Prime Minister Jacinda Ardern’s Wellbeing Budget speech
Rt Hon Jacinda Ardern
30 April 2019
We said that we would be a Government that did things differently, and for this Budget we have done just that. Today we have laid the foundation for not just one Wellbeing Budget, but a different approach for Government decision-making all together.
And for that I want to thank Grant Robertson. The vision for this project started many years ago for Grant, while we were in Opposition in fact. He created this piece of work, not because it is an interesting project – which it is – but because when he heard many an economist say that GDP wasn’t enough to measure success he agreed and did something about it. Thank you Grant. This was a first, in so many respects, and its legacy won’t be just a document, but the hundreds of thousands of lives that will be changed as a result.
I also want to thank our coalition partner, New Zealand First, and especially the Deputy Prime Minister. There are elements of this Budget including, for instance, the investment in rail that have been a huge focus for New Zealand First as a party, but there are other elements where your Ministers have taken on portfolios and delivered important agendas that are central to Wellbeing, like the Minister for Children Tracey Martin.
And to our Confidence and Supply partners, the Green Party. In this Budget we fulfil many commitments to you and our environment, that includes making sure the economic transition required to deliver emission reductions is effective, efficient and just. But more than that: Today we further our shared ambition to ensure all New Zealanders do well but especially our children.
Thank you to all parties for your collective commitment to being a Government that is not satisfied with the status quo and instead is tackling our long-term challenges. We have demonstrated that commitment today.
And here with these words of thanks is where, Mr Speaker, I will depart from the traditional Budget Day speech.
Usual practice would have me traverse various and disparate initiatives, the many areas of need and investment. Not today. Today, I want to pick up the first thing I talked about when I took on a leadership role in the Labour Party – I want to talk about mental health.
Roughly two or so years ago there was an event held on the forecourt of Parliament. It was a weekend, so didn’t have the usual gathering of people and onlookers. Instead it contained a group of bereaved people – family and friends – who had lost loved ones to suicide. They had brought with them pairs of shoes to represent the number of lives that had been lost that year alone. I knew who one of those pairs of shoes belonged to, just like every single member of this House will know someone. We have two degrees of separation to each other, but there is no separation when it comes to New Zealand’s experience of suicide. It affects all of us.
But suicide is only one part of the story. The issue of mental health and wellbeing more generally is a challenge that the World Health Organisation says will be the world’s biggest health problem by 2030. We can’t afford to wait for that to happen.
Today, we take mental health seriously. And that means starting right at the very beginning. Let me share with you today, the end-to-end journey that this Budget will create for mental health and wellbeing in this country.
And what better place to start than at the very beginning with our mothers?
Some years ago I visited a programme in the Hawke’s Bay that had been started by a Plunket nurse called Nicky. She was a passionate believer in the power of good strong relationships between nurses and new mums. So she started a trial. She paired up a well-qualified nurse who related well to young people, with a group of young mums who were considered to be vulnerable. That nurse met them before their babies arrived and she didn't just see them for her contracted visits, she connected them with other services, and whatever they needed. The result? Higher rates of breastfeeding, immunisation and uptake of other support like dealing with the consequences of trauma, or family violence and even budgetary advice. She helped these mums not just survive those first 1000 days.
I absolutely believe in early intervention Mr Speaker. I believe in the power of relationships, and I believe that when mothers are supported and given the best chance possible they and their children will thrive. And so in this Budget we begin the journey, by putting $10 million into extending Nicky’s programme into three sites across New Zealand – which I hope is just the beginning.
But what about our next generation? Children who are already in school? How do we build resilient kids in a day and age when there are so many pressures on them? Thankfully this question has already been asked and answered with programmes that have an evidence base behind them, like one called Sparklers. Sparklers is about helping educators to improve children’s emotional and mental health at school. For example, a teacher could go online and download an activity that helps a child to manage stress and relax. We know these resources make a difference to children’s mental health, and that’s why from now on they will be available to every school across New Zealand as a result of this Budget.
But even the most resilient kids can experience extremely difficult times. That’s why as of April this year, we finished rolling out Mana Ake, a programme that puts a mental health support team in every primary and intermediate school in Canterbury and Kaikōura. It has already helped 2000 kids and will keep doing that this year.
And for our older children – who we know experience additional stress through those adolescence years – in the last Budget we started the roll out of nurses in schools. Evidence tells us that these health teams are often the frontline for mental health issues, and that’s why the Budget will continue the roll out into more schools taking the total number of young people covered by the programme to almost 83,000.
Not every child or young person will want to reach out to someone face to face, some would prefer a phone or text service, or some can’t reach services quickly such as those in rural and isolated communities. That’s why we are making an investment into tele and digital health of $21 million this Budget. This will be a service for everyone – no matter what age you are, or where you are.
Mr Speaker, I’ve said before that during the election campaign I had a number of people share some really personal stories. But there was a common theme in all of them.
For all the work we do to build resilient young people and communities, there will always be a need to help people in times of distress. Or even at the beginning of dark clouds rolling in. And yet I constantly heard this message – we don’t know where to go for help.
That became one of our key tests this Budget. Will someone in the very early stages of a mental health issue, be able to get the help they need?
To create a network like that, where would we possibly start? Well with this Budget, we will start in people’s neighbourhood, in the health services they use most often.
A few months ago now I visited a medical centre in South Auckland. It was your usual GP clinic, but with a twist. It didn’t just house doctors, it was also home to mental health workers. And for a very simple reason. GPs were discovering that in their short 15 minute appointments, patients were opening up. They’d share issues that often went beyond just a medical issue. But they never had the time, or necessarily the expertise to help. They’d do what they could, perhaps send a referral for their patient to see the DHB’s mental health services, and that would be it.
I spoke to one of the patients at the clinic that day. She had a good job, good friends, was part of a close family. But she suffered from deep and dark depression. She told me she had been one of those patients that had come to see her GP in moments of real distress, when she’d struggled to leave the house or to keep putting on a brave face for those around her. But when the doctor referred her onto other specialists and gave her referral letters “I knew I would never go” she told me. And she didn’t.
So her doctors brought the service to her. They brought in mental health workers who were trained, and could take appointments right away due to flexibility in their working day. The doctor would hear their story, then walk them down to someone who could support them right then and there. The woman who had previously ignored those appointments, didn’t ignore this service. She told me how it literally changed her life. In fact, she had now brought a family member to the clinic for the same life changing support.
And that is why today, we will ensure every person in New Zealand will be able to access the support they need, when they need it, by rolling out a whole new workforce of trained mental health workers in doctors’ clinics, Iwi health providers and other health services across the country. It is a new service targeted specifically at the mild to moderate mental health support that so many in the middle miss out on. It is for all of us and it will be a game changer.
We also know from the Mental Health Inquiry that we need services that meet the needs of Māori and Pacifika. Kaupapa Māori services will receive $62 million to ensure the primary mental health service is offered in Kaupapa Māori providers. We’ll do the same for Pacific health services too.
In total it will cost $455 million and take us a full five years to get the workforce we need to have this service running at full capacity, but I absolutely believe that when we do, this new layer of early care will transform mental health services in New Zealand.
But even with early intervention care, we still need more investment for those cases where intensive services are needed. The Wellbeing Budget has delivered a three-pronged approach: we are increasing the mental health capacity of staff already working in Emergency Departments, we are putting additional staff into those Departments to help people who present with mental health issues, and we are providing further follow-up services for people who present to an Emergency Department with their mental health in crisis. And for those who have lost loved ones, we know more care is needed. We will, as a result of this Budget, provide a free counselling service for up to 2500 people bereaved as a result of suicide.
Mr Speaker, this Budget is not just about straight mental health support. Thanks to the mental health inquiry we also heard about how vital and under-resourced our addiction services are. I still remember hearing about some of that first hand in the last election. Those who work with me know this story already – I have repeated it a lot since, mostly out of disbelief.
I was in Gisborne with a group of frontline workers and volunteers from the social sector. Included in the room was the mother of a young man who had experienced methamphetamine addiction. There was a lot that stood out from her talk, but there was one thing I remember the most. That in an area that was experiencing such huge need for service, there was not one residential drug treatment facility, not one bed, in the entire Tairāwhiti area. Not one. Well today, in this Budget, that changes. A total of $200 million has been allocated to build further facilities across the country and that will include Tairāwhiti.
$56 million will also go into specialist alcohol and drug services, including enhanced residential and aftercare support services that will help over 2000 people each year. And an additional 5000 people will be able to access early support for alcohol and drug issues across 10 sites, including outreach support.
Of course in order to tackle mental health issues, we must look at the complex and interwoven issues that contribute to them. There is no point in targeting mental health if we don’t also invest in homelessness, family violence, poverty and other issues that contribute to stress in life. And that’s what this Wellbeing Budget has done.
It addresses New Zealand’s shocking levels of homelessness by acknowledging that chronic homelessness is often a result of multiple complex and compounding issues and makes the largest single investment in chronic homelessness ever.
It addresses the fact that every year about one million New Zealanders are affected by family and sexual violence, including almost 300,000 children, and so it makes the single largest investment into family and sexual violence, including working with children who witness violence to break the cycle and the mental health trauma it causes.
And finally, as the Minister of Child Poverty, there is no ignoring the stress and strain that material deprivation causes our families. We have already made a huge dent in child poverty in this country as the first child poverty reports in the Budget show – that through family tax credits changes, accommodation supplement changes, the Best Start programme, the Winter Energy Payment, changes to abatement rates and initiatives in the Budget, we are already projected to have lifted between 50,000 and 74,000 children out of poverty and are on track to meet our targets of halving child poverty in this country by 2028.
But we know more work is needed.
Today, we make a systemic change. This Budget acknowledges the work of the Welfare Expert Advisory group but also the long-standing campaign of many advocates by indexing benefits to wage increases. We already CPI adjust, but that hasn't stopped families falling further and further into poverty. Both Governments know this has been an issue – that in part was why the last Government gave a one-off benefit increase. But now is the time to make a long-term change that while modest this year, will make a significant long-term difference to relieving a major stress on low-income households.
Mr Speaker, there is so much more to say about this Budget – but one message I want to repeat is this. I have always said that politics is all about priorities. You have a limited budget and you have to try and balance the need to grow the economy, create jobs, balance the books, and look after our people and our environment. This Budget shows that you can do all of those things.
We said we would deliver and with this Budget we have.
We have delivered a surplus.
We’re delivering low unemployment.
We have delivered low debt.
We’ve delivered a plan for addressing mental health challenges. That means every New Zealander will get the help they need, when they need it.
We’ve delivered cheaper education for families.
We’ve lifted tens of thousands of children out of poverty.
And we’re delivering housing to the homeless.
This is what our Wellbeing Budget looks like. This is what we came into politics to do. And we’re doing it.