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Richard Prebble: Red tape is a toothache that needs extracting

Our grandson, aged seven, developed toothache last week. His grandmother rang the 0800 Healthline. The advice; "ring around for a dentist”.


The Maori Health providers gave the most honest response. They knew they would be no help. They did not answer the phone. The rest said:


“Ring around for a dentist”.


After failing with every school dental clinic she tried her own dentist. Her dentist said she would like to help but there is a government regulation banning dentists in private practice from treating children.


She rang back the healthline. ‘What do we do for his pain?”


“IBUPROFEN.


“If IBUPROFEN does not stop the pain are there dentists at Rotorua Hospital?”


“Yes, but he needs a referral”.


“Do I take him to our GP?”


“The referral must be from a dentist”.


“We cannot find a dentist”.


“Ring around”.


“We have rung every school dental clinic in Rotorua, we even tried Auckland”.


“Ring around”.


All last week we could not find a dental clinic that could treat him. His grandmother kept ringing. This week she has finally found a clinic. We are taking him in today.


Last week two electrical switches at our home blew. Thinking it might be a sign of a serious issue and not expecting a reply, I sent an email to the electricians. I got an immediate reply saying;


“The electrician will be there tomorrow morning”.


It was the boss. He rapidly repaired both problems. He told me;


“Over Christmas all our electricians go on holiday. I work through to take care of our customers. I will take a holiday later in the year.”


The experience illustrates what is wrong with our health service and one of the solutions.


Our monopoly soviet health system has all the wrong incentives. All the school dental nurses go on holiday because the children are not customers who have a choice. It’s the school dentist or nothing.


Our electrician ensures he looks after his customers because we do have a choice. With service like his why would we change?


There is no medical reason for the ban on private sector dentists treating children’s teeth. The regulation is to protect the dental service’s monopoly.


The country is wrapped in the red tape of costly regulations.


Government departments regard the production of new laws and regulations to be a core function. Hundreds of civil servants spent their time producing new regulations.


There is not one civil servant whose job description is to stop unnecessary regulation.

As Sir Roger Douglas has observed we will never improve the quality of government services until the government stops doing things. We could start with unnecessary regulation.


What about a Regulatory Review Department whose task is to recommend regulations that should be repealed?


Every new spending proposal cannot go to cabinet until it has a treasury report. What if every proposed new regulation had to be assessed by the Regulatory Review Department? New regulations are supposed to have a cost/benefit review. The review is done by the proposing department. The departments never say “this regulation will cost far more than any possible benefit”.


What if before a department can propose a new regulation it has to find two existing regulations to repeal?


When I was minister of transport I introduced officials to the concept of cost/benefit analysis. The officials were enthusiastic. Here was a tool that could justify any regulation. They imagined a much expanded department to manage a whole new regulatory regime. Just like what is happening today with Te Manatu Waka.


Their enthusiasm waned when none of the new regulations they were working on met the cost/benefit test. They cost/benefit tested the transport regulations passed in the previous three years. None of the regulations passed.


One of the regulations they were proposing was to ban left hand drive cars because overtaking is the most dangerous driving maneuver.


When officials went through the evidence for the cost/benefit analysis they found left hand drive cars are involved in fewer crashes. It seems the restricted view of oncoming cars makes drivers of left hand drive cars more cautious about overtaking. The better left side view of the side walk does have a result. Of the approximately 20 pedestrians a week seriously injured and the 65 killed each year the officials could find no evidence of any pedestrians being hit by left hand drive cars.


After the election I asked the new minister, “how are you finding being Minister of Transport?”


“Loving it” he said. “I have just signed off my first regulation, to ban left hand drive cars”.


“Did you ask for a cost benefit analysis?”


“No” said the new minister. “It is obvious left hand drive cars are dangerous”.


No doubt it was also obvious that private sector dentists should be banned from treating a little boy’s toothache.




The Honourable Richard Prebble CBE is a former member of the New Zealand Parliament. Initially a member of the Labour Party, he joined the newly formed ACT New Zealand party under Roger Douglas in 1996, becoming its leader from 1996 to 2004.






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