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Turia: Estimates Debate Speech

Tuesday 26 July; 2005
Tariana Turia, Co-leader, Maori Party

New Zealand has had some incredible achievements on the international stage including of course our Nga Rauru, Ngati Ruanui golf champion winning the US Open - whom we welcome home later this week.

But there’s another world record that’s nobody’s talking about.

An epidemic of type 2 diabetes is occurring in New Zealand, driven mainly by demographic trends and the increasing prevalence of obesity.

The epidemic most severely affects Maori and Pacific peoples.

Approximately 8% of Maori and Pacific populations have diabetes compared to 3-4% for the European population. That must be what is meant by “Maori privilege”.

Two out of three Maori and Pacific diabetics die from diabetes – compared to one in three European.

Just three weeks ago public health experts gathered in Wellington to discuss the fact that health inequalities are still evident.

The conference concluded that it was ironic that while some politicians are making political mileage out of claiming targeted interventions are ‘race-based’, that those same politicians are not standing up to draw attention to the race-based inequalities that created the need for the interventions in the first place.

Looking particularly at race-based privilege in relation to Maori:

- Maori develop diabetes ten years earlier than non-Maori.
- Maori are four times more likely to develop Type-2 diabetes than non-Maori.
- Maori are also over-represented in cases of diabetic renal failure, with rates up to ten times those of non-Maori.

What is even more of concern is that a study undertaken by David Tipene-Leach and colleagues, revealed the very high prevalence of insulin resistance of Maori from the East Coast north of Gisborne, particularly in young adults below 40 years of age. Such a finding indicates that type 2 diabetes is already well-established in our midst .

So what do the 2005 Estimates of Appropriations say about such a vital health issue for this nation? In the 50 pages allocated to Vote Health the word diabetes was mentioned once on page 727.

This is a life and death issue.

Diabetes causes approximately 1200 deaths per year .

One mention in 50 pages!

We cannot afford to wait any longer.

These are also issues of great significance to Vote Health.

Diabetes presents a significant health challenge for Aotearoa and it should be a major priority for health investment. We should be seeing a comprehensive, multi-faceted strategy to address this disease on all fronts.

Prevention and better quality care could reduce costly hospitalisations. Indeed, half of the cases of of kidney failure and dialysis; blindness and amputation could be prevented if there was more investment in moving upstream.

We need gold star treatment and we need it now.

One of the most bizarre statements in this years Estimates is the following: “The Ministry of Health is the Government’s Primary Advisor on health policy and issues, and its contribution to improving health and independence is largely indirect.”

One would have thought a policy agency would take direct responsibility for analysing the demographic trends, assessing the population demand and forecasting appropriate interventions.

The recent economic study commissioned from Pricewaterhouse Coopers estimates that current services for diabetes cost the taxpayer $247m. If current services are kept at similar levels the estimated costs of diabetes will be over a billion dollars each year by 2021 in current dollar terms .

This is because the projected increase in numbers of people developing complications such as blindness, limb amputation, dialysis requiring hospitalisation would results in diabetes services accounting for approximately 12% of total health spending by 2021.

Price Waterhousecoopers also noted that while there has been some investment by the Ministry of Health and District Health Boards into the development of diabetes prevention programmes, it is miniscule.

We can not sit back and allow costs to accelerate, lives to be lost, while a “degree of apathy and indifference” permeates the “Ministry of Health and District Health Boards” .

The Government – if it is genuine about addressing diabetes will invest considerably more now - to prevent a blow out of costs both personal and fiscal in the future.


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