Launch of Public Health Advisory Committee's First report

Thank you, Dr Logan, greetings to parliamentary colleagues present, invited guests, and previous speakers.

I am pleased to share this podium with Professor Alistair Woodward and Dr Cindy Kiro. Indeed it is an honour to be here to launch the Public Health Advisory Committee’s first report to the Minister of Health.

When our government came into office three years ago, we had an agenda for health that has now largely been put in place. Part of that agenda was to issue the New Zealand Health Strategy, highlighting the importance of initiatives that: firstly, improve the health status of those people who are currently disadvantaged; reduce inequalities in health; work collaboratively to provide the best services possible to those that need them, and act on the special relationship between tangata whenua and the Crown. The Government also established the Public Health Advisory Committee to provide independent advice to the Health Minister on public health issues. We wanted a “dedicated” public health advisory committee because of the Government’s commitment to public health. Population-based approaches make a real difference to the health of people and communities and to reducing inequalities.

We thought there was value in associating the new committee with the National Health Committee, because of the commitment to public health the NHC has shown during its 10-year existence. Its 1998 report on the social, cultural and economic determinants of health was a crucial document that showed that health is not just about health services but also about education, employment, housing, transport and more. In fact, it showed that these wider determinants actually have a greater influence on health than do personal health services. Based on strong evidence, the report was difficult to discount and it reinforced the thinking of politicians across all parties that there is a strong relationship between people’s health and factors such as low income and poor housing.

Labour greeted the 1998 report with enthusiasm – even though we were in opposition at the time. It fitted our view that after more than 10 years of a market approach focusing largely on efficiency, it was important to have an alternative view. It also made clear the need to specifically address areas of disadvantage. It has provided the basis for much of our health policy thinking.

We are encouraged to know that the Public Health Advisory Committee’s annual reporting programme will be filling in detail of issues raised in the 1998 National Health Committee Report. This will provide opportunities for new emphasis by Government.

The significant areas in the report we are launching today include; indoor and outdoor air quality; water quality including drinking water, surface and ground water, and sanitation; the quality of life in urban environments; and the health effects of climate change – something we can’t ignore.

Looking more closely at just one of these, indoor air quality, we see there are multiple causes for poor air including poor housing, unvented gas appliances and second-hand tobacco smoke. Considering we spend an average of 80 percent of our time indoors, the quality of that environment is a very important, but probably a greatly overlooked, contributor to the state of our health.

As Associate Health Minister, I will be doing what I can to see that the public health focus is present in our response to that particular issue and indeed on all of the issues this report raises.

As well as having health responsibilities for environmental health, I am also responsible for rural health and so I was pleased to note that this PHAC report also emphasises the multiple disadvantages people in some small isolated rural communities face. They are more likely than urban communities to experience less than adequate housing – particularly in the North, water and sanitation services.

Mäori, Pacific peoples and those on low incomes generally have poorer health than other New Zealanders and the effects of environmental conditions such as poor water and poor air quality compound this fact.

Effective action to reduce inequalities relies on co-operative working among agencies and the strengthening of relationships across sectors. The Government is committed to this “whole-of-government” way of working – not only in health but in a wider range of areas. It is clear that while there are actions the health sector can take to improve the health of disadvantaged groups, a cross-sectoral approach is needed to really make the differences that we should be making.

A good example of this approach is the work Housing New Zealand Corporation is doing with other agencies in Northland, East Coast and the Bay of Plenty to improve housing conditions for low income families. The Corporation is working with health and social services to identify substandard housing and its associated health and social problems. Some 2,000 housing improvements are expected in the next four to five years with an expected improvement in the health of all those families involved. Two Auckland DHBs are also working with housing services on a “healthy housing” initiative in areas where overcrowding is a problem.

This report from PHAC that we are launching here today strikes a nice balance between showing us the way forward with initiatives that improve the impact of the environment on our health and highlighting where there is still much for policy-makers to do.

Coming into the venue today I couldn’t help but notice that upstairs the Department of Conservation is having a meeting on environmental issues. As Member of Parliament for the West Coast, I am well known for my views on the environment. Too many people who live in urban areas consider that the environment is all about protecting flora and fauna in rural areas. But they forget the reality that they are destroying the environment by living in urban areas. I am a passionate advocate for this. We have to address both issues – flora and fauna and the urban environment.

So it is with much pleasure that I launch this first report form the Public Health Advisory Committee and I look forward to the next report in the cycle which will build on further from the 1988 report.