UCAN’s advice to political parties on forming a Coalition agreement on Health.
The NZ Health system is in serious need of attention to its heart – the current ticker has been badly neglected, with severe restrictions to its love supply. Signs of ischemia abound but are being ignored. We urgently need to support a compassionate workforce supported by compassionate organisations.
Signs of Health System Ischemia:
Mental Health Patient: “You need to be really fucked up to get help… I guess the budget doesn’t stretch to hope.”
1 million NZers are reporting access barriers to primary care, and the number is increasing each year.
The population’s self reported health status is declining in the most recent health survey, despite increasing life expectancy – we are living longer in poorer health.
Building compassionate health organisations:
Leadership – Senior health leaders need to lead the way.
Critical DHB leadership positions in the Auckland region need separating. Counties Manukau has been merged with the two other Auckland Boards by having a common chair, putting at risk decades of work to ensure effective resourcing of the largest high need population in the country. We need to stop the DHB money flowing from the poor to the rich in Auckland immediately.
DHBs needs to be stopped from sucking community services dry. Currently they are taking money from the community sector ;millions of dollars, away from where where care is most effective and efficient.
On the other hand, small DHBs have been left to wither – they need stronger DHB pairing with larger DHBs on the basis of the patient’s referral pathways. Such pairings need to be structured so that the large does not consume the small unless it really is better for patients, especially patent access.
Free primary medical care available in every community. One million people have an unmet need for primary medical care. The cost of care for these patients is the biggest barrier, including the cost of drugs. There is low availability of primary medical care services, particularly in deprived areas. Barriers are bigger for those with chronic conditions, especially mental illness. A primary health care approach with a focus on equity and social justice is required across the health system.
It needs a more sophisticated response than National’s current plan to up the VLCA scheme for CSC holders. History yells us that only some GPs pass these subsidies on to patients, the rest goes to increasing GP incomes as they maintain their ‘right to charge”. Only some general practices have the passion, the rest will just clip the ticket, and this is becoming more common as family practices are increasingly being replaced by corporate entities. Funding should target practices with a social purpose who do make care accessible to those with most need and who do effectively manage chronic conditions in the community. Where no suitable organisations with a social purpose exist and the needs are high, the government should establish accessible primary care services itself.
Free primary care should be extended to people with mental illness (who currently die 20 years earlier than the rest of the population not from their mental illness but from chronic diseases).
Free primary care for the frail elderly. We must guarantee universal access to care for our elders group in their final years. Often that care is best provided in the community and this is where the support is required.
A specific rural health investment fund is required for remote rural areas to support community based services, starting with Northland, Rotorua and East Cape, based on their high health need and geographic isolation.
 NZ Treasury 2016.
Over the last month UCAN chair person Debbie Leyland has asked each political party if they would consider endorsing the UCAN Health Charter.
UCAN members look forward to meeting with these parties after the election to make the UCAN Health Charter a cornerstone in a health system we can all be proud of.
UCAN also would like to take this opportunity to acknowledge the public endorsements of the NZNO – New Zealands Nurses Organization, The Equality Network, Porirua Union and Community Health Service, Hutt Union Health Service, Newtown Union Health Service, Department of Public Health at the School of Otago in Wellington, the Wellington branch of the Public Health Association and the College of Nurses Aotearoa NZ.
UCAN is affiliated to no political party.
On Wednesday 22nd August UCAN made the following presentation to the CCDHB Governance Board.
Good afternoon. I will speak to the item about the ‘Citizens’ Health Council’.
The UCAN network strongly supports the moves the Board is making to draw on the knowledge and concerns of the residents of the District.
We also know from experience that it is not easy to facilitate productive public discussion in this political environment.
As most Board members know we have contributed to the public discussion of Health by drafting a Health Charter.
The Charter has been endorsed by a majority of the members of this Board, a dozen well known organisations and three political parties.
We produced the Charter because the equity of primary health provision – I mean ‘primary health’ defined broadly – was being undermined in the Capital and Coast District.
We noticed that the changes in Capital and Coast planning and funding were favouring people with the money, knowledge and day to day capabilities to manage their access to health services.
We were particularly concerned as community and union health services suffered a series of cuts and restructurings that changed the nature of primary health care.
For example, the disappearance of integrated, locality-based models for primary health such as SECPHO.
We doubt that the efficiencies being driven by the national consortium of General Practices as ‘Health Care Home’ are designed for or by high needs populations.
Given these kinds of national strategies, we also note that the logic of your funding arrangements seems to encourage the Board to prioritise the needs of your predominantly low NZ Dep populations.
There are deprived populations in this District, perhaps not as geographically concentrated as in other Districts.
Our other principle concern is provision for group living and day time activity for people with enduring mental illness.
We regard the events that led to the closure of Mahora House has a scandal that has not been addressed properly. A year has past since the Board received the Mellsop report.
However we acknowledge and support preparatory work done by this Board to consider improvements across the system for people with mental illness.
We suggest that the two issues I’ve raised – primary health care for high needs populations and residential and day provision for people with mental illness – should be early items on the agenda of the Citizens’ Health Council.
We also suggest that you call for nominations to the Council so that those who cope with the situations I have described have an opportunity to influence and validate the selection process.
A nomination process would also increase the likelihood of forming a genuinely diverse and creative Council.
Objectives of DHBs
Every DHB has the following objectives:
(a) to improve, promote, and protect the health of people and communities:
(b) to promote the integration of health services, especially primary and secondary health services:
(ba) to seek the optimum arrangement for the most effective and efficient delivery of health services in order to meet local, regional, and national needs:
(c) to promote effective care or support for those in need of personal health services or disability support services:
(d) to promote the inclusion and participation in society and independence of people with disabilities:
(e) to reduce health disparities by improving health outcomes for Maori and other population groups:
(f) to reduce, with a view to eliminating, health outcome disparities between various population groups within New Zealand by developing and implementing, in consultation with the groups concerned, services and programmes designed to raise their health outcomes to those of other New Zealanders:
(g) to exhibit a sense of social responsibility by having regard to the interests of the people to whom it provides, or for whom it arranges the provision of, services:
(h) to foster community participation in health improvement, and in planning for the provision of services and for significant changes to the provision of services:
(i) to uphold the ethical and quality standards commonly expected of providers of services and of public sector organisations:
(j) to exhibit a sense of environmental responsibility by having regard to the environmental implications of its operations:
(k) to be a good employer in accordance with section 118 of the Crown Entities Act 2004.
Great reportage from Virginia McMillian, Journalist from NZ Doctor magazine:
Virginia McMillan firstname.lastname@example.org Tuesday 15 August 2017, 3:31PM
Patients’ experiences living on low pay and in cold, overcrowded houses are too common, Hutt Union Community Health Service chair and Living Wage New Zealand committee member Muriel Tunoho says.
Both the organisations that Ms Tunoho serves have endorsed a Health Charter (see illustration) that proposes liveable incomes and homes as rights for all. The charter was today handed over to Labour MP Grant Robertson outside Parliament.
The charter, developed by the United Community Action Network, received the support of Mr Robertson and New Zealand First’s acting health spokesperson Ria Bond.
UCAN sees the charter as a founding document for health. Coordinator Debbie Leyland told the small gathering in the Parliament grounds it was a challenge by which to hold to account all MPs and political parties.
Ms Leyland says the typical waits of two months for mental healthcare (“if you’re lucky”) are not acceptable, and nor are the country’s high rates of suicide, homelessness and mental illness.
One tangible way to address poverty
Ms Tunoho says the living wage is one tangible way to address poverty. The point was underscored by Paul Barber, NZ Council of Christian Social Services’ policy advisor, who said benefits were too low and beneficiaries’ health suffered the most.
“One of the best health treatments is to lift benefits and lift incomes for the lowest-income people. It’s the simplest treatment and it can be administered tomorrow if we want to,” Mr Barber said.
Instead, the Government was arrogantly paying down debt “with the anguish of the poor”.
Thirty-seven organisations belong to the Equality Network, which has endorsed the UCAN charter, he said.
More funded visits for children – NZ First
Ms Bond said her party wants to lift the funding for under-13s care to cover three visits a year, and to raise the age at least to 15.
Mr Robertson said equitable access to healthcare was a mark of a decent society.
Speaking for the Tick for Kids and the Child Poverty Action Group, Lisa Woods called on all political parties to ensure New Zealanders have the resources they need to thrive.
Child Poverty Action is a signatory to the charter, as are the Public Health Association, the public health department of the University of Otago, Wellington, the three Wellington union health clinics and the NZ Nurses Organisation, among others.
NZNO president Grant Brookes says the organisation welcomes the charter, “a refresh of the original primary healthcare vision”, and its focus on population health and eliminating disparities.
United Community Action Network (UCAN) press release
For immediate release
Monday 14 August at 7am
Health charter to be delivered to parliament
The United Community Action Network (UCAN) will deliver it’s health charter to parliament tomorrow, Tuesday 14 August at 1230pm on parliament grounds.
The College of Nurses, low-cost health providers, The Equality and Living Wage Networks and the Public Health Association Wellington branch are some of the groups who have signed the charter.
The charter calls for the right to: health care, a living income, a safe and healthy home, the ability to take party in society, a safe environment and an education.
UCAN is a national grassroots health rights organisation based in Wellington.
The group’s spokesperson, Debbie Leyland, says the growing gap between rich and poor sits next to health under funding as the country’s biggest health concerns.
“More and more people are being denied health care because they can’t afford it,” she says. “Poor housing, homelessness and low wages and benefits are as big a health problem as our growing waiting lists and number of people who need surgery but can’t get on a list.”
New Zealand has enough wealth to provide for all citizens but wealth is “poorly distributed”, she says.
“The provision of basic rights for all citizens just isn’t a priority.”
Leyland is calling on all political parties to support the charter.
Labour party finance spokesperson, Grant Robertson, Green Party social development spokesperson Jan Logie will speak at the presentation alongside representatives from Child Poverty Action Group, The Equality Network and The Living Wage Network.
It is essential that the issue of reducing inequality remains forefront with an election breathing down our necks. Any inaction on concrete and committed longterm planning to reduce inequalities will continue to have long-reaching impacts for those who live in the harshest of conditions in Aotearoa.
It is essential to keep the pressure up.
Image: Screenshot of Radio NZ page