A new estimate from the senior doctors' union puts the loss rate at about 40 per cent compared to just 16 per cent a few years ago.

The analysis, passed by the Association of Salaried Medical Specialists to the Productivity Commission, was more bad news for the stressed health workforce.

"Many junior doctors are not entering specialist training," its submission said.

In part, it blamed a rise in overseas junior doctors doing a short stint here, like a medical OE, and the junior doctors' union said it was seeing this, too. Read more

Unlike other parts of the health system, the government doesn't subsidise dental care for adults, meaning a trip to the dentist can put a serious dent in people's pockets.

Earlier this month, the Association of Salaried Medical Specialists (ASMS) released a report that found 40 percent of New Zealanders can't afford dental care.

ASMS chief executive Sarah Dalton says dentists and family doctors are quite similar, in that their practices run as businesses.

"The difference is that GPs have a subsidy, a partial payment from the government for the services they provide. Dentists do not, so it's a fully privatised service," she says. Read more

The research also discovered the wealthiest 10 percent of New Zealanders can expect to live a decade longer than the poorest 10 percent.

Widening social and economic gaps are driving health inequities that successive governments have failed to address, the Association of Salaried Medical Specialists (ASMS) reports.

"The most expensive way to treat people is to wait until they are in hospital, and they need a hospital admission," says ASMS executive director Sarah Dalton.

Life expectancy at birth for Maori males was 73.4 years and for Maori females it was 77.1 years. In comparison, non-Maori males are expected to live to 80.9 years, while non-Maori females are expected to live to 84.4 years. Current trends show the gap won't be closed for a century, according to the report.

The report - presented to Health Minister Andrew Little on Tuesday - makes several recommendations to cut the 100 year wait and reach health equity by 2040. Ideas include making general practice free, extending free childhood education to 1 to 2-year-olds and better planning to address chronic workforce shortages. More than 200 health professionals contributed to the report.

"Eighty percent of the solutions to ongoing health issues sit outside the health system," Dalton says.

She lists factors like warm, dry affordable housing, making the living wage the minimum wage, lifting people out of poverty, providing benefits that lift people up, access to primary health care including dentists, GPs and physios.

"If people can get that level of care when they need it, at little or no cost, that would bring a massive return to our economy," she says.

Little says the research should "worry us all".

In his opinion the Government's major restructure of the health system, which will be replaced with a single health organisation and a Maori health authority will help address inequality.

While the report will contribute to Government decisions, Little says making GPs free wasn't something it is looking at doing.

"It's a big problem and a big challenge. I don't have any specific solutions at the moment, but it is a big problem I want to address."

He said solutions were needed from outside the health system, but the Government was focussed on adequately funding it first.

"That is the challenge of the Government overall... free school lunches for kids is an overall part of that, making childhood education available at an earlier age remains an aspiration.

"We are very much focussed on, that the additional funding we need for other parts of health are there before we look at significantly extending mandates at the moment."

Dr Tanya Wilton, an emergency department specialist says people are struggling to get care at every step in the over-stretched health system, while people from deprived backgrounds were getting sicker at a younger age.

She cites an inaccessible health system, overbooked primary health care, long waits at emergency departments and for specialist appointments in the hospital system as contributing to poor health outcomes.

Source

• Stuff
• Image: Stuff