Thursday 29 July 2021

 

The ever-shifting sands of the Covid19 vaccination programme are increasingly eroding the credibility of this government. 

In January the Prime Minister proclaimed that 2021 would be the “Year of the vaccine” – much the same way as she had promised 2019 would be the “Year of Delivery”. But, just as the idle promises of 2019 quickly dissolved into dust, as this year has unfolded January’s bold proclamation is looking more and more like a soothing optimistic wish rather than a statement of achievable intent. 

As the seventh month of the year passes the blunt truth is that only 17% of the New Zealand adult population has been fully vaccinated. This compares extremely poorly with the United Kingdom (nearly 56%); Spain (55.3%); Germany, Italy and the United States (all just under 50%). Nor is there any real sign that New Zealand’s vaccination level is likely to come anywhere near that of those countries anytime soon. Indeed, the government no longer talks as it used to of everyone who wanted to being vaccinated by the end of the year – now it speaks of everyone having the opportunity to book a time, rather be vaccinated, by the end of the year. This is another re-writing of its own previously set-out timelines. 

Despite increasingly Goebbelesque announcements that the vaccination rate is running well ahead of schedule there continues to be a steady stream of media stories about people wanting to be vaccinated, but not being responded to. To date, according to official statistics, about half of those over the age of 65 have been fully vaccinated, but two-thirds of those in Group 3, the group considered by the Ministry of Health to be those “at risk of getting very sick from COVID-19” are still waiting to be vaccinated. 

Yet now, those in Group 4 – basically the rest of the population who are not border, or managed isolation and quarantine workers, and those in other high-risk occupations – are now being invited to “apply” for vaccination, while the bulk of the most vulnerable population are still waiting to be vaccinated. It makes no sense. Meanwhile, despite reports of so many people being desperate to be vaccinated, a mass vaccination event planned for Manukau this weekend has struggled to sign up enough people. 

The upshot is still only a small number of eligible people will be fully vaccinated over the next five months, meaning the prospect of the restrictions New Zealanders still live under look certain to be with us for most of next year, at least. And the government appears to think this is acceptable. It is a pity that it is not heeding the advice of President Biden who, last week told Americans, that the only way life would return to normal in their country was through comprehensive vaccination. Yet there does not appear to be anything like the same sense of urgency to achieve that in New Zealand. 

Rather, the government here seems content to meander along, assuring us all will be well, and that we are safer here than any country on earth, so the requirement for vaccination is less urgent, even though we are just one transmission away from a mass outbreak here. It is beginning to look increasingly like the government is quite happy to drag the Covid19 situation out for as long as possible for fear of resolving it and then having to address more intractable problems like housing, increasing child poverty rates and climate change, all of which it made bold promises about but has similarly failed to deliver on. 

Aside from the politicians whose promises have been wilfully optimistic to keep the public happy and content, the real blame for New Zealand’s current situation lies with appalling strategic leadership by the Ministry of Health and the district health boards. 

The chasm was highlighted recently by a reminder from the Prime Minister that the rollout of the vaccination programme was largely in the hands of the district health boards, and there was not much the government could do to push them along. So, why did the government give them that responsibility in the first place, especially since it has already acknowledged that they are an inefficient and cumbersome structure, which it intends to replace with a more centralised Health New Zealand? 

A far better approach would have been to have bypassed the district health boards altogether and instead engaged with general practitioners, pharmacists and specialist health providers right at the outset and given them direct responsibility for the vaccination programme and the funding to do it properly. After all, they know their patients best and could have got to those with the greatest urgency more quickly and directly. Working that way would have cut out much of the duplication now occurring where patient information held by GPs cannot be passed on to district health board vaccinators, meaning patients have to provide it all over again, when they turn up to a vaccination centre. 

All the district health boards’ handling of the vaccination rollout to date has done is reinforce the case for their abolition as soon as possible. 

As for the Ministry of Health, it has lacked leadership from the day its Director-General became more a media star than a departmental chief executive. Under a genuinely operationally and healthcare delivery focused leadership, which it currently lacks, the Ministry would never have recommended that the government hand over the vaccination programme to district health boards and would have instead focused on community-based delivery mechanisms that work and deliver the most immediate assistance to the public. As the vaccination rollout becomes more problematic and the public more frustrated and disenchanted, the Ministry needs to get back to basics. Its focus from now on must be getting many more jabs in arms as quickly as possible, by the best practical means. 

For its part, the government needs to stop all the pious waffle, soothing noises, and increasingly blatant self-justifying half-truths and simply get on, without all the accompanying fanfare, with making sure the vaccination programme at last starts to work, otherwise it will feel the needle starting to twist in a most uncomfortable way.

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