Red Alert

Archive for the ‘health’ Category

Parliament A Unique Workplace – Can Be Better

Posted by on May 21st, 2013

Have you ever noticed how some women just seem to have it all sorted? I didn’t realise how multi-talented women really were until I became a mum.

Since the birth of my third child I have appreciated my mother even more, admired other mothers tremendously and realised not only do I have a passion to make a difference in the lives of others, I want to be a good mum.

There are a number of conversations you start having by virtue of carrying out ‘mummy’ duties. Breastfeeding in public places can be as political as protesting or standing on the picket-line. Some people frown, or turn away and look a bit embarrassed and others give a reassuring smile as if to say ‘Good on You!’

Women share quite openly their experiences of Breastfeeding, when they made the choice to go back to work, how to manage illness when the whole family catches a bug, coping with the pressure of achieving work-life balance. This world of conversation can be as foreign to some people as a different language but it’s a perspective into which I have now been inducted.

The fact remains women who choose to Breastfeeding are doing so because they want their children to have the best possible start in life. And we shouldn’t assume that all  women who bottle feed didn’t try to breast-feed. It’s not easy business persevering with the right latch and getting the timing right, expressing, producing milk like a well run factory. It can be hard and I support every mum who makes the best choices she can to provide a healthy loving environment for bubs.

Returning to work is a decision that causes a whole heap of stress. If I had a dollar for every moment that I questioned myself on this single issue, there would be a tidy sum put away.

I have heard horror stories of women who returned to work with no consideration about their change in circumstances but I must say that they are the exception not the rule. New Zealand has come along way. We can chalk up many gains for women starting with the first country to give women the right to vote. Progressive change towards family friendly workplaces is considered a requirement for the modern labour market, improving productivity, overall job satisfaction and loyalty of employees.

Labour’s introduction of the Paid Parental Leave entitlement for 14 weeks sought to recognise that there is no greater job than that of being a parent. Sue Moroney’s Bill proposing to extend that leave to 26 weeks is a step in the right direction. Sadly though not surprisingly the Government is seeking to Veto the move, the fact that its on the radar of many families around the country will build momentum and it certainly ‘an idea whose time has come’.

Employers in each workplace should be encouraged to consider what level of flexibility is reasonable and achievable according to their circumstances. In Parliament, if you have the privilege of serving as an MP there are some important obligations that must be met to achieve the required outcomes of the role. But we must remember that MPs have working conditions, hours, workplaces and performance indicators that are very unique.

Our job requires a lot of travel, a high level of public interaction,   long hours sitting in Parliament, long meetings, more travel, advocacy and community work, and regular weekend obligations. The performance measures are peculiar consisting of re-election, public visibility, media profile, performance in the House and attendance in Parliament. It’s no wonder that many women get turned off by the whole scene. The whole idea of having children while serving as an MP can be even more daunting.

The short answer is that many women in our Parliament have done this in stoic fashion Ruth Richardson, Whetu Tirikatene and Katherine Rich all had their children while serving as MPs. They for me are examples that it is possible. Politics aside (for a moment) each one made progressive and subtle changes to the Parliamentary environment to accommodate their needs and those serving after them have benefitted.

My call is simple. Consideration of leave provisions for nursing mum MPs during exceptional circumstances where Members are required to sit in the House under urgency. No mum should be required to take their child to their workplace during the evening especially if they have no care provisions. They should be able to have their vote cast in a way that preserves their ability to perform a necessary duty for the role of MP without prejudicing their Party. This is a matter for Parliament to consider.

One small baby step for Parliament would send a signal to all workplaces that working mums are an asset to the workplace not a burden and if they choose to Breastfeed, then that has to be good!


Time to clean up the burning pit, Minister!

Posted by on May 10th, 2013

For the last month or two, residents of the new Wigram Skies suburb in Christchurch have been suffering from toxic smoke blowing across them. It has been coming from a fire in the nearby recycling pit caused by the spontaneous combustion of some medium-density fibreboard. You can see what they have been putting up with in this picture. No wonder 150 of them came to a public meeting called by MP Megan Woods, in whose electorate that new suburb has developed.

The toxicity comes from burning formaldehyde. The Medical Officer of Health says that there is no long term health risk posed by the smoke and fumes. That is a good thing. But it is still unpleasant, irritates the nose and eyes, stinks and is an air pollution issue. I visited it with Megan recently and even on a still day I could smell it in the air the moment I got out of the car. Now it seems the fire has collapsed and is able to be put out. It has been too hot for firefighters to get near until recently.

The question shifts now to what to do about it and how do we prevent something like this happening again. The site needs to be cleaned up and taken over by the Ministry for the Environment. Residents have legitimate questions about the environmental impact on the local area and the pollution threat to water resources given the fact that the Owaka pit is right on top of an aquifer. If we still had a democratically elected Environment Canterbury body, something might have been done or planned by now. But we don’t. This is a major pollutant and the Minister for the Environment, Amy Adams, should take it over as a pressing concern for these people.

Oh, and by the way – the pit is in Amy Adams’ electorate……


Moving on to the next challenge

Posted by on February 25th, 2013

I have enjoyed the Health portfolio. It is huge and arguably, it takes longer than one year to get around and establish networks. I have been doing that in the past year and I am grateful to all those who were prepared to engage intelligently and repeatedly with me. I have been pleased to stick up for diabetics in the disastrous changeover to the Care Sens blood glucose meters. It was a mistake and should be rescinded. It affects the way people manage their diabetes and directly impacts their well being, especially for Type 1 diabetics.

I have also made a running on the increase in prescription charges, changes to pharmacists’ contracts with the DHBs, and the burden of implementation of changes falling on local pharmacies. This sector is in chaos and Tony Ryall continues to pretend that there is nothing to see here. Shelves full of uncollected prescriptions would say otherwise. If people can’t afford medicines, and some clearly can’t, we are only going to see additional hospitalisations further town the track.  This isn’t rocket science – just medical science.

But now I take up a new challenge with the Environment portfolio.  And there are challenges aplenty.  We would all love our myth of being 100% pure to become fact again but we need aggressive leadership in this area if that is ever to happen. From our waterways to our air quality, and much more besides, there is much to do to restore our natural environment and to protect it for future generations.  I look forward to that challenge.

Thanks again to all you good health folk for working with me over the last year.  Keep up the good work!


New Year Hangover brought to you by the letters N.A.T….

Posted by on January 1st, 2013

If you thought that your hangover was starting to fade, National has made New Year’s Day a cracker for short sighted, unfair and just plain dumb policies to come into force.

- Prescription Charges Up. Today is the day prescriptions rise from $3 to $5. Might not seem much from the comfort of Tony Ryall’s viewpoint, but a trip to a pharmacy in any low income area will tell you a different story. Many people struggle to pay for their medicine now, let alone with the price increase. Maryan Street has covered it really well here. Unfair, and just plain wrong.

- Student Allowances Abolished for Postgrads. I have covered this a few times on Red Alert, but from today no postgraduate student will be eligible for allowances. Shortsighted, and likely to drive many bright hopes overseas. And so unfair to those in the middle of programmes who had no warning of this from National. Like my constituent who simply can’t afford to complete her Clinical Psychology qualification because even using a student loan she is $75 a week down in “income” and can’t afford to look after her daughter on that. Shame.

- No more Kyoto. From today the government has abandoned our commitment to the Kyoto Protocol in favour of our own “voluntary” commitments. We used to be respected in the world for our work on climate change, but National has systematically undermined that through changes to ETS and now this. Our reputation with small island states will take a major hit. We are now seen as not only not a leader, but not even doing our fair share.

In fairness today also marks another increase in tax on tobacco. Labour supports this, as the international evidence shows price is one of the most successful ways of stopping people smoking. But it has to go along with access to other treatments to help people kick their addiction.

So, its Happy New Year from National. But actually I am feeling really positive today. 2013 will be the year we see New Zealanders come together to find a fairer, more hopeful and compassionate future for our country. That is Labour’s way and that is our goal.


Health By Numbers

Posted by on December 19th, 2012

Both Vernon Small and Corin Dann anointed Tony Ryall their politician of the year. Both cited the same reason: When was the last time you heard of a health scandal?

I agree that Tony Ryall is the best politician on National’s front bench. But that doesn’t make him a good Health Minister. By forcing hospitals to focus on delivering short term statistics he can crow about in Parliament and micro-managing any emerging issue that will resonate with National’s base he has managed the politics of the health portfolio sublimely.

But by sucking resources out of public and primary health and refusing to do anything to prevent the looming obesity crisis or the fact that poverty is a primary driver of ill health, Tony Ryall is setting future health ministers up for massive problems. They will have to grapple with a health system that simply will not be able to cope with the demand that will be placed upon it. Very difficult choices will have to be made about how much we spend on health, how the revenue is raised and what the public health system can deliver. If we leave that all too late, drastic steps will need to be taken and the public health system as we know it will cease to exist.

Just like superannuation, National has their head in the sand on health. They are more worried about getting the numbers right for today’s political purposes rather than doing what is right for the future.

Tony Ryall has build a magnificent house of cards. It looks splendid right now, but the signs it could collapse at any time are there:

Maryan Street has already called Ryall out on his dodgy elective surgery numbers. Simple procedures get priority over more complex surgeries regardless of the outcome they achieve for the sole purpose of getting the numbers up.

At the Health Select Committee fincncial review of the Ministry of Health I pointed out that despite both Labour and National getting elective surgery waiting times down to now being on par with the USA and National diverting resources into getting more and more surgeries done, New Zealand ranks amongst the worst developed countries for post-operative complications such as infections and surgical items being left in the patient. So it’s all about quantity, not quality. Of course, those post-op complications are costly and soak up resources that could be used on better things.

Today there is an emerging story that the national screening programme which identifies hearing irregularities in newborns has been botched resulting in up to two-thousand babies being recalled to hospital to have their hearing re-checked. Why? Because some of the screeners only tested one ear and, bizarrely, some tested themselves rather than the baby. As Associate Health Minister Jo Goodhew had to concede on Radio NZ this morning the only logical explanation for this was to save time, get more tests done and produce the numbers the Government is looking for.

Good on the Government for dumping this story after Parliament has risen so this little health scandal can be squashed before the next question time and good on Ryall for sending Goodhew to face the music. Perhaps it was to make up for his sexist graphic about doctors and nurses (which again contained dodgy numbers).

Tony Ryall the best politician of 2012? Yes. But he’s a crap Health Minister and we will all be paying for it in the future.


Duckworth-Lewis Food Labelling

Posted by on December 9th, 2012

Buried inside a media release about innovative health food claims from Kate Wilkinson’s office late on Friday was the news that National has, predictably, let industry interests trump public health on the issue of front-of-pack food labelling.

With obesity and diabetes being the most pressing health challenges New Zealand (like other developed nations) is facing, helping people take better control of their own nutrition is absolutely vital.

Choice is important and there is no point in sanctimoniously dictating to people what they should and should not eat, but we can provide simple information and signals to help people make informed decisions.

The right thing to do is establish a universal and simple-to-read ‘traffic light’ type system that people can easily interpret whilst doing their shopping.

What was announced was not a new system but a report prepared by an advisory group  consisting of both industry and health representatives. (Oddly the Health Promotion Agency and its predecessor the Health Sponsorship Council are not represented. Perhaps Kate Wilkinson thought Katherine Rich could wear both her conflicting hats at the same time while she represented the  Food and Grocery Council).

Kate Wilkinson says the report identifies a set of principles that will provide a useful guide to food businesses that want to adopt front of pack labelling.

So it’s voluntary which means the manufacturers of those foods that people need to eat sparingly will avoid it like the plague.

It’s also complicated with foods to be compared within categories, not with all other foods and using a points system rather than the simple traffic light system. In a win for the PC brigade, negative labels will not be used, only varying degrees of positive labels.

Incredibly, it suggests that the really bad foods, the ones with no positive nutritional value should have no label at all.

By the the time I finished reading it I was surprised the group hadn’t recommended shoppers use the Duckworth-Lewis method to determine what foods they should buy.

Predictable but nevertheless disappointing.  Once again National shows it has no concept of public health and is happy to keep pouring money into the treatments it chooses and putting more strain on the health system in the future.

I think that the best system is this one developed by Sanitarium. It combines individual nutrient ratings with an overall rating while still retaining the simple traffic light approach. This is what we should be pursuing.


D-Day for diabetics

Posted by on December 1st, 2012

Today the government, through Pharmac, ceases to subsidise the Roche Accu-Check blood glucose meters used by 80% of NZ’s 200,000 diabetics. About 20% of diabetics use the Abbott meters and 0.5% use the Care-Sens meters. But Pharmac has chosen to give the contract for subsidised meters to the people who import the Care-Sens model, Pharmaco. All of them. One supplier. Dangerous and unnecessary. But apparently it will save $10 million!

Pharmaco is running training sessions for pharmacists, doctors and other health professionals on how to use these meters so they can teach their patients and customers how to use the new meters. They are calling them “Meet your Meter”. I am so tempted to call them “Meet your Maker” seminars but that would be too inflammatory.

Diabetics depend on these meters. They are used to identify blood glucose levels so that Type 1 diabetics know how much insulin they need to inject right now and Type 2 diabetics know how many jelly beans to consume right now. Pharmaco tendered for the contract on the basis of a meter which was inferior to the one used by most diabetics, but after an outcry from the diabetics themselves, they upgraded the meter to a comparable one.

Changing over medical devices is a risky business. Changing to a sole supplier is crazy.  They will have no competition to upgrade their product over time or provide good after sales service. Their predecessors did both of those things. Pharmaco is now working in a hostile environment. They had better be careful to get this right. Lives depend on it.


Aung San Suu Kyi to NZ – was anybody listening?

Posted by on November 25th, 2012

What was Aung San Suu Kyi’s word to the west during her recent European tour? “Yes – we welcome foreign investment, but ethical investment and people-centred aid please.” Did John Key hear any of this before he swanned off for another photo opp?

His post-Burma visit interview with Audrey Young was a lesson in how to learn nothing from one of the world’s greatest and most principled democratic leaders. It was like watching a child trying to speak adult language. And as for the Boy’s Own Annual approach to Foreign Affairs -  of the East Asia Summit: “It was a pretty interesting meeting just generally….I know…all these guys. I’ve met them lots now” – one wonders what Key thinks he is there for. And did he not know how ASSK might react to the name Myanmar?

Key announced $7 million in aid to go to Burma – $1 million in humanitarian aid to Rakhine state and $6 million in agricultural reforms. I blogged positively on the fact that he announced aid at all. But Key’s and National’s obsession with Foreign Affairs being reduced to trade shone through his announcement as did his disregard for everything for which ASSK stands – democracy, poverty elimination, reliable and accessible health care, accountable structures, rule of law, credible governance, anti-corruption.

Contrast Key with Obama’s brave and principled leadership shown in his speech at the University of Yangon: “Above all, when your voices are heard in government, it’s far more likely that your basic needs will be met. And that’s why reform must reach the daily lives of those who are hungry and those who are ill, and those who live without electricity or water.”

$6 million in agricultural reform assistance is another way of saying how can the NZ government make life easy for our biggest company, Fonterra? Somewhere down the track, that may be an appropriate question. Right now, instead of the developed nations circling like vultures over the next and possibly last untapped market in the world, why aren’t we concentrating on what Burma needs in order to get its people back on their feet so they can trade their riches of oil, gas, gems such as rubies and other minerals, as well as their fertile land, on their own terms and for the benefit of their people?

What business needs to flourish is the rule of law, transparency, a lack of corruption and democratic accountability. US businesses are not lining up to flood into Burma yet because they know the banking system is embryonic and capricious (crisp US bills only please, no bank accounts for foreigners, cash only). Check out what US businesses are saying here.

But to get to that stage, Burma will need health care and education. Our UnionAID programme training young Burmese leaders ($175,000!) is more likely to be effective in the long term than opportunities for NZ businesses. Getting some of the basics such as human rights, health care and education sorted are the priorities, not laying the ground for us to do well out of Burma in the future. Journos can see that. A real leader would see that.


End of Life Choice bill in ballot

Posted by on July 23rd, 2012

I have, after 6 months’ work, finished my End of Life Choice Bill. You can find it here. I think the social conversation has moved on from the last time such a bill was debated in 2003 and lost 60-58. The two missing votes at that time were one abstention and one voted not lodged. So that was close. I hope I have enough specificity and enough safeguards in place for people to support it this time. I am sure it can be improved. I am equally sure that is time that we approached this issue with compassion and gave people the right to be as self-determining at their point of death as they have been in life. It would only apply to people who were of sound mind and suffered from a terminal illness, or an irreversible condition which made their life unbearable, in their own view. It also provides for people to register End of Life Directives in the event that these situations occur and they are unable to communicate their wishes to receive life-ending medication.  Other features include: the need for two medical practitioners to attest that the person is of sound mind, has the condition they say they have and have not been coerced into their decision; the need for counselling and a period of reflection; and a Review Body to examine the law after a period of time to ensure it is not being abused and is operating correctly. It will go into the ballot this week. Let me know your thoughts.


Diabetics unite!

Posted by on March 21st, 2012

Pharmac has signed a provisional contract with an Auckland company to be the sole supplier of new glucose meters for diabetics. About 150,000 people are affected. Problem: no consumer testing – no backlight on the new one which is a bit tough when you are having a hypo event in the middle of the night; not enough memory to record history of blood sugar levels; batteries which conk out under 10C; sole supply out of Korea – the most stable peninsula we know? Tony Ryall is pressuring them to save $10 million through this contract. He ducked answering questions in the House today about this by exiting to comfort his upset mate, Nick Smith. Watch Campbell Live on TV3 tonight for this item.


Why Ryall’s Health Targets Are Wrong

Posted by 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.


Health Target Tinkering

Posted by 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?


Addicted to Food

Posted by 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.


Eliminating Child Poverty- Labour’s Health Plan

Posted by 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.


Health Policy- Reaction

Posted by 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.


Political speed dating

Posted by 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


Cuts to public services- more misleading from Key

Posted by 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.


GST off bananas (and other fresh fruit and vege)

Posted by 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, health, policy, Tax

There is more to health than a league table

Posted by 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.


Rangiora- A Community Standing Up

Posted by 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.