All the health promises left out of Budget 2024

Wednesday, 5 June 2024

Last week’s Budget saw $3.44 billion allocated to hospitals, $2.12b to primary and community healthcare and $31.2 million to lower the breast cancer screening age to 70-years-old over four years.

But there were also some major omissions — ones the National Party campaigned on. The Post asked the Health Minister Dr Shane Reti about them.

Cancer medicines

Policy: Fund 13 new cancer treatments by reinstating $5 prescription fees.

Budget: Cancer drugs policy on hold. Prescription fees will return from July 15 for most people.

This omission devastated patients, cancer groups and clinicians who say it will cost lives earlier and Labour leader Chris Hipkins called the move “cruel”.

Reti said a roadmap was being worked on and the drugs will begin to be rolled out before May 2025: “We will keep our promise. We’re committed to funding these before the next Budget … we’ll start implementation.”

Revenue from the $5 prescription charges will sit in a “co-pay bucket as part of a contribution to cancer drugs”, but Reti indicated this would not be enough.

The Cancer Control Agency is due to provide an analysis of blood cancer medications — which were not included in the original list — by the end of the month.

Reti said on Tuesday work had begun on costing the original policy, so it remains unclear what impact, if any, this analysis might have on the original list.

Labour’s Health spokesperson Dr Ayesha Verrall, who axed the prescription fees as health minister last year, called them “a tax on the sick”.

“The policy is so worthwhile in keeping people out of hospital, giving them access to medicine and things people need like contraception,” Verrall said.

Verrall said the biggest broken promise was “a lack of clear front line investment in health workers” — something National promised cuts to the public sector would enable.

Mental health specialists

Policy: Increase the number of psychiatrist registrar places by 13 places a year and double the number of clinical psychologists trainees each year over four years.

Budget: No commitment.

Dr Hiran Thabrew, New Zealand chairperson of the College of Psychiatrists (RANZCP) said it was disappointing and short-sighted, given there was a 20% vacancy rate for psychiatrists.

“Currently there's no plan on how they address remaining workforce gaps,” he said.

On this, Reti said: “We have several budgets to go to meet our campaign commitments.”

More doctor training places

Policy: Increase medical school placements at Auckland and Otago by 50 doctors each year.

Budget: Funding to train 25 doctors each year.

“First of all, it takes time for medical schools to adjust to increase places, and they've had a substantial increase this year with 50 new places,” Reti said.

“Future budgets will look at that remaining 25 to make up the quota.”

Pay parity for nurses

Policy: In a pre-election debate, National leader Christopher Luxon committed to ensuring nurses were paid the same regardless of where they worked.

Budget: No commitment.

NZ Nurses Organisation chief executive Paul Goulter said the Budget contained “nothing that gave us hope … that issues around pay parity will be fixed any time soon.”

“The longer the problem is left, the more that gap is growing, causing nurses to leave primary care and community health.”

Reti said it was an operational matter, but cited the “significant uplift in cost pressures in this recent Budget”.

A total of $1.43b has been pegged to Health NZ for cost pressures in 2024/25. The agency stated pre-Budget this would not be enough.

Bonding for nurses and midwives

Policy: Pay nurses’ and midwives’ student loan repayments up to $4500 a year for the first five years of their career.

Budget: No commitment.

“That’s now pending,” Reti said. “We have now changed the fees free to the last year, and a whole new set of modelling needs to be done.”

Increased medicine funding

Policy: More funding for Pharmac on top of the new cancer treatments.

Outcome: Pharmac received an increase of $1.77b over four years — announced in a pre-Budget move in April.

Pharmac chief executive Sarah Fitt said that would cover the costs of existing medicines and Covid-19 vaccines and treatments, continuous glucose monitors (CGMs) and treatments for multiple myeloma which have already been consulted on.

Bowel cancer screening

Policy: In a pre-election debate, National’s leader Christopher Luxon said he would lower the screening age to 50.

Outcome: No commitment.

“We’ve been working on that for a while and… we’re looking to having something to say when we’ve completed that modelling,” Reti said.