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Archive for the 'Health' Category

Rangiora- A Community Standing Up

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.

Posted in CLayton Cosgrove, After Hours GP and Health. | 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

Childrens Health Camp Stamps

July 7th, 2011

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.

Posted in Zealandia, Health Camps, Children and Health. | 0 Comments

When more means less

March 20th, 2011

Busy day today, so I only managed to catch up with John Key’s interview on Q and A just now. It seems the big story is that the (revised) new spending allowance in the Budget is gone.

GUYON Are you still going to spend $800 million more in the May Budget?

JOHN Well, I think the answer to that is no. What we are going to do is spend more on health and education. That may well be in the order of 600, 700, 800 million, but we are asking ministers and what they are working on is looking to reduce expenditure in other areas so that can be reprioritised to pay for the more in health and education we want and ultimately the Christchurch earthquake.

Leaving aside, for a moment, the thought of what is going to be cut in other areas (think housing, social development, Police etv) it could be easy to say, thank goodness that health and education will get more money. But with the sums of money John Key is talking about this will effectively be a massive cut for both sectors.

Let’s take Health. Before last year’s Budget , the CTU calculated just for spending to stand still it would take at least $555 million a year of new spending. The Budget fell at least short on that figure by more than $150 million a year, and that has delivered health cuts across the sector.

Add that investment deficit to what is required for this year just to stand still and John Key’s delightfully vague numbers above indicate that there is no chance of health getting anything like the money it needs. And remember that is not for any new services, wage increases etc. It is just to stand still.

We are going to hear a lot of spin in the next month or two about money going to health and education, but on the PMs words today it is cuts on the way. There will also be spin that anyone who proposes government spending is somehow committing economic heresy.

Of course we need to adjust to the new reality of the economy post-earthquake. It does require careful economic management, which might actually include sensible investments (spending) in our future. It needs to include support for innovation and job growth, and to give opportunities to future generations. What it does not need is a slash and burn mentality.

Posted in Economy, Health, Budget and Education. | 0 Comments

Where to in Health?

August 8th, 2010

In Wellington we woke to the news on Friday that Ken Whelan, the Chief Executive of the Capital and Coast District Health Board had resigned. In his farewell email to staff Whelan said

there was no more room to cut the district health board’s costs, despite Government pressure to do so. “I cannot see where any more major efficiency can come from without negatively impacting on services.”

Even Sir John Anderson, the government’s appointment to Chair the Board has said that any further savings “would cut into muscle”.

I have had a bit to do with Ken over the last 18 months or so that I have been an MP, and I regard him very highly. He listened, he was honest, and had a very good grasp on what was happening within the DHB. When he sounds the warning he has made on his departure, the government should listen. The two areas where I have the biggest concerns in Wellington are mental health and public health where cuts are starting to have an impact. In Mental Health this will get worse with the closing of the two community clinics in the city and Kilbirnie set to cause significant disruption to service, despite the best efforts of the staff involved.

When we combine what is happening in Wellington, the public uprising over neurosurgery in Dunedin, the at least 80 cuts to frontline services elsewhere across the country, as highlighted by my colleague Ruth Dyson, and the fact we still do not have a Director-General of Health in place, questions have got to be asked about where Tony Ryall is taking Health. It is never going to be easy. Maintaining and developing health services with an ageing population, increased costs and understandable public desire for locally accessible services is a tough ask. But it needs leadership and it needs to get beyond glib answers in Parliament.

A place to start? Of Capital and Coast’s $47 million deficit, $37 million of it relates to the building of the regional hospital. A senior health professional I spoke to on Friday noted that other DHBs with financial issues are also in this state because of costs related to the buildings. A chunk of this is due to the capital charging regime. I think we need to re-look at the capital charging regime. Of course we want DHBs and other government entities to be efficient in their use of buildings and capital, but if it starts to mean cuts into core medical services, we have to question if the priorities are right?

Posted in Health Cuts, Public Services and Health. | 0 Comments