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King speech: Health of People and Communities

Annette King speech: Launch of Public Health Advisory Committee report: The Health of People and Communities

Grand Hall, Parliament


Thank you to the Public Health Advisory Committee for asking me to receive this impressive report today.

I have listened with great interest to the preceding speakers, National Health Committee chair Dr Robert Logan, PHAC chair Geoff Fougere, NHC and PHAC member Riripeti Haretuku, and, of course, my colleague Steve Maharey, Minister for Social Development and Employment and Minister of Housing.

Both Geoff and Robert made reference to the fact that this report builds on the work of the National Health Committee in 1998 on the social, cultural and economic determinants of health.

It is appropriate, therefore, that this new report is subtitled: A way forward: Public policy and the economic determinants of health.

I am looking for a nice and polite way of putting this, but I think I can say fairly safely that when the 1998 report came out, it was considered by the then government as what might be called ‘fringe thinking”.

That’s certainly not the case now, of course. As Steve has already told you, there is absolutely no doubt, as far as this Government is concerned, about the correlation between socio-economic factors and health.

The 1998 report has become a seminal document for New Zealand public health, and its findings are now part of mainstream government policy and strategies, especially in the health sector.

Within a year of this Government taking office, in December, 2000, I launched the overarching health document, the New Zealand Health Strategy, which recognised the role of social, cultural and economic factors as major determinants of health, and of health inequalities in particular.

The New Zealand Health Strategy advocates that improving the health of New Zealanders must include a focus on factors like income, education, employment, housing and access to healthcare services.

It also emphasises the need to focus attention on those with the poorest health to reduce health disparities. In effect, the strategy acknowledges that although individuals should take responsibility for their own health, there are structural factors that may create barriers to achieving good health.

Other government health and disability strategies also reflect evidence of the effects of socio-economic conditions on people’s health.

The New Zealand Disability Strategy emphasises the importance of employment and economic development to provide opportunities for disabled people to participate fully in society.

He Korowai Oranga, the Mäori Health Strategy, stresses the need to address disparities in health status that reflect the socioeconomic inequalities experienced by Mäori.

The Primary Health Care Strategy is underpinned by a goal of improved low cost access to primary health care. The strategy aims to improve health overall and reduce inequalities in health.

In fact, in terms of government priorities for health spending, I believe the greatest advance this Government has made, in terms of recognising the socio-economic determinants of health, is our investment in primary health care through the establishment of Primary Health Organisations.

The Government has earmarked $1.7 billion in new money over six years from 2002-03 to be spent through PHOs on providing access to cheaper and more accessible primary health care for as many New Zealanders as possible. By July 2007, all New Zealanders belonging to PHOs, and by then that will be almost every single New Zealander because already 3.7 million of us are signed up, will be able to access cheaper doctors’ visits and low-cost prescriptions on most items.

I have long been convinced, and today’s report does nothing to change my mind, that it is pointless having top-quality health services if people cannot afford to access them, or cannot afford to pick up their medicine from a pharmacy. I am absolutely determined that by 2007 there will not be one New Zealander in that position.

This PHAC report, The Health of People and Communities, contains recommendations that are, of course, directed to the whole of government, not just to the Health Minister.

Some are far-reaching, such as developing an official poverty measure and setting targets for reducing child poverty, and others, such as the routine reporting of socio-economic, ethnicity and health data at regional and national level, are already being implemented in various ways around the country.

Because they are recommendations to the whole of government, it is not appropriate for me to comment on them specifically this afternoon, but I will certainly take them to my colleagues in cabinet, where I can assure you they will be considered with great seriousness.

I hope you would expect nothing less from a Government that has, I believe, already done much to show its sympathy with the overall content of this report.

I can go further, however, as far as the first recommendation is concerned. As you know, it says: Adopts the goal of improving the health of all, without distinction for ethnicity, social or economic position, to the same level as those who have the best health.

I simply cannot imagine many New Zealanders not accepting that recommendation. It would take a particularly mean spirit, the sort of mean spirit that manifested itself this year at Orewa, not to want all New Zealanders, particularly our children, to have the same level of health.

Another recommendation relates to developing the capacity for health impact assessment as a policy tool for all sectors in assessing the potential impact of significant policies on health. In March this year I launched PHAC’s Guide to Health Impact Assessment, and have supported this work by funding the promotion of health impact assessment (HIA) across central and local government.

We need to build a store of New Zealand evidence for the use of HIA, and I look forward to the evaluation of the initiatives that are now taking place. I want to emphasise again today the importance of using HIA as a tool to ensure that high-level policies do not damage the nation’s health or contribute to further health inequalities.

I know I speak for Steve as well as the rest of my colleagues when I say this Government continues to place great value on the work of the National Health Committee and its subcommittee, the Public Health Advisory Committee.

Thank you again for presenting us with this report. I am very happy to receive it, and I am looking forward to sharing it with the rest of my colleagues.

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