As we know, the changes to Te Whatu Ora Budget settings are having a big impact on the system and our ability to work and train. Since the change of government and the appointment of a commissioner we have been told time and time again that Te Whatu Ora has overspent and that we need to save money.
Unions have been asking for the data to back up these statements for some time, yet nothing has been forthcoming. The health unions collectively wrote to Te Whatu Ora outlining our concerns and that we needed to be able to see the financial information to understand the budget constraints and why they are suddenly having to find significant savings which are resulting in the defunding of projects and making positions redundant. Unions received a response to our letter last week and the result was being provided with a 454-page document of memo’s and financial statements.
From our initial review of the documents, we have formed the preliminary view (on what information we do have) that the cause of the alleged financial position Te Whatu Ora claims as the basis of a proposed change management process is not all as a result of mismanagement or “over spend”, but also in part the failure of government to pay monies to Te Whatu Ora that are legitimately owed.
Additionally, it seems that there were more nurses employed than budgeted, representing 3,522 nursing FTE and $651m in ‘budget overrun’. Another large contributor seems to be the desire to save approximately $2bn which reflects approximately 7% of revenue. We have not been able to establish if there is any science behind this number – or simply “This is a comparable target to other agencies across government”.
STONZ along with other health unions as part of the CTU (Council of Trade Unions), met again yesterday with the Commissioner, Lester Levy, Te Whatu Ora Chief Executive and senior leadership in attempt to better understand the goals of Te Whatu Ora and the Minister and to continue our advocacy highlighting that any cuts and budget constraint must be done in a way that does not impact our work, our training and the safety of our patients and communities.
Following the meeting our feeling is that there is still a big disconnect between FTE and budgets and what we are seeing versus what we are being told. We have requested further information particularly around the key workforce messages and staffing and whilst we have been told that Te Whatu Ora is still hiring, there is certain criteria in place which may differ regionally.
It is also clear that we are being asked to do more with less and we are yet to hear how Te Whatu Ora is planning on doing that without reducing services. They have a 2-year ‘Back to Budget’ programme of works where they aim to get costs down. We believe it is also on Te Whatu Ora to clearly demonstrate to decision makers about what the consequences will be of these cost pressures.
One of the other impacts which was also highlighted in our recent survey, is that the hiring freeze, particularly of RMO units and other enabling services is having a big impact on us and the ability for Te Whatu Ora to meet its compliance commitments. We raised this issue with Minister Dr Reti at our last meeting, and again with Te Whatu Ora, as it becoming a significant concern. We are also concerned that some RMO Unit staff and enabling teams such as recruitment may have been considered for voluntary redundancy – if that is correct, we are certain that trying to get reimbursements, rosters published on time and other SECA entitlements will only get worse so our advocacy in this area also continues.
As more information becomes available, we will review and share with you all – a lot of which will also be publicly available and is being discussed in the media. A big thank you to the Council of Trade Unions (CTU) and their economist for helping us make sense of it all!
And a couple of reports and articles you may be interested in which have been referred to recently as part of these discussions.
NZMSJ Editorial, The cost of everything and the value of nothing: New Zealand’s underinvestment in health.
Commonwealth Fund, Reflecting Poorly: Health Care in the U.S. Compared to Other High-Income Countries