District Health Boards Fail To Respond To Diabetes Epidemic

District Health Boards Fail To Respond To Diabetes Epidemic

Diabetes Awareness Week made a promising start with over 40 MPs (including Tony Ryall, Minister of Health) and 100-150 parliamentary staff attending a blood glucose testing and diabetes awareness event in parliament but, as Awareness week comes to an end, a very different story starts to unfold.

Surveys conducted by NZSSD (New Zealand Society for the Study of Diabetes) and Diabetes New Zealand illustrates how DHBs (District Health Boards), right across the country, are failing the rapidly increasing number of people with diabetes in New Zealand by making significant cut backs to diabetes specialist services.

In addition to these eight examples, most other DHBs, GP groups and diabetes centres around the country are struggling to achieve nationally and internationally agreed standards of care, despite overwhelming evidence that such treatment is both beneficial and cost-effective.

While there has been a welcome improvement in diabetes detection rates, GPs and general practice teams are stretched by the workload of the cut backs and specialist treatment for diabetes patients with complex needs has been largely neglected.

This will have an increasing and inevitable impact on diabetes diagnosis and its long-term complications (kidney failure, amputation, blindness, premature heart disease and stroke). The inadequacy of such services will also particularly impact on the growing number of high-risk groups including our Maori, Pacific and Asian communities who disproportionately experience these outcomes.

“The recent independent OECD report shows New Zealand is second worst among nations studied for life years lost to diabetes, not to mention the devastating personal effects of kidney failure, amputation, blindness and early heart disease – all of which are worst in our Maori, Pacific and Indo-Asian communities. We absolutely need to invest enough in quality diabetes care - both at community and specialist levels - to avoid these largely preventable disasters. The DHBs are largely not responding to the size and severity of the problem, especially in the Upper North Island. Many places do not have expert podiatry, nursing, dietetic or physician services, in others they are often limited and inadequate for the fast-growing number of people with diabetes. Failure to prevent and manage diabetes and its long term complications will cost hundreds of millions of dollars in the long term, as well as the tragic personal outcomes”, Paul Drury, Medical Director NZSSD

Diabetes in New Zealand has almost doubled in the last ten years from about 110,000 people in 2001 to over 200,000 in 2011. The average increase in prevalence is approximately 8-9% per annum over the past year with the highest growth in Auckland (about 14%). The Ministry of Health (MoH) has confirmed that diabetes is a top health priority and the Diabetes Policy Model, reveals that nearly half a million people will have diabetes by 2036.

Despite suggestions by the Auditor General on how DHBs might improve their diabetes services, many District Health Boards (DHBs) across the country are failing to respond to this increasing need and some are instead cutting back on services at the expense of the growing population in New Zealand with diabetes.

"Whilst we understand the need to reduce health spending, we are disturbed and concerned that diabetes seems to have been targeted given the increasing number of people affected and the growth of diabetes complications which requires urgent investment rather than cutbacks", Pauline Giles, Chair, Diabetes Nurse Specialist Section, New Zealand Nurses Organisation

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