trading organisation. The hospital is not there to make a profit; it is there to make people well. Sometimes the costs of doing this will be a little more than we would like, but if we give a toss about our citizens we need to grit our teeth and wear the costs. Money can always be found for pointless war memorials ($80M + at last count) and ridiculous telephone number salaries for heads of departments who simply don’t deliver.

But to take it a step further I have wondered out loud what would be the consequences of the hospital exceeding its budget apart from having to endure a ticking of from that Vile little man who calls himself the Minister of Health? Would they have to call in the receivers? I don’t think so. Would they be declared insolvent and wound up? No. All that would happen is that money would have to be shuffled from one part of the Government’s budget to another and the Minister would have a red face and probably be sent to the naughty corner by Jianqi.

How is it they cannot see that if you don’t spend the money on health you won’t have the wealth? Sick people are not the biggest contributors to the economy. They don’t go out and spend loads of money on goods that have a million different taxes on them and they don’t go out and work and pay even more tax.

I can only conclude the people who have been in power here (for far too long) have already got a good offer for this country and it was conditional on getting rid of a large chunk of the population. They seem unwilling or unable to cope with the numbers now and we are only half way through the big bubble of oldies – just wait another 20 years.