2011 July archive at Grant Robertson

Archive for July, 2011

I shouldn’ve have looked after my teeth

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.

Posted in Teeth and Dental Policy. | 0 Comments

What job has Key offered Brash?

July 20th, 2011

The cosy behind the scenes deal between National and ACT in the Epsom seat raises the question as to what other deals have been made between John Key and Don Brash in the run up to the election.

This morning we had the bizzare spectacle of Don Brash telling Radio New Zealand (story 6.35) he has had discussions with John Key about a deal in Epsom, and John Key trying to deny to Newstalk ZB that a decision has been reached about deal of the electorate vote.

Of course a deal has been done. But the real question is what Cabinet role he has offered Don Brash if National is re-elected.

The discussions Key and Brash have been having will have included what role Key might offer Brash. Its quite clear that if National is re-elected, Don Brash will be a Cabinet Minister, and will bring his extreme and divisive policies to the table. Its time for Key to be upfront about their discussions so that voters can make their choice in November fully aware of the role ACT would play in any future National led-government.

Also interesting in a later Radio NZ piece this morning were the voters in Epsom who were “irritated” felt “taken advantage of” and saw ACT as “National in disguise“. They all know that once again they are being taken for granted. It shows a lack of respect to them form National and ACT that they are not being offered a real choice by these two parties. The only real choice for Epsom voters will come from a Labour candidate.

It is arrogant of National and ACT to put up the biographer (Goldsmith) and his subject (Banks) as their candidates. It is a faux contest between two friends, and two parties who are hand in glove. With the Brash coup and the Banks/Goldsmith stitch-up it is becoming hard to tell where National ends and ACT begins.

Posted in Epsom, Brash and John Key. | 0 Comments

Shared Services- Across the ditch

July 19th, 2011

There is a lot of work going on inside the public service in New Zealand around the idea of shared services. On the surface this looks like a good idea. There are sure to be efficiencies to be found in bringing together systems and some purchasing practices. But we need to go into this with our eyes open. For instance some of the government’s purchasing contracts are shutting out smaller New Zealand companies.

And now a second Australian state has run into trouble with trying to merge payroll, HR and finance systems. This time it is Western Australia where the government has been forced to pull the plug on the new state wide payroll and finance system. It was meant to cost $82 million to set up and save $50 million a year, instead it has cost $440 million since 2003, and “saved” $42 million over the whole eight years. Premier Colin Barnett has called it “one of the great bungles of public administration.” In Queensland there was another massive cost blowout when their new payroll system collapsed.

DIA is leading the work for some massive shared services projects here. The Health sector is alive with them. Treasury, SSC and DPMC are about to launch into a shared services arrangement. Other big arrangements are in the wind. There might well be good value in some of these but there should be a good dose of caution as well.

Posted in Shared Services, Australia and Public Services. | 0 Comments

Sir Michael Marmot - Health Equity

July 14th, 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.

Posted in Michael Marmot and Health. | 0 Comments

25 years ago today

July 9th, 2011

When Trevor Mallard holds up his fingers in the House, it might not always be a friendly gesture, but on the night of July the 9th 1986, his gesture of holding up 5 fingers confirmed to supporters in the Gallery that the Homosexual Law Reform Bill had a majority of five and would pass into law. Trevor was the numbers person for Fran Wilde, the Bill’s sponsor. Their work in Parliament, supported by the likes of Ruth Dyson who was working for Fran, and other Parliamentarians was one element of the success of the campaign.

The other was the grassroots movement from right around New Zealand that kept the pressure up for law reform. In Wellington people like Bill Logan, Alison Laurie and David Hindley were the leaders. The marchers were not just gays and lesbians but their families and supporters who withstood awful hate and prejudice to demand the basic right of consenting adults to live their lives free from potential criminal prosecution.

I wasn’t in Parliament that night or in Wellington. I was a 14 year old living in Dunedin. I do remember the campaign on the Bill. My family was active in the Presbyterian Church, and the anti law reform petition did the rounds at a number of church events. I was interested in the outcome of the debate and years later when I was moving out of home I found I had clipped from the newspaper who had voted for and against the Bill, though I have no memory of doing so.

But the real impact for me of the Bill is that it has allowed me to grow up and live my life freely. That is not to say that there is not still discrimination and stigma for gay people, because it is still very real for some people. But for me, sitting here as an MP, I have been able to pursue my dreams and goals, and live my life as I choose in part because of those people in Parliament and outside, who campaigned so hard 25 years ago. It is a curious twist that the fact that I can be an MP and not focus on my sexuality, but on the whole of my beliefs, values and policy is a result of all those who stood up for what was right. I, and many others, owe them all a huge debt of gratitude.

In any case some interesting articles on the anniversary today, including arch opponent of the legislation Geoff Braybrooke even conceding that his “fears” have not materialised. Its true folks, the world did not end and the sky did not fall in!

UPDATE; Some footage from the time in this clip courtesy of NZ On Screen.

Posted in Homosexual Law Reform. | 0 Comments