The Launch of: Making a Pacific DifferenceHealth
Faka'alofa Lahi Atu, Talohi Ni, Ni Sa Bula, Kia Orana, Malo Lelei, Talofa Lava, Kia Ora.
As your Health Minister, I certainly share the commitment of those who have put this strategy together. I share their desire for greatly improved health among our Pacific New Zealanders.
That desire is personal, as my own children have Samoan heritage. It is also general. Every person in New Zealand either came here or had ancestors who came here in search of a better future for themselves and their families. We still seek that same thing.
I'd like today to talk about three things. I want to mention past Pacific health care in this country.
Then I want to talk about "Making a Pacific Difference", why it is such a significant document, and how it can be used.
Finally, I'll look at what this could tell us about improving health care for all New Zealanders.
You don't need a degree in statistics to work out what proportion of dedicated Pacific health care professionals we had in the field even five years ago.
What is practically beyond statistical analysis is the effect that those few people have had upon Pacific health care in recent years. Their commitment to meeting the needs of their people has brought us to this day. This document epitomises that commitment, and is a sign of a great deal of hard work to improve Pacific health care.
I'm going to be talking about rural health on Thursday, in Balclutha, where it would seem that the health needs are very different from where most Pacific people live. But in fact I'm going to run into exactly the same sort of issues as I do throughout the country.
Health politics is not about the usual political arguments, and the media representation of them, which are inherently conservative and usually more concerned with keeping the status quo than change to make real improvements.
Times have changed, and needs have changed, and far too many needs were never acknowledged in the first place so things can't stay as they are. The status quo gives us the negative statistics and they are not good enough.
If you ignore the needs of some in the country, so we can have a comfortable political ride, you find that everyone suffers in the long run.
The health needs of Pacific people are only now beginning to get their due acknowledgment. The idea that the traditional public health system has served the Pacific community well is just nonsense. And we do have the statistics that show that.
The past wasn't great. That is why today's launch is a significant one. "Making a Pacific Difference" confirms that Pacific health care is finally on the map. Its title tells us that from now on we want Pacific health to improve in this country, so that a difference really will be seen.
That doesn't, unfortunately, mean that things are going to get instantly better. What it does mean, is that we can no longer be blind to the health needs of our Pacific people. This strategy is one powerful way to ensure that Pacific needs are visible, among all the others that need the health dollar.
I have high hopes for this strategy, because of the strong input from Pacific people. Its consultative nature bodes well for the work that will follow it. It has taken longer than originally planned, but I think that has added to its clarity and sense of overall direction.
The document's initial value is in how clear and strong a direction it gives to people working in health.
So, rather than talking about the document itself in detail, I'd like to look at practical examples of the kind of initiatives it promotes.
The fundamental failure of the past has been the delivery of health care to Pacific people. Today, there is a "Pacific People's Health Charter" to this end. It talks of consumer participation, culturally appropriate services, funding, co-operation and health promotion. They seem obvious, but they haven't been taken seriously to date.
All of these things can be seen in action with the just-opened Tongan health centre, run by a new provider, the Tongan Health Society, and supported by North Health funding.
Of all the Pacific people, Tongans have the least fluency in English, because of little need to speak it on their islands. This means having a health clinic where their own language is spoken is a huge improvement in their access to health care, and health promotion information.
As many one or no-car families are unable to attend daytime surgery, this health centre will be open in the evenings until 9 pm, and weekends. It's also easy to get to by car, being just off the motorway in Penrose. These things might sound small points, but they really do make a difference in accessing health care. I would not be surprised if many non-Tongans also start flocking in to use such easily available services.
Another area of special emphasis in "Making a Pacific Difference" is child health. The aims for this area talk about:
strengthening the family unit and improving parenting skills
improving access to primary health care services, and
delivering health promotion strategies and research.
All these aims are driving the new initiative of home-based support services for Pacific Island babies in Glen Innes. Here, North Health is contracting with Pacific Health Star to provide culturally appropriate help and information for pregnant and new mothers who have little other support. These experienced Pacific health workers form a special team for each baby's first year of life. They will ensure the mothers are linked to a compatible primary care provider, Plunket and other public health services, and that they are given help with breast feeding, immunisation information , the use of car seats, budgeting and other areas of difficulty.
Some of those benefits are immeasurable. Of those we can measure it is expected that there will be a 90-95% immunisation rate, a completion of all Well Child checks, a 100% use of car restraints, and greatly improved breastfeeding rates.
The importance of such measuring of outcomes - of research and monitoring - is also emphasised in "Making a Pacific Difference". Change in services is important for a diverse population, whose needs are also changing.
I've talked about the lack of suitable, accessible Pacific health care in the past. I've looked at the kind of things "Making a Pacific Difference" promotes, and the very real hopes I now hold for improvement.
Finally, are there are any general lessons we can take from Pacific health care?
I think there are. Look at the challenges facing rural health care providers. Small numbers of people still need a wide range of services which aren't always viable.
For the people in my electorate low numbers and remoteness are barriers like the cultural barriers which make access difficult for Pacific Island communities.
There are no simple solutions to these problems. But I do think we have some pointers, and I think the work by Pacific providers does tell us what these are.
The people who provide the best sorts of solutions are the ones who are most intimately involved in them. They are the ones who can see what the effects are on the people they most care about.
In rural health, it hasn't just been the doctors who have organised new health centres to meet rural needs. The farmers and bus drivers and parents have also been the driving forces.
Similarly in Pacific health, it has been Pacific people themselves who know what they most need, and have worked hardest to get it. Not alone, I am happy to add. But, naturally, their motivation is very strong, because it is their children, their parents, their friends, whose health has been suffering.
This is why I am so keen on involving what others call "private" providers in our public health system. I prefer to call them "independent", because that, for me, is their defining characteristic. They are not hospitals, or doctors, or nurses. They come, by definition, from groups that have found it hard to get to the usual services. Independent Maori providers, of course, are another such example.
It simply is not practical for all Pacific health needs to be met by such independent providers. There are not enough of them, and those we have are already very busy people. But I believe we must support them because of their motivation and insight. We should also take their knowledge on board in our mainstream health care.
In summary then, the past has not been great, but, due to "Making a Pacific Difference" the future should be much better.
It holds the valuable perspectives that we need for better Pacific health care. I see independent providers as one important way we can fill out this new picture in more and more detail.
We started with the motivation, now we have the information and the direction.
It's time to put them to work.
The next celebration will be when we see the positive differences in the health of Pacific people.