On The Nation:

Lisa Owen interviews Northland GP Lance O'Sullivan

2014 New Zealander of the Years say National’s benefit increases are “a step in the right direction”, but calls on Government to do more

Backs Government’s move to require beneficiaries to start working when their child turns three; “that’s a good initiative”

“If we could get an opportunity to get these children out of those [dysfunctional] environments, and these are 3-year-old-plus or even earlier, perhaps, for six hours a day, five days a week, I think we should”.

Argues the Government should be implementing “a comprehensive plan” to tackle poverty working across all government departments

Would like to see NZ Super trimmed to allow for greater spending on health and education for children

Lisa Owen: We’ve heard a lot this week about what politicians and commentators think about the Budget, but what about those on the front line in the struggle against poverty? Well, Lance O’Sullivan is a Kaitaia GP, public health champion and last year’s New Zealander of the Year. He’s come into the studio today. Good morning. Thanks for joining us.
Lance O’Sullivan: Kia ora, Lisa.
You wanted to see a greater focus on health and social needs of children. Does this Budget deliver? Does it go far enough?
Yeah, I think it’s been a bit of a surprise. We certainly—the lead-up to the Budget announcement in terms of media commentary was that there wasn’t going to be a lot in that area. I think, yeah, it’s certainly a step in the right direction. As a doctor that works in a high-needs community with vulnerable children, I think this will make a difference to my job on Monday, at least when the initiatives start coming into play.
In what way?
Well, look, you know, certainly $25 a week extra in households in my community can be a significant percentage income for their disposable income, and so that’s useful. Though $25 a week is probably not, you know, the end game, I think this is a step in the right direction, but it’s not going to be the magic bullet. I— I have an interesting feeling that the encouraging parents back to work at age 3, I feel that’s a good initiative. I like the initiative around increasing access to early childhood education, especially for vulnerable children. So, yeah, I think those are two or three really good initiatives that have come out of this Budget.
Well, Bill English says that kids who are living in families on a benefit need to get a decent upbringing. You said 25 bucks is a step in the right direction, but can they get a decent upbringing for that? Would you like to see it go higher?
Yeah, I think the question is, you know, what is it? Is it just putting more money into people’s pockets that are living on welfare and in vulnerable situations, or is it having, you know, a whole package of greater care and services around these people?
So which is it, do you think?
It’s probably a combination of both, actually. I think, you know— I do think that there needs to be some prescriptive measures around the increased income that could be made available to families with vulnerable children.
What do you mean by that?
Well, I would really want to see that $25 being put to the best use, okay, so I would like to see that being used for— you know, if it could be used to have children be put into early childhood centres, that would be fantastic. You know, things—
So ring-fencing the increase? So if you want to see more money go to them, ring-fencing it so you have to spend this money on food or you have to spend it on early childcare?
Well, I think, you know, that would be a possible consideration, yeah.
Okay, well, the Children’s Commissioner has said that this is a one-off increase; it’s not a plan. Do you think we need something – a bigger picture, a plan, a comprehensive plan with targets and a clear strategy?
Yeah, well, I’m a simple GP working, doing a simple job, although it seems pretty complex at times, but I would say, yeah, again this is a step in the right direction. I guess it requires, I believe, you know, if we’re talking about child poverty, a comprehensive plan that goes across sectors, obviously driven by our finance— our Treasury department, but, you know, looking at more than just increasing dollars in people’s hands but actually, you know, greater connectedness between all of the sectors that work with vulnerable communities, okay, so whether it be MSD, the Ministry of Health, Ministry of Education, Justice, all of these players that actually can influence positive outcomes for these communities, in particular vulnerable children.
When you’re talking there when you say about other people who can influence the lives of vulnerable children, you talk about that it’s a good thing that children as young as 3 will be in childcare. Why do you say that? Why?
Oh, look, I’m absolutely a believer. Well, look, the communities I serve, you know, the children I’m serving and looking after are typically coming from very chaotic backgrounds, okay, so if they’re on welfare, they’re more likely to be exposed to social dysfunction. Now, that could be alcohol-drug abuse, that could be violence, that could be mental health problems, that could be problems with incarceration of any number of the families, housing problems, so, you know, if we could get an opportunity to get these children out of those environments, and these are 3-year-old-plus or even earlier, perhaps, for six hours a day, five days a week, I think we should. I think we should be able to expose them to positive environments, keep them warm, safe and dry and give them a learning opportunity that will prepare them for school, because I don’t believe we should wait till age 5. I mean, the chief scientific advisor, who used to be my dean at the medical school, Peter Gluckman, believes in this. I certainly tautuku his expertise in that area.
All right. Well, the Government has talked a lot about targeted help, so is it right that all kids under the age of 13 get free doctor’s visits? Because that means a millionaire could take her kids along to the doctor for free. Would that money be better spent elsewhere?
Yeah, look, I have for a long time felt we needed to be more targeted with our, you know, what we have. We have a limited resource and we have a scattered distribution in need, so the need at the lowest end, the investment there is going to pay significant more dividends than investment at the higher end. And, you know, that requires some people viewing they’re giving up something. My guess the aversion to targeted funding is that the political popularity of that, you know, it’s great to that all of our children in New Zealand are going to get free access to care, despite the fact that probably only about 25% really need that because of their vulnerability.
We’re talking about people giving something up there. We’ve just been having a discussion about superannuation. Do you think it’s right that someone can collect a super while still earning a full wage? Would you like that money to go somewhere else?
Yeah, well, look. Yeah, well, just looking at the Budget overview today, the biggest spend in the Government cost is social security and welfare – $25 billion in this budget. And then it’s 15 billion for health and 13 billion for education. I’d really love to see that flipped on its head and see education and health being the top spenders in a budget. So how are we going to cut down the welfare costs? Well, there is a really big section of the country who are beneficiaries that we forget to talk about, and that’s superannuates who have contributed a marvellous—made a marvellous contribution to New Zealand society and the nation building, and we can’t forget that. How do we support them through into their retirement? But the question is, where—at what end of the age spectrum are we having the greatest challenges, and how can we get the biggest dividend, I guess, for our investment? And I would be saying there, looking at how we rejig the superannuation as a smart move, yeah.
Right, thank you so much for joining me this morning, Lance O’Sullivan.
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