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Progress made in reducing inequalities in health

Media Release

25 October 2005

Revealed: progress is made in reducing inequalities in health

Progress is being made in reducing inequalities in health outcomes between population groups.

This is one of the most important findings in the Ministry of Health's Annual Report 2004/05 including The Health and Independence Report.

The report, released today by Director-General of Health, Dr Karen Poutasi reveals that inequalities between ethnic groups in suicide rates, smoking rates and infant mortality rates have reduced. Dr Poutasi says "Initiatives such as low cost access to primary health care and the meningococcal B immunisation programme are expected to further reduce health disparities."

As at 22 September over 2.5 million doses of MeNZB vaccine had been given.Over 960,000 children, have been given the vaccine, of which over 600,000 have completed the three doses of the MeNZB schedule.

Dr Poutasi says, "Good progress continues to be made in implementing the Primary Health Care Strategy including in 2004/05 the establishment of a PHO monitoring framework, roll out of additional funding for people 65 years and over and for 18 to 24 year olds, the introduction of the Care Plus service, and an increased management services fee for small PHOs."

The annual report is the Ministry's key accountability document. It includes detailed information on the Ministry's roles and functions, financial performance, and outlines progress towards the Ministry outcomes identified in its 2004/05 Statement of Intent.

The Health and Independence Report is the Director-General's annual report on the state of public health and focuses on the progress the health and disability system is making towards strategic goals, identifying successes and achievements and discussing critical issues and challenges facing the sector.It is the first time the Annual Report and the Health and Independence Report have been published together.

Dr Poutasi says "Bringing the reports together allows the Ministry's performance to be seen in the context of the wider health and disability sector and provides a coherent picture of Ministry and health and disability sector progress towards strategic goals."


Key findings of the report include:

- research as part of the Like Minds, Like Mine project shows that acceptance of people with mental illness increased between 1997 and 2004

- in real terms, the Government spent on average $1959 per person on health in the 2003/04 year

- the number of patients waiting longer than six months for their first specialist assessment has decreased slightly

- cigarette consumption has dropped significantly over the past five years

- a substantial increase in numbers of people with diabetes enrolled in Get Checked programmes

- the avoidable mortality rate has declined by about 40 percent since 1980.

The report reiterates that health inequalities persist, affecting mostly Mäori and Pacific peoples and economically disadvantaged populations. It highlights actions across the sector to address these disparities. Many population-level interventions are now producing positive effects. These include smoking cessation programmes such as Quitline and the Green Prescription programmes aimed at enhancing physical activity.

These interventions, along with the reshaping of the primary health care sector, are part of the drive to reduce the health burden from chronic diseases such as diabetes and cardiovascular disease, which are the leading cause of morbidity and mortality in New Zealand. Cigarette smoking among adults has declined from 24.5 percent in 2001 to 23.4 percent in 2004.Cigarette consumption dropped by 26 percent over the five years to December 2004.The number of cigarettes available for consumption in the year to December 2004 was the lowest since records began in December 1973.

Efforts are being made to improve cancer control and management and services. In 2004/05 the Ministry launched the Cancer Control Strategy Action Plan. A Cancer Control Council has been established and a Principal Advisor appointed. The nine-member council, chaired by Dame Catherine Tizard, will provide independent oversight of actions to control cancer and implement the strategy.

The financial performance of all DHBs has substantially improved from 2001/02 to 2004/05, with the net total deficit falling from $286.7 million to $15.2 million. Dr Poutasi says, "There has been increased government funding over this time, but DHBs have made significant efforts to operate within their funding whilst delivering comprehensive services."

The Annual Report 2004/05 including The Health and Independence Report is available on the Ministry of Health's website at www.moh.govt.nz

ENDS


Background Information

Why is the report being produced?

The Annual Report is the Ministry's key accountability document.It includes detailed information on the Ministry's roles and functions, financial performance, and outlines progress towards the Ministry outcomes identified in its 2004/05 Statement of Intent. The Ministry's performance in the priority areas agreed with the Minister of Health is also discussed.

The Health and Independence Report is the Director-General's annual report on the state of public health, as required under the Health Act 1956. It draws together information on health and disability sector strategies, funding, workforce and activities to analyse the health and disability sector's progress towards outcomes.

Why are the two reports being published together?

The Health and Independence Report has previously been published as a separate report at the end of the calendar year.Bringing it together with the Annual Report allows the Ministry's performance to be seen in the context of the wider health and disability sector and provides a coherent picture of Ministry and health and disability sector progress towards strategic goals.

What does the report contain?

The report looks at the public funds which are allocated to health and disability support services in New Zealand, the workforce underpinning the sector, the services that are delivered and what those services are achieving by way of their contribution to the health and independence of New Zealanders.

In addition to presenting data on system inputs, outputs and outcomes, the report includes interim 'headline' indicators, which are a starting point for assessing progress towards system and societal outcomes. These indicators were introduced in the Health and Independence Report 2004. An updated set of headline indicators will be reported on in the Ministry's 2005/06 annual report.

What are interim headline indicators?

A feature of the report is its reporting of progress against health and independence indicators, which link back to the goals and objectives of key sector strategies including the New Zealand Health Strategy, the New Zealand Disability Strategy, He Korowai Oranga (the Mäori Health Strategy) and the Primary Health Care Strategy. They also reflect the Ministry's policy priorities for 2004/05. The interim headline indicators have been identified as having potential to shed light on wider aspects of system performance.

These indicators were first included in the Health and Independence Report 2004. That report noted that they were only interim indicators and were to be reviewed in 2005 as part of the Ministry's wider examination of system performance indicators. The interim headline indicator set has been reviewed and refined, and an updated set of headline indicators (which includes many of the interim headline indicators) will be reported on in the Ministry's 2005/06 annual report.

Who is the audience for the report?

The Ministry hopes that the report will be widely read, to increase the community's understanding of the health and disability support sector, the resources devoted to it, how they are spent and what that expenditure achieves.

The report is intended to be a resource for health planners, health service providers, policy analysts, community groups, and those interested in the sector.

How do New Zealanders view people with mental illness?

Research as part of the Like Minds, Like Mine project shows that acceptance of people with mental illness increased between 1997 and 2004. Respondents' willingness to accept someone with mental illness as a workmate increased from 69 percent to 80 percent.Respondents' acceptance of someone with mental illness as a resident in a halfway house in their street increased from 56 to 65 percent.Respondents' acceptance of someone with mental illness as a babysitter increased from 12 to 21 percent.Respondents' acceptance of someone with mental illness as a next-door neighbour increased from 55 to 66 percent.

What are the key findings of the report?


The total Vote Health in 2004/05 was $8.81 billion (exclusive of GST) rising to $9.7 billion in 2005/06, or 20 percent of total government expenditure budgeted for the year (page 17). In real terms, the Government spent on average $1959 per person on health in the 2003/04 year compared with $1511 in 1993/94 (page 19).

The number of patients waiting longer than six months for their first specialist assessment decreased from 25,622 at 30 June 2004 to 24,127 at 30 June 2005.This indicates DHBs are improving their systems for ensuring commitments to provide assessment do not exceed the hospital's capacity to deliver on these commitments (page 49).

The total net result of all DHBs has substantially improved from 2001/02 to 2004/05, with the net total deficit falling from $286.7 million to $15.2 million. There has been increased government funding over this time, but DHBs have made significant efforts to operate within their funding (page 97).

The total avoidable mortality rate decreased by about 40 percent from 1980 to 2002.During the same period, the rate of non-avoidable mortality decreased by 23 percent (page 105).

Progress is being made in managing chronic disease. Nationally, the percentage of people with diabetes enrolled in the Get Checked programme increased from 33 percent in 2001 to 59 percent in 2004. Coverage has improved for Mäori and Pacific peoples (page 113).

The prevalence of cigarette smoking among adults has declined from 24.5 percent in 2001 to 23.4 percent in 2004.Cigarette consumption declined by 26 percent over the five years to December 2004.The number of cigarettes available for consumption in the year to December 2004 was the lowest recorded since the series began in December 1973 (page 118).

The suicide rate in 2002 was lower than in 2001: 10.7 per 100,000 compared with 12.0 per 100,000.The 2002 rate was the lowest since 1985.The 2002 suicide rate for males was the lowest it had been since 1985 (Page 128)

Research as part of the Like Minds, Like Mine project shows that acceptance of people with mental illness increased between 1997 and 2004. Respondents' willingness to accept someone with mental illness as a workmate increased from 69 percent to 80 percent.Respondents' acceptance of someone with mental illness as a resident in a halfway house in their street increased from 56 to 65 percent.Respondents' acceptance of someone with mental illness as a babysitter increased from 12 to 21 percent.Respondents' acceptance of someone with mental illness as a next-door neighbour increased from 55 to 66 percent (page 131).

The infant mortality rate decreased from 22.8 deaths per 1000 live births in 1961 to 5.6 deaths per 1000 live births in 2004 (Page 139).

As at 22 September over 2.5 million doses of MeNZB vaccine have been given.This includes over 960,000 children, being given the vaccine, of which over 600,000 have completed the three doses of the MeNZB schedule (page 178).

Good progress continues to be made in implementing the Primary Health Care Strategy. Highlights in 2004/05 include the establishment of a PHO monitoring framework, roll out of additional funding for people 65 years and over, the introduction of the Care Plus service, and an increased management services fee for small PHOs (page 230).

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