Polynesia-New Zealand Health Dialogue Opening Address
Sudima Hotel, Mangere, Auckland
Thursday 4 October 2018
The land we are on is called Mangere. It belongs to the people of Tainui. It is part of the realm of Kingi Tuheitia. In the language of the indigenous people of Aotearoa-New Zealand, I greet and acknowledge you.
E nga mana, e nga iwi, e nga hau e wha, e nga karangarangamaha. Tena koutou, tena koutou, tena koutou katoa.
In my own native Samoan language may I offer the following acknowledgement.
O lea ua fa’amua la tatou fa’apolo ma le fa’asagi. Talitonu foi ua talia fa’autugatagi. O lea ua to’a peau ole sami, moe foi matamatagi, ona o le alofa ma le agalelei o le Atua Silisiliese oi le lagi.
Talofa lava, Fakalofa lahi atu, Kia orāna, Mālō e lelei, Mālō ni, Talofa.
On behalf of the Rt Hon. Winston Peters, Minister of Foreign Affairs and our Government, I welcome you to Aotearoa, New Zealand.
I would like to welcome particularly Ministers of Health from the Pacific: Hon Vainetutai Rose Toki Brown, Cook Islands Minister of Health; Hon Billy Talagi, Niue Minister of Health; and Hon Satini Manuella, Tuvalu Minister of Health.
Welcome also to Heads of Pacific health systems and clinicians from the Pacific.
And welcome to the New Zealand participants and Pacific communities.
Members of the Diplomatic Corp present.
It’s exciting for me to see together in this room so many health leaders and decision-makers from the Pacific and Aotearoa New Zealand.
The Pacific matters deeply to New Zealand. Our prosperity and security is interwoven, with many cultural, historical links as the islands are our Ancestral lands and economic linkages.
Of the 400,000 Pacific peoples in Aotearoa New Zealand, our family links are deep and intimate. The islands are our ancestral homelands.
This Government has made it a priority to significantly lift New Zealand’s strategic ambition and investment in the region, to building deeper relationships, and to doing more on priority regional issues such as health.
This is a long term strategic focus, in line with New Zealand’s enduring interests in the region. The Government is seeking lasting impact through enhancing capacity in Pacific countries for self-delivery on national and regional priorities.
Pacific Reset & Pacific Overseas Health
At the centre of this Government’s Pacific Reset is a commitment to build deeper partnerships with Pacific countries. A core element of the Pacific Reset is an expansion of New Zealand’s Pacific development programme, of which investment in health is a key component.
Pacific Reset to me means more face to face engagement at all levels, not less.
It’s also growing NZ’s understanding of Pacific people, our languages, cultures and our relationships.
It is also about better understanding the historic context of our Pacific-Aotearoa relationships.
Greater understanding provides an opportunity to redefine New Zealand’s influence on, and relationship with the health of the people of the Pacific region. We want to ensure access to essential and quality health services so that Pacific people can achieve their potential, and to contribute to prosperity, safety, and stability in the region.
As you know, health is not just a sector but a system that has links to the wider public sector and society. Improvements in Pacific health require a trained and capable workforce; reliable access to quality essential medicines and improved diagnostics; effective governance and management of the sector and adequate financing in line with increasing needs.
It also requires an all-of-government approach and strong community engagement and awareness, to address the most binding constraints to a healthier region.
In my view, it’s giving space that empowers the local communities to be the authors of their own solutions, and delivering those solutions in their relevant Pacific languages.
Understanding the relevant Pacific languages and the cultural context is essential in the fight for better health outcomes.
New Zealand’s total ODA appropriation in 2015-18 was NZ$1.7 billion. New Zealand’s health focus for the Aid Programme is primarily the Pacific. Approximately NZ$127 million in investments were invested over the 2015-18 period. [This formed about 7.4% of our overall ODA allocation in the last triennium.]
This investment covered three areas to improve health outcomes:
- Core health sector support including policy, governance, service provision to address the impact of NCDs, maternal and child health, and communicable diseases.
- Social infrastructure including housing, culture, sports and recreation.
- Strengthening access to clean drinking water and safe sanitation systems.
Achieving the level of spending that is required to achieve improvements in health outcomes [through domestic resources alone] is unrealistic in many Pacific Islands countries.
Even though Pacific countries have made large strides forward in increasing life expectancy, reducing infant mortality and reducing communicable diseases, additional sources of funding will be required to improve health indicators over the next 25 years.
How will New Zealand Support This?
New Zealand will support access to and improve quality of health services, including preventive measures that benefit the majority of the population, prevent downstream costs and make countries more resilient to extreme weather events or disease outbreaks.
We will support governance of the health sector to ensure that appropriate budget allocations and investments by partner countries and development partners are made for basic health care.
We will broaden our delivery beyond direct investment, and engage and influence through new delivery partners and institutions.
We will consider wider contextual issues impacting on health such as changing technology, increasing connectivity and impacts of climate change.
Recently, our Prime Minister announced an increase to the global climate finance commitment to $300 million over four years, which is an increase of $100 million.
This funding allocation will focus on practical action that will help Pacific countries adapt to climate change and build resilience.
We recognise our neighbours in the Pacific region are uniquely vulnerable to the impacts of climate change.
We want to support our Pacific neighbours to make the transition to a low carbon economy without hurting their existing economic base.
We will stand with the Pacific to honour their desire to retain the Pacific’s social and cultural identity and to continue to live in their own countries, where possible.
We will work with regional partners and organisations to review migration policy to establish an immigration Pacific plan that recognises people displaced by climate change and global warming as a last resort.
New Zealand Health Context
In New Zealand, Pacific peoples have made good progress in many health areas over the past decade. More Pacific pre-schoolers are receiving B4 School Checks.
Immunisation rates for Pacific children are amongst the highest, and there are innovative initiatives and services working well for Pacific communities.
Despite positive progress in these specific areas, there are still major inequitable health outcomes for Pacific peoples.
Many of the poor health outcomes for Pacific peoples have remained consistent over time, or have improved very little.
As Minister for Pacific Peoples, I have asked and will continue to ask our Health officials, why it is the health outcomes for Pacific Aotearoa is at the bottom, when we all use the same health service.
Rates of child obesity, ambulatory sensitive hospitalisations (ASH), psychological distress and cardiovascular disease prevalence remain very high when compared to the total New Zealand population. A large number of these areas of disparity have a strong link to treatment and prevention at a primary care level.
Pacific peoples’ poor health outcomes are inherently influenced by broader socioeconomic determinants such as employment, income, education and physical environments etc. This means GPs not only experience the direct impact of Pacific peoples’ health issues, but also the influence of broader social determinants on people’s health.
Improving Pacific health is a priority and the Ministry of Health has made a specific commitment to achieving equitable health outcomes for Pacific peoples, particularly in increasing access to primary health care and workforce development.
Our Government is extending access to very low-cost GP visits to all Community Services Card holders – an estimated 540,000 people, making doctor visits approximately $20 to $30 cheaper for them.
This means nearly 74,000 Pacific people are now eligible for very low cost fees in primary health care.
In addition, Budget 2018 provides free doctor’s visits for under-14s for both health and injury-related visits.
Health Workforce Development Fund
We also recently announced the Health Workforce Development Fund, to invest in innovative workforce development and training initiatives that meet future health needs.
According to Health Workforce New Zealand (HWFNZ), in 2016, there were 69 Pacific doctors working in general practice. The Ministry is committed to developing the Pacific health workforce, particularly in primary health care, including general practice.
It is hugely important that we have a strong, skilled and sustainable Pacific health workforce moving forward.
This year over 150 Pacific health scholarships were offered to meet future health needs.
Over 100 of these scholarships were awarded to students studying medicine and dentistry, or nursing and midwifery, covering over $790,000 worth of fees.
I have a specific focus to grow Pacific leadership at all levels, including the Health Sector.
I’m pleased to say for the first time in the history of NZ, Pacific lead the Counties Manukau District Health Board with Chair Vui Mark Gosche and Chief Executive Fepulea’i Margie Apa, at the helm– both highly respected professionals. But they can’t do it alone. We need all hands on deck .
Similarly, it is the same for health challenges in our region. The aim of this Dialogue is to understand how we can all work together for more effective health delivery and outcomes in the Pacific through partnerships, between institutions, individuals and government departments.
We know that there is a range of partnerships in health already, both formal and informal, between New Zealand agencies and individuals and Pacific nations.
We need to understand what is working well, and what more can be done, to support and strengthen existing relationships, and to collaborate more broadly.
Over the next two days, the Dialogue will address the fundamental Building Blocks of Health Systems: Leadership and Governance; Service Delivery; Access to Essential Medicines; and Health Workforce.
We know that these themes, and the associated clinical issues and challenges in health outcomes, are of crucial interest to the Pacific nations and to New Zealand.
But over this short time the main focus is not to try and come up with solutions for our challenges around these themes.
The main focus is to build the dialogue between health leaders in New Zealand and in the Pacific, to establish a shared understanding of where we are at the moment, and how we can best work together from here on.
So I wish you the very best for your Dialogue over the next two days, with many new partnerships formed, and existing warm relationships nourished and sustained.
Kia kaha. No reira. Tena koutou katoa.