Address to New Zealand Respiratory Conference 2014, Intercontinental Hotel, Wellington

  • Peter Dunne

Good morning and thank you for the invitation to open the New Zealand Respiratory Conference for 2014, A breath of hope. I opened this conference two years ago, and I am very pleased to be here again in this 50th anniversary year of the Asthma Foundation – a great achievement.  This year the conferencewelcomes over 200 attendees from across New Zealand and Australia.

I would like to acknowledge my colleagues, MPs and extend a particular welcome to those who have travelled from overseas for this conference, including:

  • Kristine Whorlow, from the National Asthma Council, Australia and
  • Peter Anderson, from the Asthma Foundation Queensland.

We all know respiratory disease is an important health issue in New Zealand - the recent report, Health Loss in New Zealand 2013, highlighted that. It showed respiratory disorders collectively accounted for 6.3% of total health loss in this country, almost all from chronic obstructive pulmonary disease (3.7%) and asthma (1.6%).

Respiratory disease impacts severely on our families and communities. 52 New Zealanders die from Asthma every year – that is one person a week on average. One in four New Zealand children and one in six adults live with asthma. The impact of living with asthma, I think, is put in perspective in the statistic that one in four children struggle to blow up a balloon.

In a nation that has always recognized the importance of physical activity, and the positive impact it has health and wellbeing, for so many young people to struggle with such a seemingly simple activity is of real concern. Asthma alone affects 800,000 people and is estimated to cost us, as a nation, $800 million every year.

Given these figures, the Asthma Foundation’s vision of “Improved Respiratory Health for all New Zealanders” is one that must be supported by all. The Foundation’s current goal is ‘to reduce hospital admissions caused by respiratory conditions by 25% by the year 2025’. It is seeking to achieve this through its various programmes - educating on best practice, providing support and advice, funding research, and advising on strategic approaches.

Respiratory disease in children remains a pressing problem. More than 100,000 children need medication to enable them to participate fully in their families, schools and communities. Māori children are one and a half times as likely to be taking asthma medication as non-Māori. The government has recognized these challenges, and continues to implement policies targeting the most vulnerable in our population.

At a system level, the Government has improved access to primary care for children. Last year we invested more than $30 million to provide free doctors’ visits for children under six years of age. In real terms, that is 355,000 children who can visit their regular doctor or receive out-of-hours service for free. Before that there was no scheme that provided for free after-hours doctors’ visits. Improved access to primary care has contributed to a 25 percent reduction in the number of children being admitted to hospitals for asthma and respiratory infections.

In the last Budget the Government announced that from July 2015 it will extend the current zero fees for under-six year old children for primary care and pharmacy to all children under13 years of age. I am confident that this will lead to further improvements in outcomes for children with respiratory disease.

At a service level, the Ministry is working with the Asthma Foundation to lift health literacy among young Māori affected by asthma, their families and health care professionals. Today you will be hearing a presentation on Understanding Asthma: He Mâramatanga Huango, a research project jointly commissioned from the University of Otago. It will identify effective approaches to strengthening health literacy to allow young Māori to better understand and manage their asthma.

For adults, prevention of respiratory disease is essential. Smoking cessation programmes have a key role to play in reducing respiratory illness. This Government has made this a focus through the Better Help for Smokers to Quit national health target. In the last quarter 96% of identified smokers admitted to hospital were offered brief advice on quitting.

In primary care, the recent extension of this health target, 86% of identified smokers were offered brief advice on quitting during a consultation. The Government’s health target, national campaigns such as Quit Now, Stop before you start and Aukati Kai Paipa, and our ongoing commitment to smoking cessation services like Quitline have led to our lowest ever national smoking levels – only 16.5 percent of New Zealand adults smoke daily. Our youth smoking rates have more than halved in just five years, with only 3.2 per cent of surveyed young people still smoking daily.

However smoking rates for Māori remain far too high at over 32.7%. The Ministry of Health’s Tobacco Innovation Fund is providing an additional $5 million a year to target smoking rates among Māori, Pacific and pregnant women. This includes initiatives such as a project, called the Wero Challenge, aimed at triggering mass quitting. Teams of smokers are formed, with each team having its own coach and smoking cessation provider. The competition is informed by Maori beliefs and tikanga, and capitalises on the natural inclination of Maori and Pacific peoples towards being proudly tribal and competitive.

We know that increasing the price of tobacco is the single best policy to reduce tobacco consumption. Increasing excise tax is the lever the Government uses to influence the price of tobacco with an annual series of 10 per cent increases to the tobacco excise tax legislation until January 2016.At this point our modeling tells us that a standard packet of 20 cigarettes will be over the $20 mark or $1 per cigarette.

Housing also has a key role to play in reducing respiratory disease. Warmer, drier homes are healthier homes. Since 2009 the Government programme Warm Up New Zealand: Heat Smart has led to insulation of 235,000 homes. In the 2013 Budget we have invested $100 million over three years in a program Warm Up New Zealand: Healthy Homes to insulate another 46,000 homes.

Almost 300 state houses have been freed up for people in need in the last year alone, and we’re developing new, dry and warm homes for New Zealanders in areas of high need such as Glen Innes. Recent initiatives to monitor and reduce air pollution from heating and vehicle fuels will also help to prevent respiratory disease across New Zealand.

So the Government’s ongoing commitment to improving outcomes for people with respiratory disease is wide-ranging, encompassing improved access for children to primary care services, gradually eliminating smoking from our population and enabling better housing. These initiatives are making a difference, but there is still a long way to go.

The government appreciates the value of partnerships with specific organizations with a dedicated clinical focus, such as the Asthma Foundation. This conference is timely, which is no coincidence I am sure, with Asthma Awareness Week beginning next week from 13 October. The week will see a range of activities undertaken to help raise funds for this important cause, and a “Balloon Day” to be held on Friday 17 October. I wish you every success with this important week in your calendar.

Working together is essential if we are to continue to make progress in reducing the impact of respiratory disease on our people. Thank you all for the service you provide to New Zealanders with, or at risk of, respiratory disease. I am sure this conference will be an opportunity for all participating for learning and discussion with colleagues, which will support you in your ongoing work.

It is my pleasure to open the “New Zealand Respiratory Conference 2014, A breath of hope.”

Thank you.