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Report: Productivity in the Health Sector: Issues and Pressures

Report cover

With health spending as a percentage of the economy expected to increase more than 50 percent between now and 2060, the Government needs to put greater focus on efficiency, says the New Zealand Taxpayers’ Union.

Our latest report Productivity in the Health Sector: Issues and Pressures investigates the recent failure to achieve efficiencies in the health sector and offers some possible opportunities for reform. According to Treasury forecasts, debt is expected to hit 205.8% of GDP if we don’t make changes to superannuation or health spending – unsustainable if we want the Government to continue funding public services as current levels.

However, while superannuation receives a lot of attention from politicians, health spending is actually expected to grow at a faster pace – nearly ten cents in every dollar in the economy will be devoted to health spending by 2060. If we can reduce that spending by achieving efficiencies across the sector, public debt will be much more manageable for taxpayers.

Our report argues that the best approach for reform is in line with OECD recommendations: the Government should not up-end the entire sector, or introduce American-style private markets, but instead seek to introduce incremental reforms that deliver better returns for every dollar the taxpayer spends. In each of the next three weeks, we will be releasing an issues paper focusing on wasteful spending at DHBs – eliminating those instances of waste would ensure funding could go to more surgeries and better care for those that need it.

Key figures:

  1. Health spending is expected to grow from 6.2% of GDP in 2016 to 9.7% of GDP by 2060, contributing to debt hitting 205.8% of GDP by 2060.
  2. Between 2004 and 2015, there was zero cumulative growth in healthcare productivity.
  3. Between 1996 and 2017, labour health productivity growth (0.9% per annum) ran at half the rate of the rest of the economy (1.8% per annum).

Further to this report, the Taxpayers’ Union will release three briefing papers containing original research on areas of waste in the health system.

Tuesday 6th: Missed Specialist Appointments
Tuesday 13th: DHB Redundancy Costs
Tuesday 20th: Adverse Drug Reactions

Revealed: The $133,000 pricetag for the glossy Wellbeing Budget

Budget graphic

The New Zealand Taxpayers' Union can reveal that the Government spent $133,530 on producing its ‘Wellbeing Budget’ document, a cost blowout largely driven by spending on graphic design and photography.

The $133,530 price tag compares to $86,268 for the 2017 Budget – an increase of 54.8%.

The Government spent $31,682 on external designers and photographs. These costs were zero for the 2017 Budget, which the Taxpayers’ Union asked about for a comparison.

Even general printing and proofreading costs increased for the Wellbeing Budget compared to 2017.

The Wellbeing Budget was a great gig for the beret-wearing hipsters who designed it, but not so great for taxpayers, who were forced to pay for the PR blitz.

It’s a minor spend in the scheme of things, but it is concerning because this document, prepared by the Finance Minister, sets the fiscal tone for the rest of the Government. If Grant Robertson starts splashing out on glossy design, other departments might think it’s okay to do the same.

Revealed: Wellington City Council’s $20,000 bike light investigation

Bike lightsThe New Zealand Taxpayers’ Union has identified an absurd case of mission creep at Wellington City Council: the decision to spend $21,750 on two Consumer NZ investigations into different brands of bike lights.

Information released to the Union reveals that Wellington City Council initially paid Consumer NZ $10,600 for a comparison of bike lights in 2017 and paid the organisation a further $11,150 for an updated version of the report this year, totalling $21,750.

Consumer NZ purchased 61 bike lights and tested their battery run-time, light output, ease of charging, lighting modes, water resistance and fitting.

This sort of spending says the lights are on, but no-one is home. Consumer NZ’s product comparisons are a service to its subscribers, so why should Wellington ratepayers be the ones forking out?

$20,000 might only be a drop in the Council’s budget, but this is a worrying case because it hints at a culture of mission creep. The Council’s decision to get involved in niche consumer matters, that would usually be dealt with privately, only results in more neglect of core services like roads and rubbish.

The Wellington City Council would be wiser to conduct a comparison of the value of its own spending projects, particularly while it’s hiking rates and dealing with unexpected costs from the Town Hall and Library.

Raw information:

Proposal
Email chain

Revealed: New Plymouth District Council’s eye-watering flight expenses

New Plymouth

Update: New Plymouth District Council has corrected information it gave the New Zealand Taxpayers’ Union regarding ratepayer-funded flight expenses in 2017/18.

A Council spokesperson states:

Former Govett-Brewster Art Gallery/Len Lye Centre director’s Simon Rees’ overseas travel was not ratepayer funded.  Supplied information should not have included three overseas trips by Mr Rees, which were funded by the Molly Morpeth Canady Fund. This funds all the director’s travel and associated expenses.

Therefore, the updated total of the Council’s 2017/18 flight spending is $279,355, $23,121 of which was international travel. The Council keeps its place as the country’s fourth-highest spender on air travel for 2017/18.

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The Taxpayers’ Union can reveal that New Plymouth District Council was the fourth highest-spending council in the country when it game to air travel in the 2017/18 financial year. The Council spent $285,391 on flights, $256,235 of which was domestic, $29,157 international.

Click here to view the Council's information release.

For comparison, that is more than twice Palmerston North City Council’s spend, and even slightly higher than Christchurch City Council.

International destinations included LA, Vancouver, Sydney, and Brisbane.

New Plymouth District Council’s travel habits are eye-wateringly expensive, both in real terms and relative to other Councils.

The Council will argue that it faces higher costs due to its remote location, but that’s also true for Councils like Whangarei who managed to keep costs down. The question ratepayers will be asking is why is so much travel necessary in the first place? Every day spent travelling outside the district is less time focused on local needs.

Flight expenditure is important because it reflects the culture within the Council. How can ratepayers be assured they’re getting value for money on roads and rubbish when staff fail to display frugal attitudes on less important spending like travel?

This information has been collected as part of the Taxpayers’ Union’s annual Ratepayers’ Report, which will be released in full later this year.

Tim Shadbolt’s mayoral expenses revealed

Shadbolt expenses

The Taxpayers’ Union can reveal that Invercargill Mayor Tim Shadbolt has racked up $147,243 in mayoral expenses since late 2016 (the beginning of this term in local office).

Tim Shadbolt has shown considerable fiscal irresponsibility in his latest term of office, spending inordinate amounts of money on frivolous or personal things.

Seven different times, his card was used for ‘accommodation for Mayor Shadbolt and Family’. Ratepayers might be surprised to learn that the Mayor is using their money to take his family on junkets.

Other expenses included spending $19,534 on books and magazines, $8,051 on conference fees, $3,256 on wristbands, $2,662 in donations to private charity, and $1,854 at liquor stores.

Mayor Shadbolt also spent nearly $3,113 on maintenance for his famous ratepayer-bought Chrysler 300C, revealed earlier in the year to be the most expensive mayoral vehicle in the country. It’s no wonder that the Council is reviewing the cost of its fleet if existing vehicles are kicking up so much in maintenance costs.

We sent the same request to other councils Mayor Shadbolt’s indulgence dwarfs that of others.

Ratepayers might be concerned that the Mayor uses so much public money on gifts and personal adventures. Perhaps in the future he could personally pay for his family getaways and bottle shop runs?

The full spreadsheet of expenses, obtained under the Local Government Official Information and Meetings Act, is available here.

Councils must reject the “Nanny’s Charter”

The New Zealand Taxpayers’ Union has started a petition calling on councils across the country to reject the Childcare Allowance just introduced by the Remuneration Authority, which allows councillors and local board members to claim up to $6,000 per year from ratepayers for childcare.

“Ratepayers should not be forced to pay for local politicians’ nannies and housekeepers,” says Jordan Williams of the Taxpayers' Union.

"In very few jobs does the employer stump up for childcare. Why should politicians receive ratepayer funded benefits very few ratepayers are afforded?"

"Where does it stop? What about councillors with elderly dependents, or councillors without a partner to split household bills? Many politicians have costly personal circumstances, but we expect them to manage these costs privately.”

"I was brought by a single Mum on the District Council before I was even school aged.  The idea that ratepayers would be responsible for hiring a nanny is entitled nonsense."

Porirua’s Canadian art exchange typifies wasteful travel

Porirua graphic

The New Zealand Taxpayers’ Union is questioning Porirua City Council’s decision to spend $9,218 on flights to Canada for an ‘indigenous art exchange’.

The spending details have been released as part of a Taxpayers’ Union investigation into 2017/18 travel expenses at councils across the country.

It’s ridiculous for Porirua City Council to spend money this way when its average residential rates are 28% above the national average. Many ratepayers will be appalled that their money isn’t being used to improve the council’s financial position or maintain basic services.

Instead, ratepayers forked out for artists and Council staff to enjoy a junket to Winnipeg, for an ‘indigenous art exchange’ involving ‘demonstrations of how digital media can be used to empower indigenous communities’. This all sounds fascinating, but it is entirely unclear how it delivered value for Porirua ratepayers. In fact, the only clear beneficiaries of the spending were the two artists who got a profile boost, and the two Pātaka museum staff who even received $70 per-day spending allowances for the 14 day trip.

We understand that the Council is currently being lobbied to declare a ‘climate emergency’. If it does this, it should show it’s serious by swearing off unnecessary, feel-good junkets and air travel.

The Canada flights were purchased on top of a significant $38,950 spend on domestic flights, meaning the Council spent a total of $48,168 on air travel in 2017/18.

Despite “climate emergency”, Dunedin City Council is third-highest spender on air travel

Using figures obtained under the Local Government Information Act, the New Zealand Taxpayers’ Union can reveal that Dunedin City Council was the country’s third-highest spending council in terms of air travel in the last financial year.

The Council spent $347,885 on air travel in 2017/18 – $214,067 of which was domestic, $133,818 of which was international.

“This is incredible hypocrisy,” says Taxpayers’ Union spokesman Louis Houlbrooke. “You have to wonder how Councillors who voted for the ‘climate emergency’ did so with a straight face. On one hand they’re telling ratepayers to expect major lifestyle changes and sacrifices, on the other hand they and their staff are burning jet fuel at a rate that would make NASA proud.”

“We would love to know how or why the Council racked up this eye-watering expenditure, but the Council has refused to release the destinations of its flights, despite multiple requests. Almost every other council in the country has been able to provide this information, so why is Dunedin City Council refusing to be transparent? Is it ashamed of the extravagance of its ratepayer-funded, emissions-spewing junkets?”

“What we can say is that we see Dave Cull in the fashionable cafés of Wellington every other week. Perhaps Mayor Cull has passed on the jet-setting culture of Local Government New Zealand to his local Council, at the expense of Dunedin ratepayers.”

The first and second-highest spending Councils were Auckland and Wellington, which spent $1,221,571 and $591,310 respectively.

The Taxpayers' Union will be contacting the Ombudsman regarding Dunedin City Council's failure to release information on flight destinations.

Revealed: Wellington City Council’s climate hypocrisy

WCC flights

The New Zealand Taxpayers’ Union can reveal that, despite plans to declare a ‘climate emergency’, Wellington City Council spent a massive $623,296 on air travel in the previous financial year.

This makes Wellington City the country’s second highest-spending council behind Auckland City ($1,221,571). Notably, Wellington City’s air travel spending is more than double that of Christchurch City ($278,316), despite Wellington City’s considerably smaller population base.

A major contributor to the air travel blowout was economic development agency WREDA, which spent $201,464 – $168,672 of which was international.

For Justin Lester to declare a ‘climate emergency’ is incredible hypocrisy. He needs to look in the mirror: his Council and CCOs have been spewing emissions at a massive rate while enjoying ratepayer-funded junkets to the likes of Switzerland and Shanghai.

Ratepayers will be looking on with envy at the lucky bureaucrats who flew premium economy to Texas for the South by Southwest Festival, or London for a live music conference. It’s completely unclear how this relates to delivering value for ratepayers, or how it aligns with the Council’s virtue-signalling on climate. In fact, it’s out of touch on every level.

What’s so special about Wellington that its Council needs to spend almost twice as much as Christchurch on air travel? Councillors ought to be embarrassed and must demand changes in policy and culture inside the Council and its CCOs.

Wellington City Council Group air travel, 2017/18

  • Domestic: $275,269 (1,438 flights)
  • International: $348,027
  • Total: $623,296

 

Sub-groups (click titles for raw documents):

Wellington City Council (Destinations)

  • Domestic: $145,736 (973 flights)
  • International: $99,488
  • Total: $252,224

WREDA

  • Domestic: $32,792 (136 flights)
  • International: $168,672 (107 flights)
  • Total: $201,464

Wellington Water

  • Domestic: $50,979 (136 flights)
  • International: $7,977
  • Total: $58,956

Wellington Zoo

  • Domestic: $10,511 (36 flights)
  • International: $41,677 (23 flights)
  • Total: $52,189

Experience Wellington

  • Domestic: $16,963 (47 flights)
  • International: $19,843
  • Total: $36,806

Wellington Venues

  • Domestic: $13,225 (87 flights)
  • International: $9,901
  • Total: $23,126

Wellington Cable Car

  • Domestic: $3,782.14 (11 flights)
  • International: Nil
  • Total: $3,782.14

Zealandia

  • Domestic: $1,281 (12 flights)
  • International: $469
  • Total: $1,750

Basin Reserve Trust

  • Total: Nil

 

The number of international flights is not available for every agency.

Op-ed: The Wellbeing Budget gave beneficiaries what taxpayers deserved

Within the first weeks of becoming leader of the Labour Party, Jacinda Ardern made the call not to defend Metiria Turei’s self-confessed cheating of the welfare system. It was the right move. Workers rightly resent the idea that beneficiaries game the system while others work long shifts, pay secondary tax, and contribute to society with the aim of getting ahead or giving their children a better life.

So it was shameful when in Budget 2019 the Government announced a linking of benefits to average wages. Now, beneficiaries will get payment increases in line with the wage rises that others earned and sacrificed for.

Benefits have already been annually adjusted for inflation: that’s enough to keep up with increases in the cost of living. But last week’s change means beneficiaries will now share the cream of economic growth, automatically, every year – without having to get off the couch.

Treasury estimates the change will cost working taxpayers $320 million in the first four years (that’s $143 per worker), with costs climbing every year after that.

The Government could justify the cost to taxpayers by comparing benefits to superannuation, which has been indexed to wages since 1977, but experts acknowledge that’s increasingly unaffordable and will eventually need reform.

If the Government was consistent with indexation, it would turn its attention to tax brackets. If the top tax bracket was indexed for wages since it was set at $70,000 in 2011, it would now be set at $87,755. Likewise, instead of paying 30 cents on the dollar in tax from $48,000 a year, the second-highest rate would not kick in until $60,000.

In other words, average income earners would be in for significant tax relief.

If that seems too generous, bear in mind that it’s the same principle that now applies to both superannuation and the benefits system. Unfortunately for the taxpayers who fund these programmes, the Government cries poverty when it comes to taxes, refusing to even go so far as to adjust brackets for inflation.

This means that every year, a portion of our income is pushed by inflation into higher tax brackets, meaning we’re taxed harder even though we’re no richer. As a result, in just two or three years the average wage earner will be paying tax in the top 33 percent tax rate – meaning the Government snatches a third of any pay rise or overtime.

Grant Robertson could have used the room in his Wellbeing Budget to treat taxpayers fairly, like superannuants and beneficiaries. Instead, by ignoring the pain of inflation on taxpayers, and boosting benefits, he’s doubling-down on the unfairness of the wealth transfer system.

Labour is now giving its working base a clear message: we’ll keep increasing the penalty for your hard work, and endlessly boost the reward for unemployment. This does not bode well for wellbeing.


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