National Problem Gambling Provider Forum

Good morning, and thank you for the invitation to speak today at this year’s forum.

Your theme is ‘What’s Working, What’s Not, What’s New?’ – and they are by any measure, three important questions.

I would like to help you address them here this morning, from my perspective as Associate Minister of Health, responsible for problem gambling.

Thinking about what is new, two things in particular come to mind, though for very different reasons.

They are the February 22 Christchurch Earthquake and the Value for Money Review of Problem Gambling Services.

The Christchurch earthquake changed a lot of things for a lot of people.

For many, it took loved ones from them, be they friends, family, neighbours or colleagues.

The death toll was devastatingly high and the damage to the city and the lives within it, devastating.

Our hearts went out to those who suffered, and continue to suffer, including any of you here today who were directly involved.

To those of you, who assisted, either in the immediate aftermath or in the days, weeks and months that followed the earthquake, I extend to you my thanks.

I know that when the call went out for assistance, for a shoulder to lean on, and a shoulder to cry on, those of you who could, helped however possible, and you continue to do so.

For some of you in this room today, the earthquake and the September one prior to it have changed much about how you go about your work.

Your homes and offices may be damaged or closed, and you may be working out of unfamiliar environments.

The nature of your work you do may in many cases also have changed, with assistance for grief and trauma perhaps as relevant for your clients as helping them with their gambling issues.

Through all this upheaval we should not overlook the impact the earthquake has had on people’s stress levels and the overall tension it has given rise to in the community as people try to come to grips with what has been going on around them, and try to pick up the threads of normal daily life, in an environment that is to all practical appearances, anything but normal.

I am not at all surprised that gambling on non-casino gaming machines in Christchurch has increased significantly since the quake, in much the same way that drinking issues seem to have risen, and even smoking cessation stalled.

We are dealing with a lot of stressed people, and human nature can often take us to our weaknesses and frailties at times of extraordinary pressure and strain.

While the absolute last thing people need or deserve right now is moralistic lecturing about their behaviours, we do need to understand why things are happening the way they are, and to take the insights we can from what is happening to help in our work as in dealing with these issues.

This is an area in which we will need to remain vigilant, ensuring that as people seek ways to cope with the traumatic changes in their lives, they do not in turn harm themselves in the process.

I appreciate your sensitivity to this task and encourage you to keep up the good work.

As you are all aware, the Ministry of Health recently undertook a value-for-money review of problem gambling services.

KPMG was commissioned to undertake the review, which looked at key facets of the Government’s problem gambling programme, from service delivery through to the Ministry’s role, research and international comparison.

While the final review document is still making its way through Cabinet, a process that I appreciate can be slow, especially with the Easter break, I would like to share a few of my thoughts on the review itself.

The results have been encouraging.

I have discussed the review with the Ministry and with KPMG, and I am pleased to say that overall it points to some very positive realities.

What is working?

• The review noted that the combination of a preventive approach alongside innovative and well designed intervention services provided a comprehensive approach across the continuum, which was likely to reduce the impact of gambling harm.

• Service coverage is comprehensive, with dedicated Maori, Pacific and Asian services, and a helpline delivering services in a range of languages.

• The ‘Kiwi Lives’ awareness campaigns have achieved good recall of the key messages, particularly among priority populations – a significant achievement given the challenges involved in getting messages across in a competitive multi-media environment.

Two particular strengths of the problem gambling programme stood out for me:

One, that there are good levels of client satisfaction with intervention services and two, that value for money has increased significantly in the past three years across many of the drivers assessed.

For example, whereas in 2007/08, just 25% of treatment providers were achieving 75% of their targets, that figure had jumped to 86% by 2009/10, and is likely to have risen further since then.

This suggests to me that the services being provided are high quality, and that there is an ongoing focus on quality improvement from all involved, which is continuing to show improved value for money.

As with any industry or organisation, an ongoing focus on quality improvement is key to ensuring quality of product and staying ahead.

The significant improvements in value for money over the last three years show that this focus exists, but there is still progress to be made.

What needs further work?

My earlier comments notwithstanding, achievement against contracted targets is still an area of concern, although I note that continued improvement in this area is evident in data for the six months to the end of last year.

Follow-up contact with clients is still too low, and more effort needs to be put into this area.

This is a matter I will be paying increased attention to in the year ahead.

I recognise that keeping track of clients outside of the clinical environment can be difficult, but follow-up contact is key to providing ongoing assistance to those with gambling problems.

But we are certainly well ahead of the bad old days of 2006/07 when there was extreme and justifiable concern at the numbers of clients being seen, and the high cost of interventions at the time.

Next year will herald the beginning of another problem gambling levy setting process and service plan.

The information provided by the value-for-money review, and up-to-date client data will play a large part in assisting with allocating funding for the next three-year period.

Demand for services, effectiveness, efficiency and economy will be key drivers in that process.

Consistency and accuracy of public health messages needs improving.

As I made clear at last year’s forum, this government is neither anti-gambling nor anti-pokies.

It believes in the right of New Zealanders to choose, while providing assistance and information for preventing and minimising the harm for the small percentage who will experience it.

Let me be clear, I do not want inaccurate messages, personal crusades or inappropriate lobbying of MPs to overshadow the good work that this sector does.

As primarily tax-payer funded organisations, the work you undertake needs to pass the perception test.

If it looks like it could be perceived as overstepping the line, then you need to step back, and contact the Ministry for further advice.

I am aware that Mike Bazett and Blair Wightman from KPMG are speaking after the break on the review, so I will stop stealing their thunder.

I expect that following Cabinet considering the results of the review, it will be released publicly, and I look forward to this happening shortly.

Overall, I believe it is a positive review which recognises a number of strengths and identifies some areas for further development, and the sector will be stronger for it.

It is pleasing to see on the forum programme, an inaugural awards night and dinner this evening, celebrating what is working, and more importantly, those who are making it work.

Given the amount of hard work and dedication that goes into this sector, I suspect it will be no mean feat narrowing down the finalists.

In these times of austerity and fiscal prudence, it is these events such as tonight’s that can often be overlooked, or shaved off in the search for savings.

While I agree that prudent expenditure is necessary today, value for money is not as simple as penny pinching.

Recognising and celebrating good work and sharing best practice with colleagues is vital to ensuring ongoing good practice and good service delivery is not only recognised, but is spread and taken up by others.

Tonight’s function, I hope, will do just that and I look forward to seeing the benefits from it flowing through your ongoing work, and reflected in your ongoing quality improvement processes.

Finally, I would like to note that if there is one thing we can be certain of in the current economic and political environment, it is that change is the new constant.

To keep up, we must make sure we are in a position to move with the times, whatever challenges they may present.

No person is an island, and neither is this sector.

Despite its relatively unique position in the health sector, it does not operate in a silo, but as part of the wider mental health and addictions sector.

This role in the wider sector needs to be reflected in the skills, competencies and ongoing training of you all, as we work towards a collaborative and functional health sector.

I strongly encourage you to make the most of this forum, to learn from those presenting and those around you, and to continue to build on your skills and competencies.

In doing this you will be ensuring a strong, competent and resilient sector; one that is ready for the challenges and opportunities of the year ahead.

I thank you for your attention, and I wish you well in your work.