One of the most easily remembered initials as a result of the coronavirus pandemic is PPE – Personal Protective Equipment – which includes face masks, eye protection and gloves for those working in health, quarantine, and other relevant facilities used in responding to the virus. To access this highly specialised equipment the government is dependent on overseas supply lines to procure it.
On 5 January there was an alarming media coverage of $37 million spent on imported PPE that was never used because it did not meet safety standards (https://www.stuff.co.nz/national/health/coronavirus/123845611/coronavirus-37m-in-ppe-never-used-because-of-safety-concerns).
The basis for this coverage was the Ministry of Heath’s annual report for the year ended 30 June 2020. Specifically it stated that there was “…$37.0 million of PPE where there were quality standard concerns at balance date…”
Some context is required when assessing where the responsibility for this debacle rests. The Health Ministry reports that it organised the procurement, storage and distribution of over 46 million pieces of PPE (plus another 165 million pieces on hand) compared with previously one million annually. The cost of these 46 million pieces was around $200 million compared with previous annual average of around $25 million.
These figures highlight the magnitude of the task before the Ministry. It procured, stored and distributed around 45 times more PPE within four months more than its previous annual average at a cost 8 times higher than the annual average.
This is an achievement that can’t be understated but perspective is also required. After all, $37 million is $37 million. To begin with there were delays with the Ministry that required some of the larger DHBs with greater capability in working with overseas supply lines coming to the rescue.
Failure in emergency pandemic planning
But, in addition to lack of relevant capabilities, the debacle also exposed a major failure in pandemic planning for which the Ministry is responsible. Much of this failure was inherited by the current Ministry leadership which only commenced from mid-2018 although it still has to take some responsibility.
It is not true to say that the pandemic was unexpected. The particular form (coronavirus) and timing (2020) couldn’t be predicted but it was predictable that a pandemic of some sort would happen. While New Zealand had a pandemic plan that arose out of the SARS epidemic of 2003-04, it had major weaknesses operationally. Operational planning failure led to failure to invest in relevant Ministry workforce capabilities.
This planning failure meant that the country wasn’t prepared for quickly developing sustainable responses to emergency situations, especially where international supply lines are critical. The Ministry had failed to invest in the capabilities necessary to enable this. This included failing to encourage local New Zealand provision of PPE which could have reduced our dependence on overseas suppliers. Further, there was a failure to monitor and replenish existing stock kept in storage. This led to a situation where large amounts of existing stored PPE was too damaged to be used.
Opportunistic private companies
The magnitude of the speed and size of the pandemic did create a specific crisis that even the best pandemic planning might have struggled to operationally anticipate fully. This magnitude led to opportunistic new overseas private company providers of PPE emerging which led to supply lines and quality control much more difficult to address. It created an environment that encouraged some companies to profit off the pandemic by manufacturing faulty products.
Auckland infectious diseases specialist Dr Siouxsie Wiles has made this point strongly and she is right to have done so. She was not surprised by the $37m figure noting that other countries had also spent “huge” amounts of money on PPE not fit for purpose. In her view the “.. real story is how many companies purely [operate] for profit from the pandemic, which continues to this day.”
In my view Dr Wiles is right except that it isn’t the only real story. The failure of pandemic planning to focus operationally in order to sustainably respond to an emergency and of the Health Ministry to recruit the necessary capabilities is no less another real story. This failure also enhanced the opportunity for profiteering.