Maori Council: Health Reform a must as New Zealand tackles a multitude of challenges from rising rates of dementia to childhood poverty
March 3, 2019
New Zealand’s total health and disability spending is about $18 billion, or about 9.5% of gross domestic product (GDP); this covers spending in the public, private and non-governmental organisation (NGO) sectors, including ACC expenditure.
While New Zealanders overall are living longer, Māori and Pacific peoples still have lower life expectancies than the population as a whole
We expect the number of New Zealanders with dementia to rise from about 48,000 in 2011 to about 78,000 in 2026.
New Zealand’s health workforce also faces challenges. It is ageing – 40% of doctors and 45% of nurses are aged over 50 years.8 It also has a large unregulated workforce (numbering about 63,000), including care and support workers, or kaiāwhina, who often have limited access to training. Many of our workforce have trained overseas
Nearly 100,000 children aged 2–14 years (12.3%) were obese. The child obesity rate has not changed significantly since 2011/12 (when it was 10.7%), although it has increased since 2006/07 (8.4%).
1.2 million adults (32%) were obese, up from 29% in 2011/12.
Children living in the most socio-economically deprived neighbourhoods were 2.5 times as likely to be obese as children living in the least deprived neighbourhoods, after adjusting for age, sex and ethnic differences.
“If we are going to improve New Zealand’s Health System then we need to start investing now – Treasury has already said that the current model is unsustainable and unless we invest in better and more formative research around outcomes we will see a lift of the health budget from 7% of GDP to about 11%. And what we invest in matters based on what is happening from rises in childhood obesity to cancer rates, from dementia to the structure of our workforce.”
Were the words of the New Zealand Maori Council’s Executive Director Matthew Tukaki at a hui in Auckland this morning and the Council’s call for the establishment of a National Future Fund for Health and Wellbeing Research.
“The harsh reality is that we, as a nation, invest very little in terms of research around health and wellbeing and yet the more we do and the more we understand what is happening in primary, secondary and tertiary health as well as poverty and wellbeing in New Zealand we can go a long way to create programs that are more effective both financial and from a social outcomes perspective.” Tukaki said
“The classic example I use is Government Departments and Agencies, as well as service providers, collect an enormous amount of data but for what purpose? Are we analyzing it, researching and understanding it so far as creating better health and wellbeing programs are concerned or are we just collecting it for collecting sake?” Tukaki said
“We have also made the research environment very competitive like people are tendering for a contract – but what we should be doing is fostering a collaborative research model that encourages people to work together in a more research consortium approach. We also tend to lock out younger researchers coming through which leads many to leave the sector or head overseas” Tukaki said
“Money is also tight and often we see Governments investing small or large amounts of money depending on what the mood is. Then we have smaller foundations and organisations also funding research but often if there was just a little more in the tank the research itself could prove to be more useful and impactful. In other words there is no real consistency especially when it comes to Maori research.” Tukaki said
“That is why we want to have a look at the establishment of a National Future Fund for Health and Wellbeing Research so we can get better co-ordination, better use of taxpayers money, a higher degree of investment in young researchers coming through and a greater emphasis on the dynamics of the Maori Health and Well Being data. Importantly it needs to be the case that a fund commissions research and also is able to the ask the research questions that lead to better and more understandable outcomes. Of course it also providers our research community with greater stability.” Tukaki said
“The idea of the fund, very much like the Australian model where an upfront amount of money is invested, is where the principle is able to grow and dispersal occurs through the interest and returns on the investments. In addition it allows for co-investment to occur so private organisations and foundations can make co-investments to increase the pot but also enable them to get better bang for their buck as well.” Tukaki said
“Why can’t we more cleverly harness the power of our research community to find ways of reducing everything from child hood obesity (which leads to great health challenges later on in life) right through to cures for cancer?” Tukaki has said
“If we better understand what is happening and why, we can target our investments more towards outcomes. If we are able to harness the collective of researchers we will be able to produce higher quality outcomes. If we are able to ask the questions that focus in around specific challenges and problems then we will be able to get a high quality of solutions we can work on and if we get the model right we can use research to reduce the threat of a blow out in health budgets in future years.” Tukaki said
In the coming weeks the New Zealand Maori Council will also be launching a new National Taskforce on Health and Wellbeing to be led by National Hauora Coalition Trustee, Henare Mason. Mr. Mason is Deputy Chair of the New Zealand Maori Council and a respected health leader. Maori Council has previously announced the appointment of Dr Gary Hook as its Research Director