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HCA supports WHO call for universal primary care

Media Release For Immediate Release

15 October 2008
HCA supports WHO call for universal primary health care

Health Care Aotearoa today called on all political parties to endorse the four primary health care goals of the World Health Report 2008: universal coverage ‘according to need and regardless of ability to pay’; people-centred services; healthy public policies; and leadership.

HCA is a national network of community-driven and governed primary health care services, including Maori, Pacific peoples, refugees, youth and low-income people.

National coordinator Petra van den Munckhof said that, while New Zealand has a largely universal, well-functioning health system, it sits behind Australia and the United Kingdom in terms of universal free primary health care. ‘In spite of funding increases that have made it easier to access health services, still only 74 per cent of under-sixes are receiving free care and a significant number of adults pay more than sixteen dollars to see a doctor or nurse. No family should have to choose between buying bread and fruit, paying the power bill or taking their child to the doctor or nurse if they need to.’

The WHO report, Primary health care – now more than ever, launched yesterday, estimates that better use of existing preventive measures could reduce the global burden of disease by as much as seventy per cent, and lists the New Zealand Primary Healthcare Strategy, which ‘has as part of its core strategy an emphasis on prevention and management of chronic diseases’, as an example of people-centred services.

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Ms Munckhof agreed that the strategy was making a positive difference towards the goal of reducing inequalities. ‘For the first time in 25 years, the gap in life expectancy between Maori and non-Maori has improved. This is good news but there is still a long way to go.’ Targeted funding based on gender and age should be extended to include ethnicity and deprivation for first-level contact with a doctor or nurse, she said. ‘Health services working with Maori, Pacific and low-income families currently receive the same funding as other services but deal with more complex health and social issues in their communities.’

Ms Munckhof called for pay parity for primary health care nurses and community health workers to match DHB nurses’ salaries. ‘Staff in the community/tangata whenua sector continue to be trained and supported only to be poached by mainstream providers able to offer higher salaries and stronger infrastructure. Many are going to non-Maori, non-Pacific providers, undermining the ‘by Maori, for Maori, by Pacific, for Pacific’ focus that is widely recognised as an essential element of effective primary health care services.’

She said sustainable funding was also needed for youth one-stop shops that provide critical support for young people in areas of mental health, sexual health and general well-being. ‘Ad hoc funding and support by individual DHBs means that access currently depends on where a young person lives.’

The WHO report commemorates the 30th anniversary of the Alma Ata Declaration which put health equity on the international political agenda. To mark this anniversary, HCA has drawn up a local charter called the Whakakotahi Declaration, which means ‘Be United!’ It identifies the essential foundations for primary health care as: collective knowledge; community leadership; active acknowledgement of Te Tiriti o Waitangi as the foundation of New Zealand; equity; wellness; partnerships; active quality improvement processes; by Maori for Maori, by Pacific for Pacific, by youth for youth services; and meaningful contracts.

HCA Te Kaihautu Rowena Gotty said the Declaration was an important step in collective action for primary health care in Aotearoa/New Zealand, and would contribute to the international literature in the global movement to achieve health equity. ‘Our ultimate goal is to have the Whakakotahi Declaration adopted by the whole country so that it becomes New Zealand’s Alma Ata,’ she said.


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