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Tariana Turia - Public interest in public health

Hon Tariana Turia
12 March 2004 Speech Notes

Public interest in public health

E nga mana, e nga reo, tena koutou.

Ngati Whatua, mihi mai, mihi mai.

E nga iwi e huihui nei i tenei ra, tena koutou katoa.

I am very pleased to be here today, to celebrate what is a big step forward for your organisation, the Auckland Regional Public Health Service, and also a big step forward for the health of all the people of the region.

As a politician, with special responsibilities for the health of tangata whenua, I want to mention the current public debate over so-called special health services for our people, and the implication that somehow others are therefore missing out.

A public health forum is a good place to analyse and discuss the philosophy that underpins such arguments.

Public health is about improving health through the organised efforts of society. Public health addresses the health of society, and the populations and groups that make up the general public.

It is only indirectly about the personal health of individuals, in the sense that public health will not improve unless individuals benefit from public health measures. One measure of public health is the aggregate health of individuals, as shown in health statistics. Another is the strength of the social support networks that help each individual to cope with setbacks, and avoid them in future.

So public health does not ignore the well-being of individuals. Rather, it acknowledges that many things that impact on the health of individuals are best addressed by the community or the society they live in.

This approach recognises one of the things that make us fully human – our capacity to care for each other, and look after each other's interests, because we know that in the long term, a strong, cohesive society or community provides security for each and all of us.

Most of us are happy to support those with special needs, because we realise that, one day, the person with special needs could be me. The whole social relationship is based on shared values of love, caring, generosity, appreciation of others, and social responsibility.

There are some people, however, who feel so privileged and powerful, that they do not want to engage with those values. They feel they have the resources to cope with any adversity, and everyone else should be the same, so they can be relieved of any responsibility for others.

Their whole outlook is fundamentally individualistic and selfish. They see those with special needs as a burden.

To me, that is part of what lies behind the recent attacks on so-called 'special privileges for Maori'. It is driven by ideology and values, not facts and logic.

I think it indicates that some people do not really feel that we are all part of one society. In the end, their own selfish interests will always be more important than the rest of us.

This attitude is actually dangerous, because it undermines the trust that holds society together. If we lose confidence that others will help us in times of need, we ourselves become more individualistic, and unable to function as a community or society. In an anarchic, dog-eat-dog society like this, the powerful can more easily prey on others.

I have received a number of letters from people who say that tangata whenua suffer poor health because we eat and smoke too much – and we should take greater personal responsibility.

Their individualistic attitude blinds them to the proven fact that many of the causes of our peoples' poor health, including diet and smoking, are best addressed through collective health strategies.

I have spoken many times before about He Korowai Oranga, the government's Maori Health Strategy. The key thing about that approach, is that individuals are recognised first and foremost as members of whanau, and the health of individuals is addressed in the context of whanau.

Today, we are here to celebrate a number of achievements in public health in Auckland – which takes a similar approach.

First, we are launching a number of resources.

I love the 'Kia Kaha!' greeting cards, for whanau members and friends to send to people who are struggling to give up smoking. I think that captures the essence of what I have been saying – that family and community support and encouragement can help individuals to improve their health. As the campaign says: 'It's about whanau!'

The role model register builds on the idea of community leadership. Well-known personalities register their willingness to speak about public health issues like auahi kore or smoke-free, food safety and nutrition, injury prevention, physical activity and so on. Community groups looking for a guest speaker can choose a suitable role model from the database.

The refugee and migrant health website provides specialised resources to some of our newest community members – people who have very particular needs in terms of language, or social, mental and spiritual needs arising from dislocation from home.

This reflects values of manaakitanga, or being a good host, and our desire to create a strong inclusive society where the contributions of diverse cultures are valued.

Today, we are also launching the first Strategic Plan for the Auckland Regional Health Service. The plan represents the success of all of the region's public health services, across three DHBs, in establishing an integrated and inclusive organisation.

I am told the plan is the culmination of the efforts of "a cast of thousands", and that "every man and his kuri" was involved through the consultation process, including tangata whenua.

The process not only produced a plan, it also developed a network of relationships among the key groups who will actually implement the plan. Those relationships provide the region with capacity to plan ahead, and to use resources wisely, to achieve your shared goals.

To many people, public health or population health is less exciting than face-to-face consultations between patient and doctor, or life-saving surgery in a high-tech operating theatre.

But this gathering illustrates the depth of intellectual and social sophistication required to plan well, the practical 'bent' needed to respond in a practical way, and the knowledge that thousands of little interventions like 'Kia Kaha' cards all add up to real health benefits for real people.

No reira, kia kaha koutou, kia ora ai tatou katoa.


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