Labour On Health
INTRODUCTION
Labour’s vision for a healthier New Zealand is being realised. We are putting resources, staff, funding and
infrastructure into rebuilding a public health system that people can trust, and that will be there for them regardless
of their ability to pay. We will continue to implement the Mental Health Blueprint as quickly as development of a
trained mental health workforce allows. Most importantly, Labour is committed, through its vision for primary health
care, to keeping people well within their communities. We do not believe it makes sense to treat people in hospitals
when they could have been kept well and out of hospital in the first place. We will continue to work to reduce
inequalities in health status, and to take an approach that recognises that poverty, poor housing, unemployment and the
environment all have a considerable impact on health. Labour will continue to rebuild a healthier society in the widest
possible sense.
Labour will work with communities and the health sector to take a strategic, planned approach to improving the health of
New Zealanders. It will take some time to turn around all the negative consequences of the market approach to health in
the 1990s, but we are already seeing the benefits of our new approach in terms of reduced waiting lists, more health
professionals in training, and better relationships and morale in the health workforce.
Labour’s top priorities for its second term will be to:
- Improve access to quality primary health care.
- Continue to reduce waiting times for elective surgery.
- Further improve mental health services.
- Implement the New Zealand Health Strategy, concentrating on its 13 population health goals.
ACHIEVEMENTS TO DATE
In its first term the Labour led government has pieced together the building blocks to restore a public health system
that works again for all New Zealanders. Our major achievements include:
- Keeping our promises by reducing waiting times and providing a health service that focuses on patients, not profit.
Elective surgery figures for October to December 2001 show 16,478 patients were waiting more than six months for
treatment, less than half the 33,736 people who were waiting in the same period in 1999.
- Developing a comprehensive strategic and planned approach in key areas of health. The most important strategies and
plans are the New Zealand Health Strategy, the New Zealand Disability Strategy, the Primary Health Care Strategy, He
Korowai Oranga Maori Health Strategy, the Pacific Health and Disability Action Plan, the Palliative Care Strategy, the
Positive Ageing Strategy, the Health of Older People Strategy, the Youth Development Strategy, the Youth Suicide
Prevention Strategy and the Oral Health Strategy.
- Passing the New Zealand Public Health and Disability Act, restoring local democracy to health decision-making through
elected District Health Boards (DHBs).
- Establishing a three-year funding path of more than $3 billion in new baseline money to allow DHBs to plan health and
disability services with certainty. Elements of new funding include:
o ongoing funding for implementation of the Mental Health Blueprint
o $400 million over next three years to begin implementing the Primary Health Care Strategy
o more than $32 million over next three years in rural health initiatives
o overdue adjustment of funding of GP services for children under six to cope with inflation since 1997.
- Tackling workforce issues by:
o establishing the Health Workforce Advisory Committee
o reinstating enrolled nurses, with the first course beginning in July 2002
o investing more than $8 million in developing new models for nursing in primary health care
o sharply increasing the number of radiation therapists in training, up from 16 in 1999 to 38 this year
o establishing the overseas doctors bridging programme at a cost of $11.8 million
o creating more than 800 additional positions in community mental health services.
- Committing up to $200 million over five years to develop a vaccine to beat New Zealand’s Group B Meningococcal
epidemic.
- Funding Plunketline as a free, 24-hour a day, nationwide telephone service.
- Increasing provision of pharmaceuticals, including beta-interferons for Multiple Sclerosis sufferers and
cholesterol-lowering drugs.
- Introduction of the mobile surgery bus.
- Establishing the diabetes “Get Checked’ programme. So far 40,000 New Zealanders have had a free check.
- Providing $17.8 million so far to improve access to, and uptake of, oral health services for all children and
teenagers up to the age of 18.
LABOUR’S TOP PRIORITIES IN THE SECOND TERM
PRIMARY HEALTH CARE
Labour will:
- Improve access to quality primary health care by implementing the Primary Health Care Strategy. This will provide
affordable primary health care to all New Zealanders over the next eight-ten years.
It is estimated that up to a third of hospital admissions for people under 75 are avoidable, and of those two thirds
could have been avoided with earlier access to effective primary health care. The number of hospital admissions per 1000
each year for Maori people could drop from about 115 to 85, and for European and other ethnic groups from around 85 per
1000 to 70.
Initially, Labour will reduce the cost of primary health care for high health need, low income people. This will be
followed by the extension of cost reduction to all New Zealand children and to older people. Elements of the policy
include:
- Allocation of $400 million of new money over the next three years. In the next year alone, we will reduce the cost of
access to primary health care for at least 300,000 New Zealanders.
- Phasing out the Community Services Card over the next eight to ten years, but retaining it as long as it is necessary
to protect vulnerable New Zealanders.
- Establishment of Primary Health Organisations (PHOs) as the key mechanisms for District Health Boards to meet the
needs of their populations.
- Encouragement for all health professionals to work together within PHOs to provide quality coordinated care for
enrolled population. This will help ensure the full range of health professionals like doctors, nurses, pharmacists,
nutritionists, physiotherapists, mental health workers and others are able to contribute effectively in new and
innovative ways.
- Support for the development of services by Maori and Pacific providers.
ELECTIVE SURGERY
Good progress has been made in reducing waiting times for both elective surgery and first assessments, but more still
has to be achieved. In the next three years, Labour will ensure that there is consistency across New Zealand, that
no-one waits for more than six months either for first assessment or for surgery following assessment.
To achieve this, Labour will:
- Promote nationally consistent clinical assessment procedures.
- Encourage better liaison between primary and secondary sectors to ensure patients receive appropriate priority.
- Promote preventative services to reduce the need for elective surgery.
- Actively manage the sector’s performance and publish on a regular basis up-to-date information on the performance of
each DHB.
MENTAL HEALTH
The Mental Health Commission’s Report on Progress 2000-2001 towards implementing the Blueprint for Mental Health
Services in New Zealand says:
“With continuing Government support and the first year of additional funding announced in the Budget of 2000, services
have increased in many areas and quality initiatives have been consolidated. Further funding increases over the next two
years will bring services closer to the levels established by the Blueprint so as to ensure that in the future the
country will be able to meet people’s needs when they have a serious mental illness.”
Labour is investing $257 million over four years for mental health services to continue implementing the Blueprint and
will ring fence all mental health money, including both baseline funding and Blueprint money.
Labour will
- Continue to implement the Blueprint by:
o rebuilding the mental health workforce
o developing regional mental health networks to coordinate and plan services on a regional basis
o ensuring a fair distribution of mental health funding across regions
o continuing to meet the housing needs of mental health consumers.
- Continue the new funding of Drug-Line to go alongside the alcohol information line and, over the next three years,
more than $20 million will be spent on public information and treatment services for problem gamblers.
RURAL HEALTH
Labour is now clearly the rural health party in New Zealand. Labour introduced the rural locum scheme and the rural
practitioner support scheme, the mobile surgical bus and other mobile services, and the Healthline service.
Over the next three years, GPs, nurses and other health workers serving rural communities will receive extra funding of
more than $32 million in new money. The money is in addition to the $4 million allocated to the rural bonus scheme and
$1 million in each of the next two years for the rural locum scheme. It is also in addition to funding for primary
health care to be delivered through Primary Health Organisations (PHOs).
The new rural primary health care premium will be in two parts. The first will enable extra payments to support primary
health care workers to stay in rural areas, and the second will enable those practising in such areas to maintain
reasonable on-call rosters.
Labour will:
- Extend Healthline throughout New Zealand following successful evaluation of the pilot programmes.
- Extend the overseas doctors bridging programme for another three years, amending future Deed Bonds to require the
doctors to work in rural New Zealand and other areas of greatest need.
- Develop a similar bridging programme for overseas dentists.
- Provide a sewage treatment subsidy scheme from 1 July 2003, to help small to medium communities upgrade or build new
treatment plants. The scheme also covers new works to add fluoride to community drinking-water supplies where
communities choose to do so.
- Co-operate with local authorities to enhance the provision for rural health services.
PROMOTING A POPULATION HEALTH APPROACH
The New Zealand Health Strategy identifies a number of public health goals essential to improving the health of New
Zealanders. Labour will ensure these goals are a priority for District Health Boards and Primary Health Organisations,
which will be expected to work closely with their local communities.
The goals are:
- Reducing smoking.
- Improving nutrition.
- Reducing obesity.
- Increasing the level of physical activity.
- Reducing the rate of suicides and suicide attempts.
- Minimising harm caused by alcohol and illicit and other drug use to individuals and the community.
- Reducing the incidence and impact of cancer.
- Reducing the incidence and impact of cardio-vascular disease.
- Reducing the incidence and impact of diabetes.
- Improving oral health.
- Reducing violence in inter-personal relationships, families, schools and communities.
- Improving the heath status of people with severe mental illness.
- Ensuring access to appropriate child health care services including Well Child and family health care and
immunisation.
OTHER PRIORITY AREAS
Child and youth services
The Labour led government has delivered Plunketline as a 24 hour, 7 day a week telephone help and information service;
increased funding for doctors’ visits for children under six years; improved child and youth (school-age up to the age
of 18) access to free dental services; launched the Integrated Approach to Infectious Disease Action Plan 2002-2006,
which aims to fully vaccinate 95 percent of all children by age two by 2005; and increased funding for Youth Suicide
Prevention Strategy. An additional $3.3 million was provided for mental health services for children and young people in
2001-2002, providing 30 more full-time equivalents (FTEs) in the child and youth mental health workforce, on top of 100
additional FTEs funded in 2000-2001. A Perinatal database has been established using data from primary maternity
services with hospital data; and a High and Complex Needs Unit has been situated within Child, Youth and Family to
provide improved services for children and young people with high and complex needs.
Labour in its next term will:
- Adopt a Youth Health Action Plan to ensure better co-ordination of policies and services addressing youth health
issues.
- Continue to provide comprehensive and affordable child and youth health services, to develop Well Child services
through primary health care funding, and to deliver these services to more New Zealanders.
Maori
Labour will:
- Implement He Korowai Oranga Maori Health Strategy, which includes strengthening the partnership with iwi and Maori
communities.
Pacific peoples
Labour will:
- Implement the Pacific Health and Disability Action Plan and will engage in a major new research project with the
Welcome trust on the health of Pacific peoples.
Women
Labour will
- Implement the recommendations of the Gisborne Cervical Screening Inquiry and the National Breast Screening Programme
recommendations, including consideration of extending the age of eligibility to older women.
- Continue to provide free maternity services, and address issues raised in the CEDAW report.
Men
Labour will:
- Consult with men and develop and Men’s Health Policy to address the health needs of men not accessing existing health
services.