To say something, or to keep quiet?

Speaking up for a public healthcare service has its price.

If there is a real ‘frontline’ healthcare worker who feels that “Frontline Services have not been affected” by government funding choices and the hiring freeze, I have not met them.

Regardless of how much Shane Reti, Lester Levy, or PM Luxon keep telling us that an additional $1.4B in Health NZ cuts “won’t affect clinical care”, I don’t know anyone outside the big political leaders that believes this.

This week a couple of doctor coworkers gave me a strong message of support. Like many healthcare workers (and patients), they're acutely feeling the effects of health cuts on their ability to care for patients.

Ironically this came hot on the heels of an email from management requesting my presence at a meeting with the bosses, to ‘discuss’ my media interviews where I’d talked about the troubling state of Health NZ understaffing + underresourcing, the government denial of a profoundly damaging hiring freeze, and the stalling of long-needed hospital rebuild projects nationwide.

I’ve been asked to bring a support person to that meeting.

I think it's the first time in my life I've ever been asked to bring a support person. That can't be a good thing.

I can only assume this is the first meeting to lay down the rules. My ‘official warning’, so to speak.

One message gave a warm feeling, the other a chill down the spine. Taking care of Northland patients in the emergency department for the past 17 years has been a privilege of a lifetime. I could not think of a more gratifying place to work. I don't want to risk that.

But at the same I can't watch an austerity government grind down essential public services and infrastructure and pretend it's OK.

Luckily the warm feelings have overwhelmed the latest shivery moment.

Colleagues have stepped up and said they supported what I was doing, because they too felt the impact of understaffing on patients (and the government campaign of denials that goes along with it) was being overlooked.

I've received emails from professors of medicine and nursing whom I've never met. Phds and academics that wanted to speak up but find it hard to speak up safely without impacting their career prospects.

Nurses and HCAs (Healthcare assistants) I haven't seen for years checking back in on social media with words of support.

Telephonists and psychiatric nurses and medical records clerks and radiographers that have gone out of their way on the street, at the shops, and in the gym, just to say thanks.

And all the people out in public at Pak 'n Save, or walking in the town basin who have come up to me to say that they were cancer patients waiting 8 months for their 3-month follow-up appointments, waiting 6 months for MRI, being bumped off the waiting list for a surgery, enduring years-long delays to knee replacements that threatened their ability to continue working, or dealing with the widespread inability to find a GP taking new patients.

Or if they have a GP, to get seen by them in a reasonable time frame, due to chronic underfunding (made worse recently) that has seen GPs reduced to a shadow of what they used to be, and a fraction of what is needed.

These patients all wanted to thank me for saying something, on social media on Twitter, Facebook, Substack, on TV or radio, by whatever means I have.

We cannot let our essential public services be eroded to give more profits to private corporations. It is not right. It is not good for NZ society. It is also financially foolish.

The feedback from wider hospital staff has been incredibly supportive: nursing, admin staff, allied health. Sadly, they do not have an ability to be vocal about things that directly impact patients in the same way that doctors can.

Doctors, almost uniquely, have the ability, and indeed the obligation to speak up to minimise patient harm. One that goes beyond a paycheck or an employer. First and foremost, they must be patient advocates.

My message here is to the wider group of folks who wonder what they can do about it: just have a tiny conversation about it with somebody different. Every day.

Even if we don't feel comfortable speaking up publicly, I think we can each derive satisfaction (that's not really the right word but it's close enough) in trying to do the right thing for people who are struggling…through our daily work or even through our small daily conversations.

Even a 5 minute chat with the guy mowing the grass on the footpath can build a movement with a shared purpose: building a better society through better public healthcare, education/training, policing, and housing.

Essential public services are widely supported by people regardless of their political party.

It is only a socially dangerous and tiny minority (fronted by Luxon and Seymour, but led by the organisations who fund them) that want to strip public services and end up with for-profit hospitals, for-profit schools, for-profit public housing, for-profit police, for-profit prisons. Most regular folks know that down that path lies a dysfunctional society of ‘Haves’ and ‘Have-nots’.

A society where the profiteers prey on the bottom 95% of society. That unfortunately seems to be where we in NZ is currently heading under the current ‘profit at all costs' leadership.

The one thing I'd like colleagues to know is that if they feel I am mis-speaking or overstating things, or wrong, that they should tell me immediately, so I can correct it. Or at the very least, reflect on it.

One colleague, for example, pointed out a factual inaccuracy in an article. That allowed me to contact RNZ and quickly correct their misquote.

Other conversations have also given me pause to think about not just beneficiaries and minimum wage workers but also those who have a ‘nest egg' but are still in a financially precarious situation. It really is only a tiny crust of New Zealand that is winning big under our austerity government.

The indisputable winners under this govt: the Australian banks and supermarkets that hold near-monopolies; the Australian and international private equity groups that own our White Cross urgent care centres and primary care and private hospitals and private radiology groups; and an assortment of 300 mega-landlords, private prison operators, mining corporations, Philip Morris tobacco corporation (which has so many family or lobbyist connections to this coalition government), predatory energy companies, and other assorted opportunists that suck up all the profits, while leaving all the damage and the costs for the taxpayer to deal with.

Every day it's a new outrage. Today's is that Act & National are going after Pharmac again: Pharmac is the only real guardian New Zealand has against medication price gouging.

Big Pharma has been trying to topple it for a decade: this government they will very likely be able to. New Zealanders have little understanding of how expensive medications will be once Pharmac is gutted.

We can't let them do that to NZ.

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A couple of weeks ago I went to a small union protest that had about 200 people from six unions in Laurie Hall Park. They were protesting government cutbacks on essential services.

It occurred to me that the movement to rebuild New Zealand public infrastructure will get nowhere if it's all individuals and small splintered groups. The public workers need to understand that they're on the patients’ side too. The patients need to understand that cuts to beneficiaries affect them. And the beneficiaries that cuts to students hurt us all in the long run as well.

We are all tied up in a society. Even if our current government leaders seek to carve us up for corporate profit.

The wealthier guy at the private hospital needs to understand that if he gets critically ill, he will immediately be taken care of in a public emergency department and a public intensive care unit.

We are all in this together.

(With the possible exception of people so wealthy or powerful that they never have to “wait in lines” for healthcare or housing: the likes of Mr Luxon, Seymour, Jones, Peters, Reti, or Levy. For them influence is measured in millions of dollars: $23.5 million in the last election cycle alone.)

BTW, it's well past time to get corporate donations out of politics. Read 'Money for Something' if you want to see how bad it has already gotten.

And to fully appreciate the risk of backhanders and corruption posed by the latest rounds of tobacco policies, gun policies, and Fast-tracking legislation.

https://search.app?link=https%3A%2F%2Fthespinoff.co.nz%2Fpolitics%2F30-11-2022%2Fits-time-we-closed-the-political-donation-backdoor&utm_campaign=aga&utm_source=agsadl2%2Csh%2Fx%2Fgs%2Fm2%2F4 )

These men will not feel the pinch when a hospital unit in Greymouth closes down, or when Kāinga Ora freezes 3,000 needed homes, or when after hours doctors are removed from dozens of New Zealand cities and towns.

They will not be hurt in the least.

In fact, the more privatisation of public services they push, the better their prospects for future employment, campaign finance contributions, and political opportunities.

These leaders’ actions are not on the side of the public wellbeing. Their words may say they are public advocates. But their actions make it harder for my patients to get timely healthcare care.

Their efforts make it harder for New Zealanders to get things they need like public dental care.

Their public policies are moving us backwards.

If you account for population growth, healthcare operational expenditure in this country hasn't grown by 0.4%, it's actually gone backwards.

Waiting lists are blowing out. We still lack literally thousands of nurses and doctors but are instead being told we are overstaffed, and need to have an additional $1.4 billion in healthcare cuts, because healthcare is overfunded.

Government says there's no money for essential public services or rebuilding, but they’ve just spent $2.9 billion giving taxbreaks to landlords. Twice as much money as needed to give free dental care to every New Zealander!

As long as this sort of thing continues, I intend to keep speaking out against this government's slowly grinding assault against the public.

-- Dr Gary Payinda