Transcript
GEORGE NGAEI: By any standards it's a low figure if you compare it with New Zealand, we spend slightly over six percent but around the Pacific I'm unaware of any island country with a health spend of less than four percent.
JO O'BRIEN: Would you have an idea of why that figure is so low?
GN: It's a Government decision, whether they are indifferent or ill informed, I'm not in a position to judge but one of the things I referred to in my letter to the Cook Islands News what is generally known in the Cook Islands that politicians and their families like other members of the community choose to have their health needs taken care of outside the Cook Islands and some of these conditions can be dealt with at Rarotonga Hospital so it begs the question why are they doing this?
JO: Is it because health care locally is perceived to be inadequate?
GN: Well don't put words in my mouth but I think one can assume that.
JO: Where does it leave the rest of the population that can't afford to go overseas for health care?
GN: Unless they are referred, New Zealand Aid provides a certain sum to people to pay for the cost of health care in New Zealand but it is a fixed amount, it is not enough, to accommodate the need but it certainly is a very necessary and much appreciated service.
JO: But are there people there that are missing out on care due to a lack of money?
GN: Well this is what the population perceives, I mean I go there several times a year. Invariably I will be stopped by someone seeking advice or venting their frustration. It's a common topic of conversation in the Cook Islands, the perceived inadequacy of health care. To be fair I think under the circumstances I think the medical staff in the Cooks are doing a good job but you are limited in what you can deliver without adequate resources or funding.
JO: When you say limited in what you can deliver is it that they haven't got the equipment or the staffing. Where is the lack?
GN: Well across the board. Often they run out of drugs, often they don't have the equipment. People in the outer islands allude to the fact that many of the equipment have broken down and are awaiting repair, some do not get replaced. It's like a builder, you can't build a house without tools.
JO: And this two tier health system that you referred to how widespread would you say is that practice of wealthier people being able to access health care abroad?
GN: It happens commonly, it's accepted, it's not official but a significant number of the population do go to Auckland or elsewhere in New Zealand even for their basic primary care needs. Certainly many choose to have their surgery in New Zealand or Australia but to do that either you have to be referred through the health system or you self-fund. There's a small but significant number of the population who take out health insurance and to them that's their security to come and access health care in New Zealand.
JO: What access rights do Cook Islanders have to public health care in New Zealand?
GN: Cook Islanders are New Zealand citizens but they have to like everyone else take their turn. They need to be referred and be assessed and if put on a waiting list and in due course they'll have their surgery, otherwise they pay to have it done in private.