Friday, September 26, 2008

 

Diploma class in public health panel - 23 September.


Kia ora,

I'm Gareth Hughes, the Greens' candidate for Ohariu and number 11 on the Green party list. Speakers more experienced and knowledgeable than me – Green MP Sue Kedgley gives her apologies she couldn't be here today.

I'm a 26 year old environmentalist and former Greenpeace-activist. I work for the Greens parliamentary team on climate issues and I am also a part time student in Wellington. I’m also a dad to my one year old son, Arlo

I’m pretty happy to say that I haven’t been to hospital since I was a baby and the closest I’ve been to personal injury is a few stitches and a broken nose from rugby. I have however become a health consumer over the last year with the birth of my son. We decided to avoid the hospital track and instead my wife gave birth to our son at home which was a fantastic experience made all the better because of the great relationship struck up with our midwife over the preceding 6 months.

I guess this frames my understanding – my partner wasn’t sick or at risk so we didn’t go to hospital, and we took advantage of the availability to choose the best care for our situation.

Today I am going to talk about preventative health, obesity and food, valuing health workers and briefly on complimentary health.

To start with I would like to discuss what frames the Green Parties understanding of health. Our policy, which I will explain shortly, is developed by our members. Rather than being made in smokey back rooms with health industry lobbyists hanging outside the door our policy is made out in the open by the members both at bi-annual conferences and in regular discussions.

All of the Green Party’s policies are based on four values or principles –ecological wisdom, social justice, non violence and democratic decision making

I’d suggest that Greens see all issues, and health as no exception, as interconnected; as holistic. That means we don’t just look a disease or a patient we look at the broader picture – the environment, the socio-economic status, the disease, whanau, the living environment - all together, and see the emphasis needing to be placed on the causes of ill-health.

Health as a political portfolio is often seen as just a ‘political football full of problems’ – trying to treat waiting lists, diseases, budget over runs, strikes, illnesses, and death. However the Greens view health in a different paradigm - we see it as a question of wellness.

Others will talk of cutting health beauracracy –easy to say, but only the Greens say look at the causes, that’s the only way we are actually going to increase the health of the nation.

I’d like to start with this definition - Whare Tapa Wha — A Maori model of health described by Mason Durie, where the four components of health - te taha tinana (physical), te taha wairua (spiritual), te taha hinengaro (mental and emotional) and te taha whanau (social — family and community, represent four walls of a house. If one of these walls fails, the house will fall.

Health is also about personal responsibility. We need to empower people to take greater care of themselves. For example, simple changes, such as children spending less time in front of TV, and adults and children spending less time in cars and more time walking, cycling and eating more fruit and vegetables and less salt, fat and sugar, will increase wellbeing and health.

All of these issues are interwoven — if we want people to exercise more and ensure children have a healthy nutritious diet we need to ensure that our society works in such a way that these important things are promoted. We must create a situation where healthy living is supported and encouraged in workplaces and communities.

Preventative Health

If I would have you go away from today’s talk with one concept that best sums up what the Green perspective on health is, I hope it would be that the Greens stand for preventative health.

Last week I did a similar debate at the Law Society on justice issues; like health, I’d ask where is it best to use our scare resources – all in treating the outcomes or some earlier on in prevention? Just in short term band aids or actual long term remedies?

I’d ask you all to keep tuned to the news and to check out the Greens website – www.greens.org.nz because shortly Green health spokesperson Sue Kedgley will be launching a major preventative health policy package.

The Green Party preventative health strategy focusses on policies that would keep Kiwis well and prevent them from becoming ill in the first place–such as ensuring our homes are warm and dry, not damp and cold. I’m stoked that we have secured a billion dollars of funding through the Emissions Trading Scheme to insulate homes around New Zealand.

At present almost all of our $12 billion health budget is spent on treating people once they have become ill. We want to see a radically different and much more holistic approach to health—one the 4 walls of the whare that Mason Durie spoke about,

We support progressively increasing funding to prevent illness and injury and promote health, to 10% of the total healthcare budget, commencing with the introduction of a free annual wellness check by a health professional for all New Zealanders.

We also want the free wellness check for every New Zealander, available every year, to help identify illnesses early and focus on nutrition and lifestyle factors, and we want community health and wellness centres set up around New Zealand.

One example where it just makes common sense, is trying to reduce adverse events. We spend roughly $800 million a year treating adverse events – it’s not all avoidable but many are preventable – for example drug compatibility. We support setting up a national reporting register with standardised reporting template – not a name and blame exercise but as a way to foster shared learning across the country.

Health and socioeconomic factors

Our 7th ranked list candidate – West Coast District Health Board CEO Kevin Hague sent me this, and he asked, “try this: think of more or less any illness, disease or injury and draw some conclusions about its distribution in this country and around the world. With very few exceptions ill health and disability disproportionately affect population groups who are in some way disempowered or marginalised in societies.

Yet a traditional biomedical view, that sees disease caused by genetics, chemical imbalances or microscopic organisms cannot explain this. Individualistic approaches to disease that attribute poor health to poor choices and lifestyles (wrong food, wrong substance use, wrong sexual behaviour etc) also fail to explain why individuals from one community are systematically more likely to make bad choices about everything than those from another.

Of course biological risk factors and individual behaviours are important in determining who ends up sick or healthy, but usually neither of these is adequate to explain health outcomes. The fact is that the patterns we actually observe are, instead, strongly related to the control that communities feel over their life circumstances and the physical and social environments in which they live.

The implication of this understanding is that the solutions to health problems associated with these inadequate theories will also fail. If we wish to improve health outcomes we need to empower communities and create environments that support health in a sustainable way.”

Obesity and food

One example of this is the question of obesity. It is the biggest emerging health issue and has the potential to overwhelm public hospitals. We know that poor diet is the leading cause of premature death in New Zealand, and that conversely a good diet is one of our most powerful weapons against disease and sickness, so another goal of our health strategy is to improve the diets of New Zealanders.

We are seeing an epidemic of obesity, with the well known resulting symptoms - type 2 diabetes, heart disease, and more. Almost everyone agrees it’s a problem but I’m not sure if many people have ideas on the solutions. We have put a great deal of work into this area because preventing the problem is much wiser, and cheaper than dealing with it after the fact. We are trying to move the ambulance from the bottom of the cliff to the supporter at the top.

We have created a situation in New Zealand where unhealthy food is cheaper, far more heavily promoted and far more accessible than healthy food, and one of our priorities is to reverse this situation.

As a first step we want to get rid of junk food ads on television, which provide the only nutrition education many children receive; and get vending machines selling fizzy drinks out of schools, extend the fruit in schools programme to all primary schools, and develop gardens in every primary school in New Zealand so children can learn, once again, how to grow and cook food. We were very proud last year to have secured $12 million for a nationwide nutrition fund. And we want to change the way we grow and produce food, to reduce the pesticides and other contaminants we are exposed to, and encourage local organic food production.

The Green Party is also committed to a traffic light labelling scheme which would enable consumers to readily distinguish health and unhealthy food. The Green Party is very concerned that healthy food is becoming unaffordable for many New Zealanders - we support an inquiry into the conduct of supermarkets, and the development of a code of conduct to ensure farmers, suppliers and consumers are treated fairly.

We have also challenged Fonterra to decouple the price of their dairy products sold in New Zealand from the escalating price they can get on the global market.

We believe it is critical that the minimum wage is increased to at least $15 an hour, that core benefits are lifted, that the first $5000 of income is tax free, and a universal child benefit is introduced so that all families can afford healthy food.

Traditional health sector

I know the other speakers today will address the traditional health sector in some detail but I want to quickly touch on one of two of the major issues in the sector – the possible move to towards a greater private model and why we are facing such a crisis in staff in this area.

Aotearoa/New Zealand was the first country in the world to publicly administer and fund health care services, a model which was copied around the world. This commitment has been severely eroded over the past 20 years, resulting in a two tier health care system where the rich can afford quality private services, and the poor face long waits for specialist services.

The Green Party wants a strong public health system that functions effectively, delivers a high standard of patient care, and has sufficient funding for service delivery, administration, and ongoing research and development.

There are critical shortages of health professionals in our health system, owing to the loss of up to a third of our health professions' graduates to overseas posts. Also, there is a shortage of posts in Aotearoa/New Zealand because of the under-funding of health services. The shortage of qualified health care professionals is a factor in long waiting lists for specialist services and causes scarce resources to be diverted to costly overseas and locum recruitment. It is important that the pay and working conditions of New Zealand health professionals be improved.

The Green Party will support improvements in the pay and working conditions of health professionals, including mandatory staff to patient ratios in order to ease nationwide recruitment and retention problems.

We will Increase the number of positions for nurses in the health sector and work with nurses to identify other models to enhance the role of nurses, for example, giving prescribing rights to nurse practitioners. In the aged sector we‘d like to see nurses achieve pay parity with hospital nurses.

Lastly we will introduce lower tertiary fees and a student allowance for all students including those training for health professions. For every year after study of work in NZ will we will write off a years worth of course debt. These would greatly help health professional graduates deal with the mountain of debt they receive studying for a career in the health industry.

Complimentary health

I (fortunately) don’t have many personal health stories to relate to you, but one which I do, concerns complimentary medicines. I was travelling in Sri Lanka a few years ago and for a fortnight I had terrible headaches. I tried all the drugs the pharmacy recommended and none seemed to work. Eventually I was persuaded to go to the village doctor of which I was pretty sceptical of. It was pretty funny, he had his little clinic tucked away down an alley with benches full of glass jars full of different things and he looked all very professional in his white lab coat, but when I looked at the label, it turned out to be a Dulux paint coat.

He gave me an inhalation, a head rub and some herbs for further inhalations from the bush and it cleared me up pretty promptly.

Personally I’m still sceptical of some alternative medicinal practioneers but I’m also aware that at least one in four New Zealanders uses complementary therapies. We want to see traditional or so called complementary healthcare like homeopathy, acupuncture and naturopathy, recognised and accepted throughout health system, and complementary health practitioners working throughout the health system, using whatever treatment is most effective for the patient.

We would establish a Complementary Health Care Unit within the Ministry of Health to facilitate the integration of selected complementary health practices and therapies into the public health system.

Conclusion

I would like to thank you very much for listening to me today and wish you all the best of luck in your studies and careers. Health is always going to be a major election issue and rightly so – it is so very important. Today I’ve discussed the Greens holistic approach top health, our focus on preventative approaches – for example in terms of housing and diet; the need for a strong public health system that values staff and removes debt off graduates and why complimentary health needs to be incorporated into the wide health sector.

The Greens bring new and fresh ideas to the table and realistic, positive solutions to health. I think our 6 MPs have a fantastic track record of achievements in parliament and I would like to see another 6 more. The only way for that to happen is for you to party vote Green.

Thank you.



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