Interview with Dr David Galler

By Nicky Treadwell

Doctor David Galler knows a few things from the 25 years he has worked in the Intensive Care Unit at Middlemore Hospital. The main thing being that many of his patients wouldn’t be requiring his care if the health system in Aotearoa New Zealand was in a good state itself. 

Galler believes that if people had better access to general medical practices  many of the very sick people he sees wouldn’t be so sick. Added to that are the many “social ills” as he describes them, that continue to cause harm. Early intervention for illnesses from tobacco and alcohol consumption, poor nutrition, poverty and cultural insensitivity  often isn’t available or adequate.  

A health system that is now suffering from an imbalance in resources and the inability to meet demand (for specific groups especially) is one he says is “on its knees”. The lack of funding of public health services is a major driver of this decline. 

There is, he says, no easy solution to what is a very complex situation. Underfunding means the wages and conditions of those who work in the front line of the health system are inadequate, and therefore fail to attract and retain the level of skills and experience required by a well-functioning system.  

Galler believes there is now more work required in treating the consequences of a declining health system than there is in prevention of illnesses in the first place. Access to general practice services is more transactional, less consistent and there is an increase in the inequities as a result. 

Wait lists for surgeries are increasing, general practices are closing their intakes of new patients and the continuous doctor/patient relationship crucial to trust and understanding is under threat due to the constant pressure on practices to retain long-serving practitioners. 

Concerned that there is a drift – if not deliberate policy – to disestablish the public health system, Galler and others have formed a group called Nga Kaitiaki Hauora to address this. Those involved are united in the belief that the country needs a better, more sustainable public health system – not a weakening one. 

Underpinning the groups’ goal is recognition that an equitable and efficient system must have Te Tiriti at its core, alongside proper funding of the public system, and resistance to the increase in the private system which sees health as a commodity and not a public good. 

Kaitiaki Hauora is made up of a wide range of organisations, including high profile individuals, unions, medical professionals, patients, health workers, health and healthcare organisations, unions, youth and community representative groups. All are giving their time and energy on a voluntary basis with a strong common purpose: “To promote and ultimately achieve full funding for our public health system that cares for all in Aotearoa.”  

The initial aim is to raise awareness of those who access the public health system, and who are feeling the pain of a system under attack and duress. The thinking behind this is simple: give a voice and purpose to those experiencing growing concern, and educate those who are experiencing substandard care and feel powerless to expect, and get better care.  

Galler says this “is a conversation for many mouths”. There is a need for the public to be motivated to see public health funding as a political, and therefore, an election issue. The common message will be driven by the group, but also amplified by each organisation in their own communications and approaches. 

 It is a time, Galler says, for people to be thoughtful and motivated and above all, feel they have a voice that will be heard.