5 July 2001 Speech Notes
Asthma New Zealand nursing course inaugural graduation
Thank you for your invitation to speak today. It is a pleasure to be here to acknowledge the achievement and
hard work that has seen you successfully obtain your Certificate of Asthma Care. I would also like to offer my
congratulations on the initiative and effort that has gone into the development of this nursing course. This course, as
I understand it, is one of only two tertiary accredited asthma nursing courses offered by distance learning in the
world.
I want to stress that one of the key issues for this Government is developing a collaborative culture between
healthcare groups and organisations. We want them to build from each other's strengths to deliver the best possible
services for New Zealanders. The collaboration between Asthma New Zealand and UNITEC is an example of how two
organisations can work together on a mutually beneficial project, with excellent results.
I am pleased to support this new qualification, as I believe that by encouraging effective self-management of
asthma, a community health education programme has a real chance of making a difference and reducing the effects of the
condition in New Zealand.
This event is important because it picks up on several strands of the new public health service:
● It encourages collaboration between different organisations
● It shows the importance of primary healthcare and preventative care in particular
● It recognises that nurses can play a far greater role in healthcare in the future
● It also recognises that special efforts need to be made to help health professionals within rural areas.
Most of you will already understand the broad outline of the way in which the Government is working toward improving the
health of New Zealanders. Successful implementation of the New Zealand Health Strategy is a key to the process of
change.
This strategy was released in December 2000 after a period of extensive public consultation. The strategy sets
out the direction for action on health by providing a unifying nationwide framework within which the health sector will
develop. I know nurses support the strategy’s broader goals of improving the health status of New Zealanders, reducing
inequalities, emphasising public accountability and improving coordination in the health sector.
The Primary Health Care Strategy involves a new direction for primary care, with an emphasis not just on the
day-to-day care of people when they are unwell, but also on health education and prevention, with a focus on population
health, health education and promotion, and community partnership.
The model that has been decided is that Primary Health Organisations will be formed as non-profit bodies to look
after primary health care needs of a defined population. PHOs will involve different health practitioners, and local
communities will have a say in their governance, to ensure local views and priorities are taken into account. It is
expected that some DHBs will establish PHOs in the second half of this year.
I believe there are some very positive opportunities presented by the Primary Health Care Strategy. General
practitioners, nurses and others will network together in PHOs covering a population of people who have enrolled with
them.
There will be more emphasis on developing workable models of teamwork, and recognising the complementary skills
of others, as well as sharing power in order to achieve group goals.
Nurses will play a critical role, and through the national nursing project, nurses themselves can create a
framework for how their practice can achieve better health gain, while working in primary health care teams.
Continuity of care will also be important in PHOs, especially for those with long term conditions, the elderly,
and families with young children, where they can get to know a small team of nurse, doctor and others for their primary
care needs. I am convinced such co-ordinated services will improve the health of New Zealanders.
Which brings me back to asthma, one condition that highlights health inequalities. Although asthma is very
common in New Zealand, and a wide range of New Zealanders are affected by it, Mäori and Pacific children suffer the
most.
Mäori children are more often hospitalised with asthma than other children. Their hospitalisation rate is more
than twice the rate of non-Mäori children. Pacific children also have a high rate of hospitalisation from asthma. Access
to primary health care and subsequent good personal management of asthma are important components of reducing this
disparity. Adequate preventive medical care and asthma management by children and their families is important for
effectively controlling asthma and preventing severe attacks.
Asthma affects approximately 1 in 6 New Zealanders, usually beginning in childhood. It is a concern that,
although it is part of a worldwide trend, the prevalence of childhood asthma in New Zealand has increased over the last
20 to 30 years. An estimated 44 percent of New Zealand children experience asthma symptoms at some time before they are
15 years old.
Fortunately, few New Zealand children now die from asthma, although a lot are hospitalised. Improved medication
and clinical management of asthma has played a big part in preventing deaths.
This Government is committed to reducing the incidence and impact of asthma in New Zealand and to reflect our
commitment this aim is included as an objective within the New Zealand Health Strategy listed under the goal of ‘Better
Physical Health’.
I am very supportive of asthma groups identifying ways to work co-operatively with each other and with health
professionals to achieve this aim, particularly in the primary care environment.
Our commitment to addressing the issue of asthma is also reflected through the former HFA’s investment of $2.7
million in 1999/2000 for a disease management initiative. This money is being spent around the country on a number of
service projects and relevant training for nurses through our national asthma organisations. Other initiatives in the
area of asthma include the development of clinical indicators for asthma, and meetings of a national asthma working
group, which is being run by the New Zealand Guidelines Group.
The money spent on asthma through the disease management initiative is only a small portion of what is spent on
asthma by the government. Overall, we spend approximately $71 million in direct care costs for asthma. This money is
spent in various areas, such as the provision of asthma drugs, GP services, hospital services, and emergency department
services.
More people need to be given the best asthma management advice and referred to their local health professional.
The Certificate in Asthma Care course encourages collaboration between doctors and practice nurses to improve the
management of patients with asthma at a primary care level. Long term this means that asthma will be better managed, and
also more cost-effectively at a community level, rather than through emergency hospital admissions.
For many of you, this course is the first study you will have undertaken since you received your nursing degrees
some years ago. I understand the flexibility of distance learning, by being able to study without too many lifestyle
disruptions, has been part of the success of the course. In addition, the opportunity for practice nurses to access the
course at no charge, via funding from the Ministry of Health, has also encouraged a return to study.
I am pleased that this course reinforces the importance of life-long learning and the opportunities that exist
for practice nurses to play a more pivotal role in community nursing.
Another advantage of distance learning is that it enables nurses working in rural communities to access tertiary
level education, which I am very supportive of.
The health sector’s ability to recruit and train competent staff, who remain the sector’s most important resource, is
very important to the government. To address health workforce and training issues, the Health Workforce Advisory
Committee has been established, and had its first meeting in May.
This Government is committed to providing excellence in healthcare, in all its facets, to all members of the
population. That is why this course, and ongoing training and education of our health workforce, is so important.
Thank you to everyone who has contributed time and resources into developing this course and to all of you who
have worked so hard to obtain this qualification. You can be very proud of your accomplishment, and our health system
will be well served by this investment in the management and care of asthma by health professionals.
Thank you again for inviting me to attend this inaugural graduation. I wish you every success for the future,
and I am very pleased to be sharing this proud moment with you.
ENDS