Yesterday, the Health Ministry’s briefing to the incoming minsterwas published. The ministry identified the priorities it thinks the government should be focused on:

• Preventing cancer, cardiovascular diseases, diabetes and chronic respiratory diseases which make up 80% of the disease burden of the total population.
• Improving mental health outcomes.
• Adressing the long term health conditions facing our ageing population including the increaseing incidence of dementia.

Compare that with National’s targets:

• Faster transit through Emergency Departments
• More elective surgery
• Shorter waiting time for cancer treatment
• More immunisations
• Better help for smokers to quit
• Better cardiovascular services

The two sets of prioities do cross over on getting smokers to quit and cardiovascular services although these are the weakest measures in the government’s set. National’s cancer target is for treatment, not prevention and beyond that, the ministry’s prioirites don’t get a look in.

No one is saying that the things the government identifies as priorities are not good, worthy things that we want to see happen in our health system. The problem is that when this narrow focus is combined with reduced funding in real terms, all the other things that the ministry says need to be addressed now before they get out of hand aren’t getting the attention they need.

Association chairman Paul Ockelford said the health targets were commendable, but the emphasis on targets was flawed.

The targets needed to work alongside other approaches, such as housing and education, that influenced people’s health.

“If these are not addressed we will continue to have glaring health disparities in our communities and a high prevalence of preventable diseases that affect not only quality of life, but life expectancy,” Dr Ockelford said.

The targets were “narrow and simplistic”.

“They do not give a full picture of how our health system is performing because of the difficulty of linking these targets to information about patient and public health outcomes.”

The real challenges for our health system are the projected increasing cost of delivering healthcare and the increasing prevalence of preventable diseases such as diabetes and heart disease as well as depression and anxiety disorders.  

Tackling both of these requires that a much greater emphasis be placed on keeping people well and preventing the need for costly treatments. This is desperately lacking in National’ approach to health.

To me, two of the most glaring omissions from National’s priorities are mental health and chronic disease management. The lack of resources to respond to people with low acuity need in these areas means they end up with much bigger problems than necessary and the taxpayer foots a much bigger bill than we ought.

Tony Ryall will enthusiastically point to short term output data that my look impressive now, but what is his strategy doing to improve long term health outcomes for our nation?

Waikato University scientist, Dr Pawel Olszewski suggests sugar and fat may produce changes in the brain which resemble the effects of addictive drugs. This may have a profound impact on the way governments, health practitioners and communities plan to combat the impact of the growing incidence of obesity.

We must be careful, though, not to directly equate sugar and fat, which our bodies need, to nicotine, alcohol, THC, amphetamines etc which we can quite happily do without:

Dr Olszewski says that while the brain responds to tasty foods in ways that have a lot in common with its reaction to drugs, he stresses there is a clear distinction between the complex mix of substances found in foods and a single compound such as morphine or nicotine. For this reason he describes over-eating patterns as “addictive-like”.

“We don’t want to send the message that if you’re eating a sandwich, that you’re consuming a drug. However palatable, high-sugar foods very often increase activity of the same brain circuits that are involved in the creation of the addictive state.

“So we believe this addictive-like behaviour stems from the effect that nutrients, in particular sugar and to some extent fat, have on the same set of brain areas that drive addiction.”

Immediately one can see the absolute pointlessness of a sugar tax. Potatoes, white bread, rice and pasta become sugar in the body as fast as pure cane sugar and nearly as fast as glucose powder. Taxing sugar is like sticking your finger in the dyke when the tsunami alarm has just gone off. And taxing carbohydrates in general is just adding a tax to nearly all food.

all that causes obesity is taking in more calories than you burn up.

Add to the mix research released from Ohio State University this week that shows the attachment between mothers and toddlers is linked with incidence of obesity and you quickly get the picture that obesity is not straight forward and solutions will be neither singular nor simple.

Obesity is a significant driver of the increasing cost of healthcare and therefore cannot be ignored. Developing prevention and treatment strategies is the responsibility of governments as much as it is the responsibility of parents, communities and individuals.

Trevor mentioned the fact that half the conference have been members for less than ten years. Another interesting statistic cropped up: When asked how we came to join the party, we were given four options: Family; Friend(s); Union/Church; Epiphany.

All groups were fairly even but noticeably smallest was Union/Church. Guess we don’t always live up to the stereotype.

It’s a very good example of the need to consider the long term effects of government policy. Yes, we all understand that putting GST up without proper compensation for people on middle and low incomes is making life harder for kiwi families right now, but the long term effects are much more concerning.

National’s policies have not only increased inequalities, they are creating a problem for future governments by failing to keep people well and increasing future demand on all health services including mental health.

It might not be of much concern to John Key and co because it won’t be their problem. But someone will have to deal with it and we’d all be a lot better off (financially and socially) if we prevented the problem when we can see it coming rather than waiting for someone else to clean up the mess.

By taking part in FebFast – and swearing off the booze for 28 days – we are raising funds for four organisations working with at-risk youth, particularly on drug and alcohol issues.

I can’t say that I’m missing alcohol all that much. Actually I feel pretty good. Being on FebFast is a great reason to say ‘no’ when the inevitable opportunities to consume occur at Parliament and around the electorate. Don’t think I’m going teetotal just yet though, and that’s not the point. This is just about having a break from alcohol and raising money for a really good cause.

If you’d like to donate, go to the Labour Party Team page on the FebFast website.

Cheers!

I thought Bill might fall asleep. He certainly looked relaxed.

Contrast that with the passion and belief in Phil’s delivery. He believed in what he was saying and that came through when he spoke.

Key is bereft of ideas and it shows. In the speech he tabled he even resorted to stealing Labour policy. Strangely, though, I don’t recall him mentioning it when he actually spoke. Shows how much of a priority kiwi kids are to this Government.

There is a good reason I’ve been seeing a lot of these cases – there has been a number of totally avoidable deaths on Manawatu roads recently, several involving cyclists.

The thrust of the complaints I’ve received is that we are too lenient on those who cause lethal accidents on the road. It’s an understandable response from people who have lost loved ones.

The gut reaction is, of course, to lock people away longer and to punish them harder. I’m not sure that achieves much but I do wonder if we need to look at how long drivers might lose their license if found guilty of careless, reckless or dangerous driving causing death and what might be demanded of them before that license is returned. Same goes for driving under the influence of alcohol or drugs.

So I have some questions:

1. Is the current system too lenient?
2. If it is, what is the appropriate method of punishment and rehabilitation?
3. Should a driver’s license be automatically suspended when they are involved in an accident causing death pending the outcome of their trial?

There are other ways to prevent road accidents besides tougher penalties and while that is not the focus of this post, feel free to share your thoughts on those too.

It’s clear that one of the over-riding reasons behind the decision to refuse some cancer patients treatment and the failure to even place them on the waiting list is to ensure that Tony Ryall can manipulate cancer waiting times to present to the media.

Cutting cancer waiting times is one of Tony Ryall’s narrow-focused targets for the health system. A laudable aim at first glance, but did anyone really expect that this would be the method used to achieve it?

National criticised Labour for sending patients needing cancer treatment to Australia when there was a shortage of specialists. We know now that instead of sending patients to Australia when there is a shortage, National’s answer is they just won’t treat patients who have some cancers.

Ryall has been virtually silent since this issue came to light. Guess there’s no photo-op in it for him.

Having said that, this one is about giving the licensing power back to communities, something I totally support.

Have a look.