National Leadership and Workforce Development Forum

I am pleased to be joining together with you today at this National leadership and workforce development forum. And I say joining together deliberately because I see this event as a joining together of many parts.

Firstly, it is the bringing together of many key stakeholders in Cancer Screening; the National Screening Unit; National Services Purchasing; and the National Health Board.

But it is also about the bringing together of a range of historical group meetings and conferences held for the kaimahi, Pacific screening workers and health promoters operating under the auspices of the National Cervical Screening Programme and BreastScreen Aotearoa.

All of these groups and their service managers will now meet as a collective.

But there is a third even more fundamental reason why I am so pleased to welcome this important development in collaboration – the bringing together of many parts – including the different parts of our bodies.

In Te Ao Maori, we often draw upon the wisdom of our tupuna to understand key concepts in our health and wellbeing.

And so it is that we consider the phrase, “Ko te wahine te kaitiaki o te whare tangata" - Women are the guardians of the house of humanity.

It is a phrase which reminds us that within every female is the nurturing home of humankind – ko te wahine, he whare tangata, he waka tangata. It is a worldview in which we appreciate te whare tangata – the role of women as the carrier of future generations.

In many ways, it resonates with other spiritual images describing the body as a temple.

We should note there are no references which suggest the body is a corporate apartment block, a multi-storyed boarding house or a series of prefab buildings which can be split apart and relocated, dislocated at whim.
The body is a temple, a sacred house of humanity, to be respected, to be protected, and to be treated in such a way as to understand the fundamental relationship between our bodies and our spiritual, emotional and cultural wellbeing.

It is not about splitting up separate body parts – but it is more about treating the body as a whole.

In this sense, the critical aspect of the work that you are all doing – whether it be with breast screening or cervical screening – is to realise we are not just focusing on specific body parts in isolation of each other.

They say that the real voyage of discovery consists not in seeking new landscapes but in having new eyes.

And that is what today is about – it’s not about building a new house – it’s about looking anew to understand how our approach must reflect the whole of life; a holistic view of our health and wellbeing.

We all know the incredible success rates that have following the television advertising featuring Pasifika women on a beach, around a table at home and in the van off to have their smear tests.
While the use of humour is a significant factor to the success – it’s also about looking through a Pasifika lens – appreciating the importance of the collective and making the discussion of cervical screening part of everyday life rather than treating it as a medical speciality. It’s about making health real – and normalising screening as part of that.

I remember a good friend, Waireti Walters, once drawing on the concept of a flower to explain how cervical screening worked – it had great resonance with groups of Maori women who could understand and talk about cervical care through the use of metaphor and story, far easier than a textbook explanation of the methodology or procedures to be followed.

This forum is about normalising good health and wellbeing – and as a key part of that supporting actions across the country to increase breast-screening and cervical screening rates for Maori and other priority group women.

And I do want to acknowledge, upfront, that more women, particularly Maori women, are participating regularly in both programmes and that is a reflection of the tremendous work of kaimahi and others recruiting Maori women to participate.
But we can always do better – and we must, as long as the rates for Maori and Pasifika women in breast-screening and cervical screening are low.

We have seen the narrowing of inequalities in cervical cancer incidence and mortality amongst Maori women compared to other groups and it is really important that we celebrate the success we have had. It will help us to steel ourselves for the ongoing efforts that must be made to confront the ongoing challenges.

There are challenges in recruiting women to participate. There are also challenges in screening tests in detecting normalities. As long as both of these challenges continue, none of us can rest easy.

And so, the most immediate thing we can all take on, is to be prepared for the new service specifications which will be phased in on 1 July 2011. The specifications will include clear coverage targets and strategies that regions will use to increase breast-screening and cervical screening coverage rates for Māori and other priority group women within their regions.

This is about regional coordination – making sure East is talking to West; North to South – rather than nine different systems all operating at once.

The key focus of coordination and collaboration is about planning for success in setting outomes for equitable screening coverage.

I’m really pleased that the Forum signals a shift from overly concentrating on programme delivery to actually target specific outcomes – such as increasing screening levels for priority group women on both programmes.

The Forum is also really timely in that it coincides with the National Cervical Screening Programme parliamentary review.

I was thrilled to meet with the review panel last week – Dr Jeffrey Tan – the Chair – who has come over from Melbourne for the purposes of this review. His experience has been his work in gynaecology, cytology and the treatment of women with cervical abnormalities.

The second member on the team is Linda Thompson – who has extensive experience in Maori health, nursing and health management.
And the final member of the panel is Dr Roberta Howlett from Canada who has enormous credibility in cancer screening and research.

My time with them was extremely constructive and I have every confidence that this team will push the boundaries in reviewing the operation and evaluation of the National Cervical Screening Programme with a view to improving it even further.

I hope that if any of you are asked to respond to the panel you will feel able to share exactly what is working and what isn’t – I’m really keen that we know exactly what we should be doing; what we should be doing that we’re not – and of course what - if anything – we shouldn’t be doing.

Even before the review reports back, I know that we cannot stand back and just abide by the different rates that we still see enduring in Maori and Pasifika communities. We must build the capability and capacity of the workforce; we must collaborate with primary care and the wider health and social services sector, and we must share our highest thinking about how to experience the difference we need.

And so I will be as eager as you are to hear the report-backs after this forum, from the various strategic leaders, sector specialists and service managers who will be helping you all to crystallise your thinking over these three days.

I wish you a very stimulating, challenging and fulfilling three days.

Take care of yourselves – take care of each other - the health and wellbeing of all of our women is literally in your hands and we all need you to be strong; to be well; and to be optimistic that we will see a brighter future ahead.