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Health is a critical investment in New Zealand's human resource - not a balance sheet item. New Zealand First believes a properly funded and resourced public health service will not only provide better for our country, but save money in the long run.

We must accept that health outcomes are a defining feature of our first world status. Where once New Zealand was in the first five countries in the OECD, we are now in much inferior position – in the bottom third for infant mortality and we are busily importing third world diseases. New Zealand First is committed to improving health statistics in areas of non-communicable diseases such as diabetes and obesity, as well as stamping out third-world diseases such as rheumatic fever.  

While there are no simple solutions to the many and varied difficulties confronting the health sector, we must face the realities of an ageing population and improving technology and medicines which will shape the health sector for the coming decades.  Neither of these driving factors are to be feared, rather, if they are embraced correctly both patients and health care professionals will reap the benefits.   

When last in government New Zealand First undertook to remove the profit focus from the health system. We promised to introduce new initiatives in the area of child health, and to reduce hospital waiting lists. We delivered on these promises. Five years ago New Zealand First ensured an additional $530m for eldercare and achieved improvements to the under sixes health scheme. Major challenges remain.

Spending smarter must be a focus in the health sector in the coming years, as not all issues can be solved by increased spending. We find it most disturbing that Treasury reports continue to show that despite increased spending in the health sector, health productivity has not kept pace.

Even more disturbing are the huge differences in need throughout the population that are becoming very apparent. Māori health outcomes are not improving at the same rate as non-Māori and this must be rectified.  

New Zealand First does not want to undertake whole-system reform and add to the ‘structural fatigue’ caused by successive government overhauls. Our current system needs some refinements to ensure interoperability and a focus on patient needs.  Our ultimate aim must be to provide our citizens with certainty about their healthcare and ensure timely access to quality services.

COMMUNITY HEALTH

New Zealand First will:

  • Review accessibility of affordable healthy foods, with the aim of ensuring all families can afford to eat nutrition rich meals.
  • Review accessibility of safe spaces in communities to exercise and play, with the aim of ensuring all New Zealanders can have somewhere to maintain physical fitness.
  • Continue to focus upon family health, and particularly early intervention, by expanding such programmes as ‘Family Start’ and home based support.
  • Ensure that essential health and safety products such as sunscreens being promoted to our community have undergone independent evaluation and/ or review.
  • Facilitate the improved co-ordination and integration through PHOs and other organizations of community health, dental health, disability support, family health, Maori health, maternity, mental health, and public health services and overcome the effects of a health system that lacks cohesion and common standards of delivery.
  • Restore emphasis on preventative measures and health education and ensure the nationwide health screening of all children under one year.
  • Ensure that all New Zealand pre-school and school children receive adequate dental care and fully implement a national strategy including implementing the recommendations of the Health Select Committee Report on Oral Health, including a review of the state funding for teenagers' dental treatment.
  • Increase the options of mental health services available, working towards a community view instead of a medical view of services.  
  • Improve residential services for people who have severe illnesses or disabilities and/or substance abuse problems.
  • Commit to increasing the number of medical professionals choosing to be General Practitioners in line with the needs of the communities being served.
  • Ensure that there is adequate funding for, and improved access to palliative care services.
  • Ensure that safety considerations are paramount in funding decisions relating to maternity care services and require improved provision of ante-natal classes, maternity services for rural, Maori and Pacific Island women, and the improved monitoring of maternity services.

PRIMARY AND SECONDARY HEALTH

New Zealand First will:

  • Establish and implement a national strategy for addressing cancer treatment, men's health issues including prostate cancer, diabetes, osteoporosis, osteoarthritis, gout, asthma, obesity, dementia, and other diseases and health concerns where a national strategy is clearly needed and incorporating health education initiatives, improved screening programmes and strategies.
  • Immediately review funding of PHOs that fail to maintain adequate emergency services and establish a process whereby funding for emergency services must be ring-fenced by DHBs when distributing funding.
  • Introduce the Teen Health Check Bill to require DHBs to make provision for health checks on all Year 9 students and other measures to ensure no young person enters secondary school with health problems likely to be a barrier to their learning.
  • Improve access to high quality oral healthcare services.
  • Consult with the natural health industry and other stakeholders to ensure there is an appropriate regulatory regime for complementary medicines.
  • Provide additional resourcing for child and youth mental health services, and the necessary resources and funding to address the continuing appalling state of mental health services by completing the full implementation of the recommendations of the Mason report.
  • Increase rural health services and ensure good access to basic healthcare equitably throughout the country including the immediate development of a rural and provincial health services plan with a view to early injections of health funding to ensure the continuity of essential services.
  • Develop 'centres of excellence' for strategically placed specialist services.
  • Provide funding to assist the diagnosis of osteoporosis by DXA scan for women over 50 years who have experienced a low trauma fracture.
  • Adequately resource elective surgery and provide additional waiting times funding so as to firmly establish guaranteed maximum waiting times for a range of surgical and specialist treatment.

ORGANISATIONAL

New Zealand First will:

  • Confront the duplication of management and administration costs arising from the excessive number of District Health Boards (DHBs) to ensure they are appropriate for the demographic demands of health and efficiency of delivery of services, and support the amalgamation of and/or the development of co-operative agreements between DHBs.  
  • Redress the balance between health administration and health practitioners within DHBs, ensuring that extra money going into health is ring-fenced for the delivery of health services rather than growing the health bureaucracy.
  • Increase clinical engagement by medical staff in all DHBs to ensure the needs of the community are being met, and increasing the quality of patient care.
  • Increase the number of acute and non-acute beds and accommodation units for the mentally ill and modify the process of judicial review of decisions to release mentally ill patients into the community.
  • Cap the number of places at medical training institutions which can be taken by foreign students while increasing the number of places available in areas of need for New Zealand students.
  • Review the costs of gaining initial medical qualifications, including exploring the option of a 'bonding' system for medical students who are willing to trade-off student loan abatements for staying in New Zealand.
  • Explore amending the recent changes to the Student Loan system to ensure Graduate Entry Medical Students are not disadvantaged compared to their peers.
  • Review the medical students pathway with a focus on future proofing the system, and ensuring it is set up in a way to service the future health needs of New Zealanders.  
  • Use a range of measures to ensure the adequate recruitment and retention of health professionals in rural areas including: consideration of student loan abatements; fees reductions; scholarships and bonding schemes; amending the definition of ‘rural’ in relation to the rural GP premiums and lifting the levels of primary healthcare premiums; the development of a robust peer support programme for rural practitioners; an alternative route for the registration of family doctors; the supply of locums to enable ongoing training, support and a sustainable quality lifestyle; and resources for visiting specialists.
  • Ensure a high quality 'rural service' specialization is available in our medical schools.
  • Require consistency in the provision of emergency health services such as ambulance and helicopter services and ensure the adequate funding of a core of fulltime employees.
  • Review the funding of rest home care contracts, particularly in relation to costs imposed by legislative changes which impact on the cost of care.
  • Ensure that the subsidy paid to elderly in care is automatically adjusted for CPI inflation each year.
  • Conduct a review of the eldercare sector in order to facilitate long term planning in the sector.
  • Assure equity of access to health and disability services across generations by removing income and asset testing for older people needing long stay aged hospital care services and asset testing for long stay geriatric private hospital care.
  • Implement national standards for aged home care that are appropriately monitored and enforced.
  • Review the National Travel Assistance Policy with the aim of ensuring it is adequately providing transport assistance to those who cannot easily access hospital medical appointments.
  • Conduct a review of the efficiency and efficacy of Pharmac's operations and of the adequacy of pharmaceutical funding.
  • Review issues relating to the treatment of overseas patients within our public health system.
  • Legislate for clear labelling of all genetically modified food (GMF) products.

FUTURE PROOFING

New Zealand First will:

  • Review the processes and funding for the public purchase of essential equipment and new technology to ensure that decisions are timely and the New Zealand public have access to the best possible health services.
  • Establish a Commission of Inquiry into the public health system with the aim of establishing precisely what the public expects of the health system and what the system can deliver. Our ultimate aim is to establish a public health compact with the public stipulating the guaranteed minimum services the public can expect from the public health sector. It will also consider the overlap with the private sector.
  • Increase the use of technology to reduce isolation (e.g. mobile services, helplines, telemedicine, teleradiology) and consider the appropriate expansion of the health-centre model.
  • Further develop a strategy for meeting the health needs of an ageing population and review specific disability provisions and rest home care.
  • Incrementally work towards pay parity between eldercare nurses and DBH employed nurses.
  • Develop a specific Industry Training Organisation for the eldercare sector.
  • Ensure that planning for the eldercare sector incorporates the capacity for family home carers.
  • Introduce an independent perinatal database to ensure data being collected about New Zealand births is internationally comparable and used to inform future policy directions.  
  • Ensure an on-going commitment to the funding of health research, research institutes, and for training.
  • Explore options associated with boosting uptake of private health insurance, including the provision of tax rebates for those with private health insurance.
  • Set up a separate pharmaceutical fund for sufferers of rare diseases administered separately to Pharmac.
  • Review implementation of Electronic Health Records globally to ensure New Zealand follows international best practice and avoids all known complications.

Barbara Stewart on this policy

"Health is a critical investment in New Zealand's human resource - not a balance sheet item. New Zealand First believes a properly funded and resourced public health service will not only provide better for our country, but save money in the long run."