Pasifika Medical Association and University of Auckland Medical School Children and Youth Conference

  • Bill English
Health

INTRODUCTION
Good morning. Thank you for the invitation to open your conference. It is a pleasure to be here with so many people who are achieving so much for Pacific health in New Zealand.

What I want to do this morning is simply underline this Government's commitment to improving Pacific health, and the health of our children and young people. They are also two areas of particular personal concern for me.

The best way of showing this commitment is to give you an overview of what has happened in the last ten months or so since your first conference, and what to expect over the next few years.

Things are happening. The momentum is continuing.

Of course, you have been the instigators, and sustainers, of much of this activity. But I hope it will be encouraging for you to get the overall picture, and, especially, to hear how the Government is supporting your work.

There is a lot of work to be done, and we need to do it together.

STRUCTURE
Perhaps an easy way to outline what is going on is in terms of:

documents
appointments
current activities
future developments.
BODY
Documents
Three main documents, all published within the last twelve months, contain the theoretical building blocks for better health care for our Pacific children and young people

The first is Making a Pacific Difference, published last November. It was the first national strategy to be developed by Pacific people and Pacific health workers. It contains a thorough, high-level yet practicable set of strategic initiatives to improve Pacific health.

The second important document is a direct outcome of the first. Making a Pacific Difference called for a clear direction in health policy for Pacific health.

This has been followed up with Making a Pacific Difference in Health Policy. This is a work plan for the Ministry of Health, concentrating mainly on the areas of sector leadership and practice.

Six key result areas are to be the focus of Pacific health policy over the next three years. They are:

Developing good strategic policy advice, especially as regards mental and child health
Monitoring Funder Performance effectively
Fostering Leadership and Strengthening Relationships
Health Sector Financing - working out the best ways to finance Pacific health care
Supporting the development of Pacific peoples within the Ministry, and increasing the awareness of Pacific health issues in the Ministry
Supporting the work of Te Kete Hauora (the Maori Health Group) and ensuring Pacific policy fits in with the Treaty framework.
The third important document for our purposes today is the Child Health Strategy. Much of this document also follows on from Making a Pacific Difference. The Child Health Strategy lists Pacific children as one of the four priority population groups..

This document talks in some detail about specific issues for the health of Pacific children, such as - the importance of empowering parents, of improving intersectoral coordination, of developing better information, and increasing the numbers of Pacific peoples in the health work force and leadership roles.

Appointments
Good words are only the beginning. They need people in the right places to translate them into effective action. One of the recommendations that came out of your forum last year was to have a strong national voice for Pacific health within the Ministry and the Health Funding Authority.

We now have that with the appointment in January of Debbie Sorenson as Chief Advisor Pacific Health in the Ministry.

I am also pleased to announce today Leita Foliaki has been confirmed as the Pacific Health Manager for the HFA, and will be working within the Personal Health Services division. There are now a total of five dedicated Pacific positions within the HFA.

As part of the new emphasis on child health in general, Pat Tuoy was appointed in December last year as Chief Advisor, Child Health, for the Ministry.

Activities
Now I'd like to mention some important, indicative, initiatives for improving the health of Pacific children and young people.

Family Start is an intensive home-based support programme for families who need extra help. It is part of the Strengthening Families initiative, which has Health, Education and Social Welfare all working together to support families under stress.

One of these intensive home-based support programmes is in the Ranui/Massey area, largely because of the high Pacific population there.

Health is funding this particular Family Start programme on our own, because I think it is so important that we understand how to make this programme work for Pacific families.

WestKids, in West Auckland, is another initiative that works in very closely with families who need extra support. This is one of 33 integrated care initiatives around the country supported by the HFA, which has been working very successfully since last year. This venture has seen Starship Children's Hospital, the local GP group Integrated Primary Care Services and other providers, such as Pacifika Fono, the Waipareira Trust and Plunket work together to support the families of children who have high health needs. Because of the home support, the children can be kept out of hospital, or discharged earlier than usual, and receive good care at home. This is a model for the future of agencies working together.

WestKids has also been given additional funding to enable it to become one of the new pilot Family Health Teams, which I announced last week. The other two pilots are in Whakatane and Otago. The Family Health Teams will involve staff from the hospitals working with providers such as Plunket, Maori and Pacific Island providers, education and welfare services, to improve services for children, particularly those with high health needs.

The first year of life programme at Glenn Innes also uses home visiting to provide the most accessible and appropriate care for young children. Pacific women are supported through the first year of their babies' lives with advice on immunisation, breastfeeding, using child car seats, budgeting and any other difficulties they may face. The Pacific health workers also ensure mothers and children are put in touch with a GP, Plunket nurse and other public health services. Measurable outcomes have been excellent. This service has also been actively involved in meningococcal prevention and awareness.

A new example of an effective youth health service is the one stop shop in Auckland. This is a joint venture between Waitemata CHE, Pasifika Fono and Waipareira Trust. It took as its inspiration the Manakau Youth Resource Service which has been operating for some time.

It is natural that a lot of the work in improving Pacific health is in Auckland. That is where the largest population is, by far. But I am very keen to see that work extended.

We do in fact now have Pacific providers aiming to set up throughout the country, so that Pacific people in other parts of the country have access to services that meet their needs.

The spread of good ideas is also going to be made much easier by now having one national funding authority. It has stronger focus now we have Pacific people in the leadership positions in the Ministry and the Health Funding Authority. And the momentum will continue to grow as Pacific health providers and workers gain experience and confidence.

Already I think the work being done can teach much of the rest of the health sector. The strong, mutually supportive relationships between community groups, providers, the HFA and the Ministry are exemplary.

A completely different, 'one-off' area of work is going to be the Pacific representation at the Action for Health and Independence Conference in October this year. We are going to have significant Pacific input presenting on Pacific health issues in a very upfront way.

Pacific health is on the New Zealand health care map, and it is here to stay.

Future Developments - ANNOUNCEMENT of PPDS
You here today are leaders in Pacific health care. You have not chosen an easy route. Your numbers are few, and the needs are great.

What your recommendations last year emphasised was the importance of developing new leaders in Pacific health care, developing the skills of those already working in the field, increasing the numbers of Pacific health workers, and increasing the awareness of the importance of Pacific health issues.

I am very pleased to announce today that $1 million has been allocated for the 1998/99 year to a Pacific Providers Development Scheme, which has been designed to extend the business capacity of Pacific providers. It will enable them to operate on an equal business footing with other providers.

This Scheme will increase the numbers and improve the business skills of people working in Pacific health care, promotion and prevention. It will also greatly raise the profile of Pacific health issues throughout the entire health sector.

This Scheme has three major components, and will be managed by the Ministry of Health.

The first priority is to enhance the Pacific Island involvement in the Family Start Pilot which I mentioned earlier. The grant will include:

sponsoring training for Pacific Directors involved in the programme
strengthening the Pacific management capacity through business plan training, establishing information systems and business management training and supervision for staff over 12 months.

The second priority is workforce development among existing Pacific providers. This will be in the areas of business management skills, and broadening health sector understanding. Funding will be divided into four areas:

The establishment of a Pacific leadership programme in association with the Victoria University Graduate School of Business.
The Ministry will also fund further training for graduates from the Pacific leadership programme.
There will be sponsored training for Pacific health directors.
Health sector fellowships will also be offered - to enable Pacific workers in the health sector to widen their experience of the health sector.

The third priority is sector integration. Its aim is to support and encourage better integration amongst Pacific providers as well as between them and mainstream providers. It is intended to strengthen existing structures whenever possible.
This component requires much collaboration with the HFA. Partnership with the HFA is essential to ensure consistent funding and practices.

An important part of integration is to utilise the unique skills within Pacific provider organisations to work alongside mainstream providers. We want to have the best cultural models and practices spread as widely as possible. This will ensure better health outcomes for Pacific peoples.

Conclusion
We cannot be complacent about Pacific health. But I think we can be confident - confident that we are heading in the right direction. We have the map, we have the motivation, and we are gaining the skills - the equipment we need to make a difference in the health of our Pacific children.

It's not going to be easy, but the rewards are great. There is nothing more precious than the full health of our children and young people. Healthy children are those who can participate physically, mentally, socially and spiritually in their communities.

Our children are the greatest gift we can leave this country. I wish you well in your work at this conference. May your efforts continue to protect and nurture our gift to the future.