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King Address: Health Research Council Symposium

King Address: Health Research Council Symposium

It is a genuine honour to be at this important symposium today.

One of the realities of being a Health Minister is that although people, particularly the media, often expect you to be an expert on everything, you actually do not have to be one to be able to do the job.

And looking at some of the subjects that will be discussed during today’s event, I am very thankful for that. And I am even more thankful that a country our size does have so many experts, and can share expertise and collaborate with our Australian neighbours.

I’d like to wish a special welcome to the Australians who are here today. I know some of you are from Monash University, and I wish to extend our deepest sympathy for the tragedy that has just occurred there.

You certainly have an incredible amount of ground to cover today in areas of neuroscience and mental health research, and I am sure you will all be positively stimulated by the addresses and discussions that follow.

The occasion is all the more important because the symposium is named in honour of Sir John Eccles, whose research on the nervous system received a number of awards, most notably, of course, the Nobel Prize in Physiology and Medicine in 1963.

Sir John Eccles was an Australian who spent a lot of time in New Zealand, so it is appropriate that there are both New Zealanders and Australians here to celebrate the 100th year of his birth.

I’d like to welcome some of the leading neuroscientists from Australia who are here: Dr Helen Christensen, Professor Colin Masters, Professor Bevyn Jarrott, and Professor Lyn Beazley.

And, of course, I would also like to mention the leading New Zealand neuroscientists, Professor Richard Faull, Professor Wickliffe Abraham, Professor Peter Joyce, and Dr Jian Guan.

Much of Sir John’s research has certainly influenced some of the work completed by researchers attending this symposium today.

Health research is essential for improving people’s quality of life and reducing disease. Health research has succeeded in making health services more effective and efficient, as well as improving the equity of service provision.

However, health research also has other benefits. Research opportunities can be an incentive to encourage medical practitioners to stay and add value to their profession.

Health research helps save the health and disability sector money, directly or indirectly, by reducing the incidence of disease, shortening hospital stays, and reducing the invasiveness of surgery.

As part of its investment strategy, the Health Research Council is now collaborating more with the Ministry of Health. Such joint initiatives mark a new era of co-operation, and promise real potential in terms of health gains.

Under these initiatives, the Health Research Council either jointly funds research with the Ministry in priority areas, or invests research funds on behalf of the Ministry.

It probably almost goes without saying that, given the funding constraints always faced by governments, finding support for additional spending on research has not always been easy.

However, the joint initiatives with the Ministry provide a very successful model for collaboration between funding agencies. The initiatives involve an applied research agenda that ensures that the research has the maximum chance of impacting on Government policy.

The joint initiatives also provide an opportunity to develop a system through which the Ministry can identify issues where urgent actions may be needed.

The Health Research Council can commission high-quality research to find and evaluate solutions that the Ministry in turn can use as a basis for planning health services.

I want to talk in a little more detail shortly about two areas of special importance to me, implementation of the Primary Health Care Strategy and the recruitment and retention of nurses, but generally I am pleased to see available health research opportunities in New Zealand focusing on the Government’s priority areas for health.

There is significant evidence to suggest these areas need attention over the short and medium term in New Zealand, and this highlights the need for New Zealand specific research to be carried out.

I will just mention a few examples of such research that I believe is of particular relevance to New Zealand.

Eight people are currently employed on a large-scale national study of mental health epidemiology.

The Te Kaharoa based diabetes project is being funded to design and trial interventions that will reduce the incidence and impact of diabetes in high-risk communities.

The Immunisation Research and Development Strategy aims to fund research that addresses the key issues of why immunisation rates are so poor in this country, address public perceptions of immunisation, and find ways of increasing immunisation coverage.

I also understand initiatives relating to primary care, cancer control, tobacco control and child health are under development.

I am also pleased that current research is concerned with reducing inequalities. Much evidence suggests that some populations, including people from lower socio-economic groups, the Mäori population and the Pacific peoples, are relatively disadvantaged in health as measured on a number of indicators.

The Mäori Health Joint Venture is a cross-departmental research pool for funds for research into Mäori consumer use and experience of health and disability services.

The Health Research Council has also joined forces with the Ministry of Health to fund an extensive programme of measures that will increase the number of trained Pacific health researchers and build Pacific capacity in the health workforce.

Many of the projects I have just mentioned impact considerably on primary health care, and that is a subject that is very dear to my heart.

On October 1, I was delighted to announce the formation of four new Primary Health Organisations, the not-for-profit organisations of providers that are to be the flagship in implementing the Primary Health Care Strategy.

The formation of these new organisations, funded through one of two formulae known as the Access formula or the Interim formula, signal a highly exciting time for primary health care in New Zealand, and indeed for the health sector generally.

I firmly believe that good primary health care is critical to improving the health of New Zealanders and reducing health inequalities between different groups.

The Government has committed $400 million in new money over the next three years to begin implementation of the Strategy, and I believe the Health Research Council is one of a number of organisations that can help make our vision for primary health care become a reality.

The other and related area I particularly wanted to mention was the importance of recruiting and retaining our health workforce, with an emphasis on our nursing workforce.

The Ministry of Health has, of course, recently commissioned the Health Research Council to undertake a national study on the costs of nursing turnover.

International research has shown that high turnover rates not only can have an adverse effect on staff morale, but may ultimately have a negative impact on patient care as well.

The estimated costs of nursing turnover are significant. Initial international benchmarking of the overall costs of nursing turnover, not just advertising and recruitment, is approximately $48,000 per nurse.

The New Zealand study is part of an international examination of the cost of turnover, and its impact on patient and nursing safety and satisfaction.

The Ministry is still working with the Council on the final specifications for the research, but I am confident that once it is completed we will all have a better idea of how to address retention issues and to develop nursing programmes throughout our DHBs.

There are two areas affecting nursing retention that particularly interest me. The first is the work that has occurred in Victoria, Australia, concerning the establishment of safe ratios in hospitals; and the second is the United States concept of magnet hospitals.

At the recent annual meeting of the New Zealand Nurses Organisation I discussed the impact of the Victorian campaign in terms of reversing the apparent nursing shortage there. If the Victorian experience is valid in New Zealand, and there is not a shortage of nurses, but rather a shortage of nurses willing to nurse, then we need to learn more about it.

I am keen that New Zealand embarks on pilot research to determine if the Victorian experience is valid here, and I have asked the Ministry to look at how this can be done.

Considerable interest is also being taken in New Zealand in the concept of magnet hospitals. Earlier this year the Ministry facilitated establishment of the New Zealand Magnet Advisory Network, including representatives from the Ministry, nursing organizations and 12 DHBs.

Magnet hospitals feature, among other attributes, decentralized unit-based decision-making by nurses, nurses being part of the governance structure, investment in nursing education, good communication between nurses and doctors and good nurse to patient ratios.

I am interested in the success magnet hospitals apparently enjoy in the United States in terms of nurse and patient satisfaction, and I am looking forward to discussions later this year with Professor Linda Aiken, director of the Centre for Health Outcomes and Policy Research at the University of Pennsylvania.

I am sure that the Victorian and United States experiences both relate closely to overall issues of nursing retention, and both could impact favourably on New Zealand.

Before I finish today, I would like to take this opportunity to highlight just some of the recent achievements in health research in New Zealand.

Pride of place may go to the Dunedin Multidisciplinary Health and Development Study, led by Dr Richie Poulton, which is New Zealand’s longest longitudinal study. Having been active for over 25 years, this study has the highest follow-up rate achieved by any large study of this kind (96 percent).

Professor John Tagg at the University of Otago has discovered an antibacterial protein, which has been used in developing the BLIS K12 Throat Guard, which prevents streptococcal throat infections that can lead to serious complications such as rheumatic fever and rheumatic heart disease.

This research discovery is the culmination of 20 years of basic biomedical research, which has been supported by the Health Research Council.

Another research achievement is using census information to investigate health inequalities. This study is the first in the English-speaking world to examine the association of socio-economic status with mortality for a country’s entire population.

I also understand that the Bone Research Group led by Professor Ian Reid and Associate Professor Jill Cornish is continuing to make headway. Their research into bone formation has lead to development of new therapies that will reverse the damage caused by osteoporosis and other degenerative bone diseases, through stimulating the growth of new bone.

One member of the group, Associate Professor Tim Cundy, has also been working closely with staff at the Molecular Genetics Laboratory at Auckland Hospital in identifying an abnormality in the genome of children with a rare familial skeletal disease of unknown cause.

The research of Professor Bill Wilson and Bill Denny at the Auckland Cancer Society Research Centre needs also to be mentioned, with their research into prodrugs for cancer therapy over the last ten years offering an alternative approach to conventional cancer chemotherapy, with profound implications for patients.

Unfortunately there is not time to discuss all the achievements of New Zealand researchers in the last year, but I hope the few examples I have mentioned illustrate in just a small way the impact of health research in terms of improving health outcomes for New Zealanders and people around the world.

Thank you again for inviting me to your symposium today. As I said at the start, I am no expert, but you do not have to be an expert to recognize the years of dedication represented by the people in this room today. I wish you much stimulation and enjoyment in the day ahead.

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