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Access: How many agencies does it take to change a light bulb?

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  • Moz,

    This stuff never ends, does it? And OMG, dealing with Paula Bennett doesn't strike me as the solution to anything. In IT we have a cliche that goes "I had a problem. So I decided to use regular expressions. Now I have two problems". Paula seems the sort to be like that. "I rang her office, and now the media are hounding me".

    But also, this is where a pet geek is handy. Every home should have one :)

    Depending on just how much power is required I would have suggested borrowing a portable UPS (Uninterruptable Power Supply) as used for computers and important medical equipment. Ahem. Those are more expensive than a generator, but smaller and quieter, as well as easier to use. I'm kinda surprised that the hospital and/or power company don't have those ready to go for people like you. It may even be that they do, but you never managed to find one of the 8 people who know about it it.

    Sydney, West Island • Since Nov 2006 • 1198 posts Report Reply

  • Lucy Telfar Barnard,

    I think the DHB is extremely lucky to have had the option to pay $104 for the cost of a generator, when the average cost of a night in hospital is well over $4500.

    And yes, given that planned power outages are necessary and inevitable, it makes absolute sense for a clear, workable, known back-up plan for medically dependent people to be part of their care plan.

    Wellington • Since Nov 2006 • 580 posts Report Reply

  • Rosemary McDonald, in reply to Lucy Telfar Barnard,

    when the average cost of a night in hospital is well over $4500.

    I'm not questioning this figure....but have you a source for that?

    I'll have a read after my eyes have stopped watering.

    Waikato, or on the road • Since Apr 2014 • 1344 posts Report Reply

  • Rosemary McDonald,

    Phone calls continued. I was repeatedly treated like an idiot, asked if I’d rung the power company, and surely I must have friends or family who could put us up for the night (friends and family with spare beds and wheelchair-accessible homes?). I was told to go and see our GP (at whose expense? And what could he possibly do?).

    I'm surprised no one told you to take a chill pill and wash it down with a cup of harden the f*ck up.

    After what happened to this person...http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10806437 (from your post)

    and this person....https://www.wsws.org/en/articles/2007/07/newz-j05.html

    An Auckland District Health Board spokesman said that although the power cut had stopped the oxygen machine, Muliaga should not have been reliant on it and would not have been sent home had she needed the machine to keep her alive.

    bold mine.

    .....one could have reasonably expected that they would have got their collective shit together on this one.

    Waikato, or on the road • Since Apr 2014 • 1344 posts Report Reply

  • Kumara Republic,

    Well, my previous MP was Paula Bennett. My dealings with her office were unproductive.

    A charitable description of Paula Bennett is that she's Jenny Shipley with better PR. She gets away with using her working-class background to basically set half the working class against the other half.

    The southernmost capital … • Since Nov 2006 • 5418 posts Report Reply

  • Phil Twyford,

    Thanks for the acknowledgement Angela. Glad to help.

    Te Atatu • Since May 2011 • 1 posts Report Reply

  • linger, in reply to Kumara Republic,

    A charitable description of Paula Bennett

    would have to start with the word "uncharitable”.

    Tokyo • Since Apr 2007 • 1889 posts Report Reply

  • steven crawford,

    The piece of medical kit should have a back up battery built into it. We had an unplaned power outage the other night, when somebody drove a car into a power pole up the road.

    Atlantis • Since Nov 2006 • 4316 posts Report Reply

  • Sacha,

    Thanks for writing this, Angela. It is so typical of disability support that the cost of all these agencies saying NO is more than it would cost to just say YES.

    Because of the buck-passing, only those people with enough social capital end up getting help. All of us pay for that one way or another. We deserve to live in a society that does better.

    Ak • Since May 2008 • 19686 posts Report Reply

  • Angela Hart, in reply to steven crawford,

    The piece of medical kit should have a back up battery built into it.

    Specialised batteries are available but not built in. The DHB responsible for respiratory equipment like ours in Auckland does not purchase the batteries. Their policy is to offer to provide a letter for the patient to take with their begging bowl to the Ministry of Social Development who may provide some funding which most probably would have to be paid back.
    We decided not to go down that path because the batteries are likely to be specific to the model of machine. You get one sorted and then the hospital changes your machine and the battery is useless to you. All you can do is donate it to the hospital and go through the rigmarole again.

    Our back up plan for emergency unplanned power cuts is to get our person out of bed and sit up until the power comes back. Her breathing is good enough when sitting, at the moment. That plan relies on me hearing the machine alarm when the power goes off. Our model of machine has changed recently and the new alarm is very brief, so this is a concern.

    Christchurch • Since Apr 2014 • 614 posts Report Reply

  • Angela Hart, in reply to Moz,

    I would have suggested borrowing a portable UPS (Uninterruptable Power Supply) as used for computers and important medical equipment.

    Thanks Moz, I researched UPS some time back and found that we couldn't afford to purchase one. It didn't occur to me to ask the hire outfit if they have them, but it's a good thought if there's a next time. I don't know anyone who could lend us one, they're usually needed to make sure those servers etc keep right on serving, no matter what.

    Christchurch • Since Apr 2014 • 614 posts Report Reply

  • Angela Hart, in reply to Lucy Telfar Barnard,

    I think the DHB is extremely lucky to have had the option to pay $104 for the cost of a generator, when the average cost of a night in hospital is well over $4500.

    Thanks Lucy, I didn't think it was as much as that but yes, there were three grounds on which we felt a night in hospital was not a good solution
    the cost to taxpayers
    the taking of a bed that someone else might need
    the inconvenience/trauma

    Christchurch • Since Apr 2014 • 614 posts Report Reply

  • Angela Hart, in reply to Rosemary McDonald,

    one could have reasonably expected that they would have got their collective shit together on this one.

    yup, the Ministry of Health funded agencies (Manawanui and Taikura) both thought it had been sorted by obliging the power companies to do something. But they are wrong about that. I politely informed them that they are wrong, and gave them the facts, but who knows whether it will change what they tell people.

    Christchurch • Since Apr 2014 • 614 posts Report Reply

  • linger, in reply to Angela Hart,

    It seems that if DHBs were at all serious about solving this problem, the starting points should be: (i) when evaluating and choosing equipment to order, seeking interconvertibility of battery packs and power trains across a wide range of medical equipment; and then (ii) using central purchasing for a Pharmac-style economy of scale.
    Policy that requires individual patients to make individual purchases is user-pays ideology gone mad.

    Tokyo • Since Apr 2007 • 1889 posts Report Reply

  • Berinthia Binnie,

    The piece of medical kit should have a back up battery built into it. We had an unplaned power outage the other night, when somebody drove a car into a power pole up the road.

    Absolutely agree Steven. If the technology doesn’t exist it seems like an incredible design flaw. Minimising risk doesn’t need to be overly bureaucratic-simple and practical has merit too.

    Your family member, to my mind, is best served at home, satus quo with the old bip-bap machine: comfortable and stress free in a familiar, loving environment. What a wonderful support you are for them Angela.

    Good on you for reaching out to your local MP. It is easy to dismiss pollies as being only concerned with seeking/holding portfolios and other bits of whimsy and self interest…….BUT…..I found my judicious use of my Nelson MP’s position when a dire situation emerged gleaned a result.

    My local MP Nick Smith, and his office, were efficient and effective for my family when we were caught up in the horror that is the ORR’s funding application. They responded immediately and followed the case without drama. I have to say (irrespective of party politics) his office served us well on a local advocacy level.

    Since Sep 2015 • 23 posts Report Reply

  • Hilary Stace,

    There are 20 DHBs, about 15 NASCs and numerous power companies in New Zealand. You would think there was a standard process for dealing with these issues. Or that one could be developed.

    Wgtn • Since Jun 2008 • 3202 posts Report Reply

  • Angela Hart, in reply to Kumara Republic,

    A charitable description of Paula Bennett is that she’s Jenny Shipley with better PR.

    We previously had a problem obtaining an essential piece of therapeutic equipment. Although recognised by the medical experts in the field as necessary and urgent, the Ministry of Health in its wisdom has a policy of stopping funding this sort of thing once a person turns 18. So I asked Paula's office if anything could be done. They wrote a letter to Tony Ryall and the response back from him was largely garbage, to the extent that I really wonder what the letter to him, which we never saw, actually said. Anyway he suggested we go to charity and since the need was urgent and we'd already wasted time with these people, we got out the begging bowl.

    People can be very good. The company which made the equipment loaned it to us until we could pay for it, and the Freemasons provided the money.

    I don't think I'm a particularly proud person but it bothers me when we are obliged to beg for survival.

    Christchurch • Since Apr 2014 • 614 posts Report Reply

  • Moz, in reply to Angela Hart,

    I do keep thinking "this is not $100 for a generator overnight, this is $4500 to keep someone out of hospital for a night", and somewhere there should be $1000 for a portable UPS... the payback period is 1/4 of the first time it's used. But I suspect the gap between "I found it on Amazon" and "medical equipment" is large.

    . I don't know anyone who could lend us one, they're usually needed to make sure those servers etc keep right on serving, no matter what.

    Yeah, but eventually those things get thrown out. The new server needs a bigger one or it's out of warranty or whatever. Sure, it can't power a 2000W server for an hour any more, but your 200W medical device will be fine for several hours.

    But I was suggesting a portable UPS, not the computer-style installed ones. It's basically a briefcase full of batteries, and I'm somewhat surprised that they're not standard equipment for hospitals (in the sense that they'd obviously be useful but hospitals probably don't have the budget). I can see that being the sort of thing a Lions club might donate to the disability services people for times like this.

    There's been a revolution in the last few years, those things used to have lead-acid batteries so weighed a lot and didn't have much capacity. They use lithium batteries now and are much more useful.

    Sydney, West Island • Since Nov 2006 • 1198 posts Report Reply

  • Moz, in reply to linger,

    the starting points should be: (i) when evaluating and choosing equipment to order, seeking interconvertibility of battery packs and power trains across a wide range of medical equipment; and then (ii) using central purchasing for a Pharmac-style economy of scale

    That's not usually how it works, though. As with cellphone chargers, it takes regulatory intervention to force a standard. Otherwise every manufacturer goes with what suits them best. And battery compatibility is a long way down the list of features, because far more people are killed by bad user interface, unreliability, difficulty of service or "we need five but can only afford three" than will be killed by "does not work during power cuts".

    Sometimes the simple answer is to look at the back of the device and say "look, it runs off 12V/1A" and wire a battery into it. Which is trivial if you're an electrical engineer, but for the average person... DO NOT EVEN TRY THAT.

    Sydney, West Island • Since Nov 2006 • 1198 posts Report Reply

  • Berinthia Binnie,

    Mind boggling when professionals tell you directly (genuine experience) that three times the cost of the equipment will be spent analysing, peer assessing (flying experts in from Wellington….cream cakes ‘n’ drip filter coffee) and debating whether the ‘essential piece of theraputic equipment’ is actually required. A process with no guarantee of actually getting said equipment, despite the in depth analysis.

    Oh no, now I am back to my elaborate job creation scheme thesis, apologies!

    God forbid we have people trying to rort bip-bap machines out of the system for the thrills!

    Since Sep 2015 • 23 posts Report Reply

  • Angela Hart, in reply to Sacha,

    Because of the buck-passing, only those people with enough social capital end up getting help. All of us pay for that one way or another.

    Yes, and we had quite a lot of worry until we came up with a workable solution. You don't need extra anxiety when you already have a fragile life.
    There probably are not many people in our situation, but if we hadn't had the money to hire, we'd probably have spent the night sitting up. The thing is people like us are cash strapped at the best of times because the "safety net" doesn't cater for us fairly. When your income will rise significantly if and when you turn 65, there's a problem.

    Christchurch • Since Apr 2014 • 614 posts Report Reply

  • Rosemary McDonald,

    http://www.hpenz.co.nz/product.aspx?ProductID=142

    2kVA? Would that do the necessary?

    "Retail price (excluding GST): $2,595.56"

    Trade or bulk buying...much cheaper.

    This model s popular with the motorhoming fraternity...must have your coffee machine! Seriously though, there are a few living fulltime in Buses that have CPAP and BiPaps...the genny is a must.

    Waikato, or on the road • Since Apr 2014 • 1344 posts Report Reply

  • Angela Hart, in reply to Moz,

    portable UPS, not the computer-style installed ones. It’s basically a briefcase full of batteries, and I’m somewhat surprised that they’re not standard equipment for hospitals

    Thanks Moz, that's extremely useful information, which I will follow up on. I'm not sure of the power needs of the BiPAP, there isn't actually much info on that apart from the ratings on the back of the machine. (a label says 24v DC, 1.25A(FG), 3.75A (sys). But it is a fairly powerful air pump and also has a small heating element for humidifying the air.

    Christchurch • Since Apr 2014 • 614 posts Report Reply

  • Lucy Telfar Barnard, in reply to Rosemary McDonald,

    Thanks for asking :-D… though you may regret it.

    And of course when I review my figures, I find I have posted in haste, and must now repent. The actual figure per night is somewhere in the range of about $700 – $1425 rather than “over $4500”. The “over $4500” figure is per hospital stay, rather than per night. Either way, it’s still a significant saving for the DHB.

    Source: My own number-crunching. As an epidemiologist, I have access to and work with anonymised national hospitalisation data. I did a quick check on the Health & Disability Ethics Committee form to confirm this analysis was exempt from needing ethics approval.

    One of the fields in hospitalisation data is “cost weight”. This provides an index of how expensive any given hospitalisation was to treat. Each year the Ministry of Health sets a cost weight multiplier. To find out the cost of any hospitalisation you multiply the index by the cost weight multiplier for that year.

    The cost weight multiplier for 2014/15 was $4681.97. If you exclude births, the average cost weight index for a hospital stay is 1.11, which gives an average cost per stay of $5194.92 (I was being conservative with the $4500, or so I thought).

    The most recent data I have is 2013, but this should be recent enough to be relevant. I excluded a whole bunch of admissions as being unlikely to be similar to the author’s relative’s case: births-related admissions, same-day discharges, transfers, non-NZ residents.

    I then summed the cost weight index for all patients, multiplied it by the cost weight multiplier, and then divided by the total number of hospital stay nights. That comes to 0.25 (rounded). If we multiply this by the cost weight multiplier, we get $1161.19 per night.

    There are ways to make this figure more similar to the author’s hypothetical relative visit. The most obvious one is to include only arranged admissions. That gets the figure down to $691.73 per night, though that’s for the 2014/15 tax year, so would be a little higher this year.

    Or I can limit the data further by health specialty, to a range of respiratory specialty codes. That gets us back up to $1425.67 per night.

    There are also additional complications – a night in hospital increases your risk of subsequent hospitalisation, which then costs the DHB more. I haven’t factored that into the cost.

    So an estimate of the likely cost for the author’s relative, or any other hypothetical patient, really does depend on how we slice the cake.

    Wellington • Since Nov 2006 • 580 posts Report Reply

  • Rosemary McDonald, in reply to Lucy Telfar Barnard,

    though you may regret it.

    Not at all....and believe it or not we had kinda worked out what you said (gulp!) but not in so many words.

    The $1425.67 per night sounds about right...just for the bed, and peripherals...such as nursing care and the like. No actual treatment per se.

    Add on chemo at $30,000 a pop and the average goes way up.

    There are also additional complications – a night in hospital increases your risk of subsequent hospitalisation, which then costs the DHB more. I haven’t factored that into the cost.

    Comes as NO surprise that one.

    Be almost worth it to do a survey just on that alone.

    Thanks for that response.

    Waikato, or on the road • Since Apr 2014 • 1344 posts Report Reply

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