Protecting wellbeing - ACC HQSC Trauma Forum

ACC

Introduction

As the Minister for ACC I thank you all for the work that you do supporting New Zealanders in their literally most vulnerable moments.

From those who hold people’s lives in their hands, to the people who research technique, technology and trends, your work is highly valued.

A special thank you to those of you who assisted with the mosque attack earlier this year, as Minister for ACC and as a member of Cabinet I have been able to learn of the incredible work done by medical professionals and support people.

You will know better than anyone how much damage and pain has been caused by these violent events and understand the impacts for everyone involved, not only the injured but also for those supporting the injured.

I hope you also know the joy of saving a life and can take heart in our increasing ability to do so. And I have no doubt that everyone in this room contributes to this.

Wellbeing

As a politician, I am no expert on trauma but I can guess that some of you will be supportive of stricter gun laws, in fact anything to reduce the amount of violence in our communities and when it comes down to it, you may have a view on what role our culture plays in a world that includes so much trauma, and in particular so much unnecessary trauma.

With all the advancements of humanity, why do we still do so much harm to one another. At least we can say that we are making progress. We are working on prevention, we are working on how best to save people’s lives when they are injured, and we keep working on recovery. We are also working to build a caring society.

As you will know, Prime Minister Jacinda Ardern is providing leadership on improving wellbeing, the wellbeing of communities, children, everyone from our youth to our senior citizens.

Our Budget last year was focussed on wellbeing with historic investments in mental health care, lifting children out of poverty and preventing family violence in particular.

By highlighting and promoting wellbeing we make it clear to the community that the outcome of the work of government needs to be the increased wellbeing of New Zealanders.

We are not interested in economic growth for the sake of it. And don’t get me wrong – we are interested in economic growth – but what we are working for is economic growth that is shared and sustainable, and contributes to lifting the wellbeing of all New Zealanders.

You may know that every year about one million New Zealanders are affected by family and sexual violence, including almost 300,000 children. It is a huge figure and we need to bring that down as quickly as possible.

In the Wellbeing budget we made a record investment in family and domestic violence prevention and services that will help the many organisations already working in this area to continue and increase the good work they are doing to eradicate family violence.

Breaking the cycle of violence helps so many people to live better lives, and saves others from trauma too. It is a good investment from all angles.

But this, like your trauma work, is a complex and multifaceted issue to solve.

Our $320 million package to address family and sexual violence for example covered eight portfolios, including funding and support for:

  • 1 million New Zealanders covered by Integrated Safety Response sites in Christchurch and Waikato; and 350,000 by the Whāngaia Ngā Pā Harakeke and Whiria Te Muka sites in Gisborne, Counties Manukau and Kaitaia
  • 24/7 sexual violence crisis support services for up to 2,800 children and young people every year, and an additional 7,700 adult victims and survivors from 2020/21
  • Funding for major advertising campaigns and intervention programmes to reduce violence occurring
  • Using video victim statements to reduce trauma for up to 30,000 victims of family violence every year, and reduce time spent in court
  • Enabling victims of sexual violence to give evidence in court in alternative ways in order to reduce the risk of experiencing further trauma, and providing specialist training for lawyers in sexual violence cases
  • Specialist training for lawyers in sexual violence cases
  • Improving the wellbeing of male victims and survivors of sexual violence through peer support services, up to 1,760 from 2020/21 onwards
  • Dedicated funding for a kaupapa Māori response to sexual violence
  • Training for health practitioners in District Health Boards to provide effective screening and referrals for family violence.

Christchurch mosque attack

The most traumatic event we have experienced in New Zealand in my lifetime was, of course, the attack on our Islamic community on 15 March this year.

We know that in some countries this sort of attack sadly is not uncommon, but for our peaceful and welcoming nation to experience this sort of attack was unheard of, and it shocked many nations.

I am constantly reminded by people I meet in my trips to communities around the country how outstandingly proud people are of how our prime minister reacted and led us through the sadness of the event and brought us together.

Throughout the complex and multifaceted government response we had a leader focussed on ensuring the wellbeing of those affected was our top priority.

Our government work included:

  • Emergency services: ambulance, police, civil defence
  • Health care, mental health care, ACC support
  • Victim support
  • Immigration support for immediate visitors and a special residence visa offer
  • Funeral support
  • Memorial support
  • Firearms legislation development and gun buy back work
  • Foreign Affairs and intelligence support
  • Social and financial support services
  • Criminal justice work

And much of that work will continue for some time of course. As you know, any sort of trauma event has significant impacts on those involved and those supporting those involved.

  • The recent events in Christchurch highlight the need for us to extend trauma network work to consider managing mass casualty trauma care, in addition to more regular causes such as accidents on roads and in workplaces. ACC is keen to hear what has been achieved in other jurisdictions, so we can consider incorporating ideas into our national and regional approaches across New Zealand.
  • However, this cannot be done by ACC alone. Improvements in care for injured patients requires a collaborative effort between ACC, emergency services, our hospitals, and rehabilitation services. We can all benefit from a better and more integrated system.
  • ACC welcomes the actions already taken by the Major Trauma National Clinical Network to engage district health boards, road and air ambulance providers, transport agencies, and others. There is a good opportunity to continue building on this progress.
  • We can learn from the events that do happen to help prevent future ones. For this reason, agencies are collaborating with the Major Trauma National Clinical Network to establish a national trauma registry. For example, the New Zealand Transport Agency (NZTA) is using its Community Road Safety fund to support this initiative.

New Zealand can build on the experience of others

  • New Zealand has more than its share of natural and man-made disasters and welcomes the opportunity to learn from international experts who have experience with shaping a system to be capable of managing a wide range of disasters.
  • Our understanding is that a more coordinated system will save lives and reduce disability for those who survive. We are very fortunate to have Professor Karim Brohi with us today. He has been instrumental in transforming the London trauma system, and we are keen to learn from his insights and experience.

ACC’s investment in injury prevention

  • Most injuries are preventable, and ACC has an important role to encourage behaviours that prevent injuries from occurring. Success in injury prevention goes a long way towards reducing trauma.
  • ACC focuses on seven major areas: falls, sports, intentional harm (family and sexual violence, self-harm and suicide), treatment injury, workplace injury, road safety and community (including child injury), which together contribute to approximately 85 percent of new costs to the scheme.
  • There are 59 ACC injury prevention initiatives in delivery across New Zealand with a range of partners and a further 39 initiatives in various stages of the design phase. Many of these will contribute to reduced incidence and severity of trauma.
  • ACC has been increasing investment in injury prevention programmes in the last five years, from $22 million to a target of $90 million in 2019/20.

These investments, like our economic investments, pay off significantly in terms of improving the wellbeing of all New Zealanders.

Last week ACC published its Annual Report. Amongst the many positive results was one that stood out as an excellent investment. It sounds small compared to the $44 billion dollar scheme, but it shows us yet again the value of investing in wellbeing.

ACC’s injury prevention scheme, boosted to $75 million last year, has realised good returns – for every dollar invested they estimate a $1.81 return.

The programmes cover everything from motorcycle safety to education for the ‘mates and dates’ scheme designed to support healthy relationships and prevent sexual violence.

It has recently been used to support, not to fund, but to support the Government’s gun buy back scheme that has been developed post-the Christchurch mosque attack. ACC invested $40 million with an expected return of $70 million in reduced costs of injury.

Conclusion

Finally, while I can not pretend to understand what you go through in your work every day, or how you unwind and look after yourselves after doing such work, I can say that what you do is essential, and valued and I hope that you continue to learn from and support each other as you go about saving lives and ensuring we have hope in some of our most vulnerable situations.

I hope you enjoy the rest of the forum.

Thank you.