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Why Ryall’s Health Targets Are Wrong

Posted by Iain Lees-Galloway on February 3rd, 2012

Labour, along with many people working in healthcare, has been saying for a long time that National’s health targets are narrow and simplistic, short sighted and lack enough focus on the looming problems for the health sector.

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.

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Filed under: health
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Health Target Tinkering

Posted by Iain Lees-Galloway on January 19th, 2012

Yesterday, Tony Ryall announced he is tinkering with his narrow and simplistic health targets. The changes in of themselves are positive but the targets are flawed. Even the Medical Association thinks so.

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?

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Filed under: health
5 Comments

Addicted to Food

Posted by Iain Lees-Galloway on December 30th, 2011

Perhaps it’s just because Christmas overeating is still heavy on my mind (and other body parts) but I’ve noticed there seems to have been a lot of discussion about causes of and suggested solutions to obesity over the last few days.

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.”

Tony Falkenstein, chief executive of Just Water International, made the connection and took it to a seemingly logical conclusion by suggesting a sugar tax. (Which, of course, would benefit his company).
This drew a thoughtful rebuttal from Dr Jim McVeagh at MacDoctor:

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.

I’m inclined to agree that taxing sugar is pointless and taxing fat just becomes ridiculously complex as you attempt to define ‘good’ and ‘bad’ fats.
As Jim McVeah says,

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

So if an excise-type tax were to be used in an attempt to curb obesity, the only logical approach I can think of is for it to be based on calorie density. Extremely calorie dense foods tend to be those that we ought only to eat occasionally although I expect there will be exceptions. A similar  effect could be achieved by taking GST off  low-calorie density foods. Both approaches have flow-on consequences that would have to be thought through before suggesting that either is worth implementing.

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.

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Filed under: health
28 Comments

Eliminating Child Poverty- Labour’s Health Plan

Posted by Grant Robertson on November 21st, 2011

Tomorrow night on TV3 there is a documentary about child poverty in New Zealand. I think every New Zealander should see it. It is a very real depiction of how life is for some of our most vulnerable families. The issues raised about child health and well being are ones we all have to take some responsibility for. Stuff has some preview of the content this morning.

More than 100 New Zealand children who died last year would probably have survived had they lived in Japan, Sweden or the Czech Republic, a new documentary shows….Last year, more than 25,000 children were admitted to hospital for respiratory infections. Doctors routinely treat cases of rheumatic fever and scabies – diseases now rare in Europe.

It is for these families that Labour has made eliminating child poverty our number one social policy priority. When it comes to avoidable hospital admissions (for issues like skin infections and respiratory illness) the National government has removed reducing them as a priority health target. This is wrong. They have increased by 5,000 between 2007 and 2010. The reason targeting these admissions is important is not only are they a proxy for how many children are in poverty, they are also an indication of lack of access to primary care as these infections should never get to hospital admission status.

Labour will restore the reduction of avoidable hospital admissions as a priority target. We will also make child health a priority by

  • enrolling all children with a Well Child provider before birth so that we have continuity of care for all babies
  • 24/7 free primary care for all under sixes (and we are funding this, unlike National)
  • enhanced B4School Checks and a mop up service at school for those who don’t get them
  • requiring District Health Boards to adopt child health implementation plans with nationally agreed measurable outcomes and targets that are monitored by the Ministry of Health.
  • developing systems during pregnancy to identify children who are vulnerable, and then ensure that the relevant levels of support are in place to support and optimise parenting.
  • strengthening the Health in Schools Programme, including social workers, starting with low decile schools, with the aim of expanding the programme to higher decile schools as resources allow.
  • 10 year plan to improve access and affordability of dental care, starting with a package of free dental services for pregnant women.

And the rest of the Childrens Policy agenda that we have released. You can find all the details here.

This is an issue that it is already past time to take decisive action. National do not seem prepared to do it, Labour is.

Filed under: #ownourfuture, children, health
14 Comments

Health Policy- Reaction

Posted by Grant Robertson on November 10th, 2011

Had a good launch of our Health policy yesterday. The full policy runs to nearly 30 pages. You can find all the details here. From my point of view it was the culmination of a hectic nine months or so that I have had the portfolio. I have listened to health professionals and service users all over the country, and this is the result.

I make no apology for the focus on prevention and more affordable primary healthcare, especially for children. That is how we will help New Zealanders stay healthy, and avoid the need for more expensive treatment further down the track. You will see that in our list of priorities, finding efficiencies in the system is high up the list, because it is essential we do that. We also can not ignore the cuts to services that have occured because the funding has fallen behind inflation and population growth.

In any case, here is a story from Checkpoint last night that covers some of the reaction to the story. I am really pleased the focus on dental health has been picked up.

Filed under: #ownourfuture, health
16 Comments

Political speed dating

Posted by Trevor Mallard on November 6th, 2011

Not just another candidates’ debate – this is your chance to debate the real issues facing our communities.

Five union/community election forums will be MC’d around New Zealand by some of New Zealand’s favourite funny people, including Michele A’Court, Jeremy Elwood, Darren Ludlow and Ian Harcourt. The forums have been organised by a group of unions and community organisations joining together to bring you a fun, fast and furious evening of political debate.

There’s a serious side to this as well. Candidates will be asked the hard questions on welfare, public services, inequality and more.

Please come along by going to the Facebook event and inviting your friends in Auckland, Hamilton, Wellington and Invercargill to join in too.

The issues: Welfare, inequality and a living wage | public services, health and early childhood education | disabled people’s issues | caring work | ACC

The format: Party spokespeople will have 2 minutes each to answer questions on these topics.

The venues:

West Auckland – Tues 8 November, 7pm. Kelston Community Centre, cnr Great North & Awaroa Rds. MC’d by Jeremy Elwood. Labour candidate – Carmel Sepuloni

Wellington – Wed 9 November, 5.30pm. St John’s on Willis St. MC’d by Ian Harcourt. Labour candidate – Grant Robertson

Invercargill – Wed 9 November, 7pm. Lindisfarne Community Centre. MC’d by Darren Ludlow. Labour candidate – Lesley Soper

Auckland Central – Tues 15 November, 7pm. Trades Hall, 147 Great North Rd, Grey Lynn. MC’d by Michele A’Court. Labour candidate – Jacinda Ardern

Hamilton – Wed 16 November, 5pm. YWCA, 28 Pembroke St. MC’d by Jeremy Elwood. Labour Candidate – Sue Moroney

Filed under: ACC, disabilities, education, health, inequality, public services
9 Comments

Cuts to public services- more misleading from Key

Posted by Grant Robertson on November 2nd, 2011

A very interesting story in the Manawatu Standard today where John Key is accused of misleading the New Zealand public. The accusation does not come from a Labour politician, it comes from a health professional.

A leading injury rehabilitation specialist has lashed out at comments made by Prime Minister John Key, saying he has misled the public over cuts made to the health system. Rehabilitation medicine consultant physician Jurriaan de Groot said he was left outraged at a statement made by Mr Key in a televised leaders debate that only administrative jobs had been cut from the public health service.

This is the mythology that the National Party have tried to create. The fact is that they have no idea whether the jobs that have gone in the core public service or the wider state sector are frontline, back office or any other term. They are just the result of indiscriminate cuts. In this case services delivered for rehabilitation.

Dr de Groot said the slashing of MidCentral District Health Board’s rehabilitative Star Unit from 12 beds to eight, proved Mr Key was “wrong at best, deliberately misleading at worst”. “It certainly wasn’t just administrative services that were cut from there, the hospital lost a valuable resource expertise and they’ll never get it back.”

Throughout the health sector cuts in funding have caused lost services. This was the result of $10 million being taken from a budget. In other places its been mental health or youth health or public health.

I am really glad a medical professional has called out the misleading from the government on the real impact of cuts to services. Many have been scared as to what will happen to them when they speak out. Good on Dr De Groot.

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Filed under: health, public services
10 Comments

GST off bananas (and other fresh fruit and vege)

Posted by Stuart Nash on November 1st, 2011

The Labour policy of removing GST off fresh fruit and veges is a very good example of evidence-based policy development.

The facts:
NZ is the third fattest country in the OECD (astounding). The productivity and health costs associated with this are huge – and growing.
Auckland University and Otago University medical schools undertook a joint research project into ways to influence consumer behaviour around the purchase healthy foods. Three groups were set up; 1) control group, 2) a group given very targeted information and education about the outcomes of healthy purchases, and 3) a group that were given information and a 12.5% price discount. The result: no change from control group (expected), no change from the group given a high level of education and information only (surprising), however, a 11% increase in the purchase of healthy food by those who received a 12.5% discount.

After consultation with a lead member of this research team, we decided that one of the best ways to influence buyer behaviour and promote healthy choices was provide a price incentive. This works. Six months after the study had finished and prices returned to normal for the third group, the researchers found the majority in this group were still making healthy purchase decisions.

So, education alone will not work in changing the eating habits / purchase decisions of the vast majority of NZers. A price incentive does. If anyone has a more effective way to directly target the obesity problem then I am very interested in hearing, because while it is a problem now, it is set to become an epidemic within a short space of time.

As an aside, we did briefly consider a ‘fat tax’ on unhealthy foods, however, ‘unhealthy’ is very difficult to define (under many definitions, milk and cheese are ‘unhealthy’) and so we decided that in this case, it is easier to remove a tax than add one.

Filed under: GST, Tax, health, policy
47 Comments

There is more to health than a league table

Posted by Grant Robertson on August 29th, 2011

The conventional wisdom is that Tony Ryall is making a good fist of the Health portfolio. Now that I am up close in the area I can say that he keeps a tight rein on matters health, and is managing the portfolio effectively. But there is a big difference between managing the politics of health and actually doing what is right for the long term health outcomes of New Zealanders.

The best evidence of that is the release today of the Child Health Monitor Report. It shows, among other things, that in the last two years there have been an additional 5 000 avoidable hospital admissions for things like respiratory illness and skin infections. The authors of the report note that the cost of going to the doctor, especially after hours is a factor in whether children are getting the healthcare they need, along with a range factors associated with child poverty.

I am not saying all of this is down to the Health policy of the current government. But the focus on the narrow range of health targets set by the Minister means that child health is not the priority it should be. The Minister has narrowed the health targets in such a way as to scratch the itches of waiting lists and time spent in ED, but it is at the expense of early intervention and public health programmes. District Health Boards have responded by pursuing the Minister’s targets, spending on public health has been slashed ($124 million in the last Budget) and funding for primary care has failed to keep up with inflation.

Just managing the Health portfolio is not enough. I actually think it is irresponsible to avoid the long term investments that will lead to long term health benefits in favour of things that are designed to fit on a coloured chart and make the Minister look good.

Labour, through Annette King, has already outlined our Agenda for Children that will put children’s well being at the centre of our social policy. More details will be announced in the election, but from a health policy point of view public health and affordable and accessible primary care must be a priority.

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Filed under: children, health, inequality
24 Comments

Rangiora- A Community Standing Up

Posted by Grant Robertson on August 24th, 2011

On Monday I was in Rangiora for a public meeting organised by local MP Clayton Cosgrove, calling for the reinstatement of the after hours GP services that were cut last year. It was a great turnout, 250 to 300 people. They are understandably angry. This was a service they have had for more than 20 years. The population is growing, and it is also ageing. The 40 minute ride to the nearest after-hours in Christchurch is expensive if the one ambulance is not available and you can’t drive yourself. On Monday we heard the story of young mother who had to take her toddler who had burns to Christchurch. The total cost of taxi and being seen came to $300. By the end of the week she did not have enough money for food for the week and had to rely on the support of other agencies.

I have great admiration for the people who are behind this campaign. With Clayton’s support, a local woman named Paula Thackwell set about getting signatures for a petition to get the services back. She managed to get 8,246 signatures. That amounts to about 70% of the population of Rangiora, a truly phenomenal effort. The submission found its way to the Health Select Committee, which eventually reported on it in July.

I was on that committee, and I can tell you that the attitude of the government members was that there was no issue here. We got a report from the Canterbury District Health Board, and they said there was no issue. The majority of the select committee rejected the petition. Labour put in a minority report backing the petitioners. We asked questions in Parliament, Tony Ryall said it was not his problem either.

At that point Paula could have given up, the government was not listening. But she did not. Along with Clayton, she kept the pressure up. Eventually the government reacted, and the District Health Board have proposed a “solution”. It involves a six month trial of paramedic and nurse triage phone service. That is a step forward, and a complete change of heart from the DHB. But the community is not satisfied. The view at the meeting yesterday was that there needs to be a solution that still gives the people of the Rangiora area the confidence that there is a doctor available in their community when they need one. The meeting passed a motion to keep up the fight for the reinstatement of the services.

There is of course a bigger question here, which I have put to Tony Ryall which is what responsibility does he take for people across New Zealand having access to after hours services. Last week they were cut in Temuka and Geraldine. There are stories from elsewhere as well. The government needs to be up front with New Zealanders as to whether they will ensure that the services are there. But in the meantime, hats off to the prople of Rangiora for keeping up the fight. We are right there with them.

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Filed under: health
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I should’ve looked after me teeth

Posted by Grant Robertson on July 27th, 2011

In the strange old world of television, its funny what generates a story. Kevin Milne makes an aside in his consumer advice column in Womens Weekly about bunking off your dentist bill (an option he does not recommend) and both our major current affairs shows climb into the cost of dentistry, off the back of an NZ Herald story. A month or so back Jim Anderton launches a fully researched and costed plan for universal access to dentistry, and while it gets some modest coverage, its ignored by TV.

Ah well, at least this is getting the issue debated. There is no doubt that the cost of visiting the dentist is a major issue for many people along with the other increasing costs of daily life, and the low cost options (such as hospital clinics) are unable to cope with demand.

One thing that is interesting to note in the Campbell Live story is that there are DHBs out there that are putting more resources in to make dentist visits more affordable. But the National led government has clearly signalled that they do not see oral/dental health as a priority. They got rid of dental health from the list of targets for DHBs, and the majority of DHBs have responded to that by putting resources into the other target areas. This is a big mistake from the current government in my view.

Labour did make significant advances in the last term of government with getting the mobile school dental clinics into our communities. Access for primary school children (which is still free) has improved. It is harder with teenagers, who are still free until 18. Many dentists do not think that the subsidy they get for treating teenagers under the Combined Dental Agreement is sufficient to meet the costs they face. Anecdotally we hear of practices turning away teenagers, and of course by this stage avoidance behaviour with the dentist is beginning.

It was no surprise in both the TV stories to hear dentists say they were concerned about so-called “socialised dentistry”. They are business people and the government wading into their sector scares them. But the truth is that our current model is not working as it should. 44% of Kiwis are not seeing a dentist annually. Dental problems are a gateway to other health issues, and the long term costs of dealing with those are huge, let alone the personal health impacts.

As ever in health, many of the answers in terms of good oral health lie with actually helping to keep teeth healthy in the first place. Supporting children and teenagers to stay in the habit of good dental care, which includes regular check-ups, oral health education for parents and children, an increased role for dental therapists to provide early intervention and,dare I say it, a wider take-up of fluoridation in our water supply.

But we can not get away from the need to make dental care more accessible, and that means more affordable. Jim’s plan, which he has handed over to Labour, is costly. Up to $1 billion per year when fully implemented. We are looking closely at what we can afford to do, and over how long a period of time. But it is an issue that we have to face up to.

Filed under: Cost of Living, health
14 Comments

ACC and hearing loss

Posted by Chris Hipkins on July 24th, 2011

When National took office, they manufactured a financial crisis in ACC in order to cut entitlements and prepare it for privatisation. Nick Smith’s hysterical claims about the financial state of ACC have now been widely discredited, and even Smith himself is now trying to back away from them by claiming a miraculous financial turnaround in just 18 months.

Smith and the National government used the financial crisis to make a number of changes to ACC that undermine some of the central principles behind the scheme. The changes that they made to compensation for victims of work-related hearing loss illustrate it well.

Under National, the guidelines ACC works to when considering hearing loss claims have been changed and ACC now discounts a person’s hearing loss as they get older, regardless of whether or not that loss is age-related. They’ve also set up an arbitrary 6% hearing loss threshold before compensation is considered, regardless of where on the hearing spectrum the loss happened. It’s quite possible to have less than 6% hearing loss and still not be able to hear the person standing next to you in a crowded room.

One of the core principles of the ACC system is that it’s comprehensive, no-fault coverage. Hearing loss is now the only injury/accident where the victim has to meet an injury severity threshold before they’re covered. I’m pleased the Human Rights Commission has agreed to hear the case. The only fair way to deal with hearing loss cases is to deal with each one individually, based on its own merits. That’s how ACC should work.

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Filed under: ACC, health
4 Comments

Marmot lesson in real time

Posted by Grant Robertson on July 19th, 2011

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Last week I blogged about Sir Michael Marmot’s visit to New Zealand to highlight the importance of addressing the social determinants of health. In essence he, and many others, are arguing that if we are to improve health outcomes we need to ensure people have jobs, adequate income, good housing and education, particularly in terms of access to early childhood education.

Intellectually this makes sense, and it is the core of the message about Labour’s health policy that I have been talking about around New Zealand.

But the reality hit home to me yesterday when Carmel Sepuloni took me to visit West Fono in West Auckland. The fantastic team there (pictured above) provide a range of health services to a mainly Pacific population.

They are especially proud of their chronic disease management programme where they get out into the community to work with people suffering from, among other things diabetes. Yesterday they told me about the story of a patient they had not seen for some time who they visited. She is partially sighted. Her husband had lost his job and had taken off to Australia to try to find a job. She does not have a car, and has to rely on others to get her to see the nurse and doctor.

Their programme is reaching her but guess what, the funding for it has been cut. They are trying to keep it going themselves but can probably only do so for six months. That is tragic.

But the bigger picture is that the loss of jobs in the community is having an impact. The staff also talked about the lack of social housing and the poor quality of the housing. They know if they treat kids for strep throat, sending them back to the same cold, damper, over crowded house will not solve the problem.

I really admire the work being done by West Fono. To support them we need to ensure that we get the focus on jobs, ECE, growing incomes and having warm dry homes. To me these are the building blocks of a proper caring society.

Filed under: health, inequality
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Abandoning provincial New Zealand

Posted by Grant Robertson on July 17th, 2011

DSCF0294How many times have you passed through Taihape? Have you stopped? Was it for more than just a cup of coffee at the most excellent Brown Sugar Cafe? Yesterday I spent several hours in Taihape with Labour’s candidate for the Rangitikei electorate Josie Pagani.

Like a lot of other provincial towns I have visited in the last couple of years, Taihape is struggling. There is a string of empty shops on the main street, and one of the local business people I met with yesterday told me he thought another half a dozen would close by the end of the year. Taihape folk know there has been a global recession, but they feel let down.

Exhibit A is the local hospital. Refurbished a few years back, operating as a first point of contact for medical emergencies, rest home, maternity wing. In short a small town hospital that gave people confidence, and also helped hold the community together, particularly a community with an ageing population. Then last year, without any consultation, the hospital was effectively closed down. There is still the maternity bit, and a some day stay capacity for elderly patients, but the rest is gone.

Its putting real pressure on the community. We were told the story of someone who badly cut their hand. He knew it was bad, and that he needed treatment. He began to drive to the nearest hospital in Palmerston North. He nearly made it, but passed out half an hour from his destination. Fourtunately he had rung ahead to a relative who came and got him. Old people have been scattered across the North Island, breaking down community and family connections. Other stories include someone ringing the emergency number that is now on the door of the hospital only to be told by the operator in Auckland to go to Taihape Hospital.

Its not just the hospital. This is a town, actually a region, crying out for some support to get economic development going. The people we spoke to yesterday weren’t the type who want the government to do everything for them, but they do want a government that gets its hands dirty helping to give people a start and some support, not sitting on the sidelines hoping the market will provide.

We finished the day at the school. It is brilliant. It is an area school that came about from one of Trevor’s school reviews, and it had some hefty investment behind it. Its modern, and a real community facility. As one local said yesterday, its building was the last time it felt like someone “gave a shit about us”.

I know Labour has not been traditionally popular in parts of provincial New Zealand, but actually when the people stop and think about the Labour approach of getting alongside communities vs National’s abandonment, there is a case for a re-think.

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Filed under: economic, health, rural
7 Comments

Sir Michael Marmot- Health Equity

Posted by Grant Robertson on July 13th, 2011

Today I am attending a symposium organised by the NZMA on health inequities to coincide with the visit of Sir Michael Marmot from the UK. I have blogged before about the influence of Sir Michael on the excellent NZMA statement on health equity.

Its occasions like this that highlight just how ridiculous are the assertions of Maori privilege made by Don Brash. Just a couple of examples have been highlighted by Tony Blakely from Otago University and Don Simmers and Norman Sharpe from the NZMA.

- despite improvements in the first decade of this century Maori life expectancy is 7-8 years short of non-Maori.
- mortaility rates for Maori in middle age are 2-3 tomes higher than non-Maori including all causes such as heart disease.
- Maori babies are 5 times more likely to die of sudden infant death syndrome than non-Maori
- diabetes rates, suicide rates and infectious disease rates and mortality are all higher for Maori than non-Maori

Health inequities are certainly relate to economic depravation,and it was a good achievement that income inequality in New Zealand did reduce slightly in the 2000s under Labour, but there is much more to do. It is also clear that there is an ethnic component above and beyond that. Addressing this is not privileging a group, it is in fact correcting a systemic disadvantage. Doing so, with early intervention, will benefit us all in promoting social inclusion and reducing the cost of expensive health interventions at a later stage.

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Filed under: M?ori, children, health, inequality
4 Comments

Getting rid of middle aged spread

Posted by Trevor Mallard on July 8th, 2011

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For a while after I had my accident the painkillers I had acted as an appetite suppressant and I wasn't allowed to drink. Weight stayed pretty constant at 88kg.

Over a few weeks in June I ate like I was riding 350k a week. Had a few wines as well.

A couple of weeks one of my mates looked at my rapidly growing middle age spread and recommended a set of scales he bought over Internet from the States. They arrived last Thursday and are great. Measure body fat %, BMI, lean mass as well as weight. They showed 96kg a week ago.

Will get on them each morning I am home. They send readings to the iPad. And to a couple of friends. They show when I eat rubbish. NZ Council last weekend had my favourite fancy sausage rolls. I pigged out and you can see the fat % (yellow line) skyrocket.

When I am in good form on te bike I ride at under 85kg. Will be interesting if I can get down there without distance riding.

Filed under: health, sport
13 Comments

Childrens Health Camp Stamps

Posted by Grant Robertson on July 7th, 2011

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Yesterday I got the job of launching the 2011 Childrens Health Stamps, up at Zealandia (otherwise known as Karori Sanctuary). The reason for doing the launch at Zealandia, apart from being a great place to visit is that this year’s stamps show flightless native birds, including the takahe. Earlier this year Zealandia began the proud home for two takahe, one of them pictured in the photo above, along with some children from the Otaki Health Camp, staff, representatives from NZ Post and me.

The release of Childrens Health Stamps is the result of an 82 year partnership between New Zealand Post and its predecessors and Te Puni Whaiora Childrens Health Camps. We were told yesterday that it is the longest running corporate/charity partnership in New Zealand. Essentially 10c from every stamp goes to the Childrens Health Camps.

It was great to meet the kids from the Otaki Children’s Health camp who came to the launch yesterday. The work that Childrens Health Camps do has changed a bit over the years. The focus is now more on mental health and well-being a bit more than physical health issues. Nowadays most of the kids come to one of the seven camps around New Zealand for a period of weeks on referral from their schools to help them find some stability and confidence. Staff from the camps work with both the children and their families to try to establish the basis for on-going positive development for what are some pretty vulnerable children.

I visited the Rotorua camp earlier in the year and was really impressed with the approach they are taking, working across different agencies and trying to address the causes of the issues that have brought the children to the camp. It was inspiring, as were the kids who were at the launch yesterday.

So, if you get the chance, buy some of the stamps and support their work. There is an order form in the link above.

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Filed under: children, health
2 Comments

My day with Tony

Posted by Grant Robertson on June 22nd, 2011

This morning the Health Select Committee held its annual estimates hearing. This is the opportunity for MPs to quiz the Minister and officials on the Budget and plans for the coming year(s). Gerry Brownlee was next door talking Canterbury issues, and so the media (ex NZPA) were not present to cover what happened.

I wish they had been. It is clearly a planned strategy this year for Minister’s to do ’show and tell presentations’ as part of their appearances, to give a nice soft story and also to waste a bit of time. I was present for Judith Collins doing this with Police, and today Tony showed off some drugs and the new throat swabs.

Having got past that, my first question to Mr Ryall was to get him to be more specific about some of the health cuts in the Budget. The Ministry had provided a table (which will become public when the estimates are reported back) of the cuts, and it included an item “Public Health- Reprioritisations”. This is $60 million over four years, no small amount. After repeated attempts to find out what was actually been cut, it became clear the Minister had no idea. He started reading some names of programmes off a sheet, but he did not have a clue.

Even if you think its great that $60 million was cut from public health (which I don’t) you would at least expect that the Minister would know what it was he was cutting. The same thing applied when Iain Lees-Galloway asked him about mental health. No idea.

I then tried to see if he felt any need to intervene in another example of a community who’s after hours service is in danger, this time in Temuka and Geraldine. Again, he was not interested in answering on a specific issue.

As readers might have gathered by the time I got to the House for question I was pretty frustrated. I wont bore you with the details- but here is the link. The bottom line is that the Minister continues to pretend he is putting more real spending power into health, but the agencies who are actually delivering the services, such as the mental health and addicition services in the Northern Region, are getting nothing to help with increased cost pressures, and that can mean only one thing. A reduction in services. And that is the one thing Tony Ryall told us would not happen.

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Filed under: health
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Improving ACC #1

Posted by Chris Hipkins on May 23rd, 2011

Over the weekend I blogged about Nick Smith’s manufactured crisis in ACC. National’s agenda is pretty transparent. They’re trying to soften up public support for our excellent accident prevention, compensation and rehabilitation scheme as they prepare to privatise it. Labour will strongly oppose National’s plan to carve up ACC and hand it over to the private insurance industry.

But we’ll also be looking at how we can improve the scheme that we have now, because although we think the system overall is a sound one, we agree that it could be even better. Over the past few months I’ve been meeting with a wide range of ACC stakeholders, from claimants and their advocates through to medical providers and medical assessors.

One of the issues that I’ve become increasingly concerned about is the lack of independence in the specialist medical assessor process. It’s pretty clear to me that ACC have some “tame” medical assessors who are giving them the result that ACC wants, rather than the one that is in the claimant’s best interests.

In some cases, these assessors are working almost exclusively for ACC, making them reluctant to bite the hand that feeds. I’ve also met with specialists who have been all but ‘black listed’ by ACC because they haven’t been willing to give them the assessment results that they want.

So the question I’ve been contemplating is whether we need a bit more independence in the ACC medical assessment process. Should specialist assessors be required to be ‘current practitioners’ in the field they are assessing? Should there be a limit on the proportion of a specialist’s work that can be ACC assessments? Should claimants be given more ‘choice’ over who they go to for specialist assessments?

I’m interested in your views and your stories. Like I said above, I think ACC is a very good system and I’d hate to see it carved up as National want to, but that doesn’t mean I’m not willing to debate how it can be constructively improved.

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Filed under: ACC, health
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Traditional Chinese Medicine not just for Chinese

Posted by Raymond Huo on May 17th, 2011
Raymond Huo presenting certificate to Rebecca Wood at the NZ College of TCM Graduation ceremony on May 12, 2011.

Raymond Huo presenting certificate to Rebecca Wood at the NZ College of TCM Graduation ceremony on May 12, 2011.

Attending the New Zealand College of Chinese Medicine graduation ceremony last week I was immediately struck by the diversity of graduates.

Showing that Traditional Chinese Medicine (TCM) is becoming a wide-spread and accepted form of health care in New Zealand, graduating students came from Kiwi, Chinese, Korean and Iranian descent.

However it is unfortunate that New Zealand sits behind Australia who has implemented legislation to recognise TCM as a legitimate form of health care. While it seems on the outside that New Zealand has a strong awareness of Asia while Australia lags behind with its connection to Pauline Hanson and the One Nation Party, this anomaly would suggest otherwise.

When you take into account the recent anti-Asian leaflet campaign by Kyle Chapman and his far-right group, I wonder if New Zealand really does sit ahead of Australia in regards to race-relations and awareness of other cultures.

So I put it to Red Alert readers out there, do you think legislation should be implemented in the field of Traditional Chinese Medicine and what would you like to see this legislation achieve?

I look forward to reading your feedback.

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Filed under: asian, ethnic, health
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