Speech to Addiction Leadership Day

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Opening remarks:

Tēnā koe, thank you for your mihi. Thank you Peter Barnett  and NCAT co-chair Lynette Hutson and welcome everyone to this Addiction Leadership Day.

I am very pleased as Minister of Health to be able to host this event for the second time. 

I would like to acknowledge the organisers, the National Committee for Addiction Treatment and Matua Raki within Te Pou. 

I would also like to acknowledge all of you here today who are involved in some way in the addictions sector, and to acknowledge those people in our whānau and community who struggle with the effects of addiction. 

I’d like to begin by talking briefly about the recent tragic events in Christchurch.

As a nation, we mourn for those lost – those taken from their loved ones in the most brutal and hateful of ways.

As the Prime Minister has said, this act does not define us as a nation. This is not who we are. 

Our thoughts are with the families and friends of the victims, the Muslim community and all who have been affected by this act of hate and terror. 

While we grapple with a form of grief and anger we may not have experienced before, the compassion and kindness that has been expressed by people right across the country shows us who we are as a nation, who we can be. Those are the values we need to protect.

Sadly, the scars from March 15 will be with us all for years to come. There’s no question the need for mental health and psycho-social support in Canterbury will be ongoing. 

Already there have been around 6,000 counselling sessions provided to people in distress through the ‘Need to Talk’ 1737 service. They have brought on extra staff, have interpreters available, and have worked with the Ministry of Health to provide resources for mental health that are available on the Ministry’s website. 

Beyond that, the Ministry of Health is working urgently on a comprehensive plan to address the ongoing need – not just of Muslim New Zealanders, or Cantabrians, but for people nationwide.

That work is an absolute priority for the Ministry of Health and the Government.

Many of the people who are leading our mental health response in Canterbury are also involved in finalising the Government’s response to the Inquiry into Mental Health and Addiction. 

I will have more to say about the Inquiry shortly, but I do want to signal that the Government’s response to the Inquiry will be a few weeks delayed as a result. I think that will be a surprise to no one.

I do want to assure you, however, that responding to the Inquiry remains a priority. In fact, if anything the events of recent days underline just how important this work on mental health and addiction is.

So while I can’t tell you today the precise date the Government will announce its response, I can indicate that it will be in the second half of April.

Equity:

I trust those of you working in the addictions sector, our wider health services, and the public can see clear signs that a key focus for this Government is to make our health system work well for all New Zealanders, no matter where they live or who they are.

Examples of this include the extension of pay equity to mental health and addiction support workers. 

The Families Package was one of our first major announcements as a government - $5.5 billion into making sure that families with young children are supported in the early years of their lives.

In our first Budget we also made it cheaper for Community Service Cardholders to access primary care. That will benefit more than half a million New Zealanders. And it’s not just the fact that it will be $20-30 cheaper to go to the doctor – it means some people can now actually afford to go to the doctor, because we know that cost is a barrier to more than half a million people a year.

My core priority as Minister of Health is improved equity of health outcomes for New Zealanders.

The disparities different people face are largely preventable, yet persistent across the health and disability system.

They’re clearly evident in the impact of drugs and alcohol on our people, and in how we respond to that.

This failing for groups of New Zealand’s population carries costs for us as a country, for communities and for individuals in terms of quality of life. 

I want a health system that delivers the same high-quality health outcomes for all people, so they can reach their full potential no matter where they live, what they have or who they are.

In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. 

This government recognises that different people with different levels of advantage may require different approaches and resources to get the same outcomes.

Many Māori and Pacific New Zealanders, and New Zealanders on lower incomes, still have significantly worse experiences of the health system than the rest of New Zealand.

They have higher rates of major conditions like diabetes, cancer and mental health, have less trust and confidence in the health professionals supporting them, and live shorter lives.

As a country that prides itself on giving everyone a fair deal this cannot be acceptable. 

We must change how we work to live up to the principle of a public health system that delivers results for all New Zealanders, rather than most New Zealanders.

If we are to make a real difference and achieve equitable health outcomes for Māori and Pacific peoples, we need significant change across the system in how we deliver and design services.

Improving health equity means actively addressing differences in health outcomes between different groups, and removing barriers to health care service access. 

Inquiry:

Last year when we came together for this event here in Parliament Buildings we were all anticipating the Inquiry into Mental Health and Addiction.  

Having the panel members here that day, and I understand at other Addiction Leadership Days around the country, really helped set the scene for the panel members and yourselves to get to know each other. 

What was remarkable about the Inquiry process was the degree of participation with over 2,000 people attending public meetings, over 5,200 submissions, and six petitions with nearly 340,000 signatures. 

The Inquiry heard from people with a range of experiences.  

The report has clearly captured the voices of Māori and Pasifika and we have listened to what they had to say.

Overwhelmingly what the Inquiry heard from people is that the current system is not working, services are under pressure, and that we need to take a more holistic approach to wellbeing. 

The report of the Inquiry into Mental Health and Addiction is a substantial and considered piece of work.  

The report charts a new direction for mental health and addiction in New Zealand, one that puts people at the centre of our approach. 

It is important we make services easy to access for all, but particularly Māori and Pacific peoples, and design culturally relevant services which work for these groups as well as they do for other groups.

As I mentioned earlier, the Government is yet to announce its response to the report of the Inquiry. There are very good reasons for this.

This government regards mental health as a high priority area. We are committed to improving mental health and wellbeing across the board and as part of this, we are making mental health a focus of the Wellbeing Budget 2019.  

It was a considered report, and we are determined to deliver a considered response.

As we finalise our response, the Ministry of Health is working to engage with a range of stakeholders, including people with lived experiences, their family and whānau, and NGOs.    

By way of comment, I will note that one of the characteristics of Government, and coalition government in particular is the need to brief and consult with other Ministers, other members of the coalition, and to consider advice from officials. This takes time, but we want to get it right.

Last year, Ron Paterson the Chair of the Inquiry Panel spoke of the weight of expectation.

I am very aware that the weight of expectation has now shifted quite rightly to the Government.

Reshaping our approach to mental health and addiction is no small task.

Embedding sustained change within a sector as complex as Health is no small task either, but it is important that we start.

Sixteen months ago, in the Speech from the Throne, the Coalition Government outlined an ambitious programme designed to build a stronger and fairer country for all New Zealanders. 

Looking back over that time, we are proud of what has been achieved, and there remains lots to do.

The work of this Government is split into three key themes: growing an economy that works for all, improving the wellbeing of New Zealanders and their families, and providing clear, compassionate leadership that recognises the value of every New Zealander.

Implementing our response to the report of the Inquiry sits right in the heart of this work.

However, as you will know we did not wait on the Inquiry into Mental Health and Addictions before getting on with addressing many of the challenges you and your members face every day.

I would like to highlight some of the work that has been done, just how much work is currently going on, and what will continue in the near future that affects this sector.

Synthetics response:

Late last year, along with the Minister of Police, I announced a range of measures agreed by Cabinet to assist in tackling the harm related to synthetic drugs. 

The measures specific to Police allow for increased powers to crack down on suppliers and manufacturers of these drugs, whilst also amending the Misuse of Drugs Act to create a temporary drug classification category to assist with the police’s search and seizure efforts.

In so far as it is possible, we want to get this stuff off our streets and out of our communities as much as possible.

However, we’ve also formalised the use of Police discretion.

Importantly, Police discretion means not prosecuting for possession and personal use where a therapeutic approach would be more beneficial or there is no public interest in a prosecution. 

To be clear, this is not the full decriminalisation of drugs recommended by the Inquiry into Mental Health and Addictions.  

However, these are immediate steps we have taken in response to the problems communities face with synthetics while we consider the Inquiry’s recommendations. 

From a health perspective our response to synthetics also includes $16.6 million over four years available to boost community addiction treatment services, and to provide communities with the support they need to respond to synthetic drug harm. 

$8.6 million of that funding has been set aside for an Acute Drug Harm Response Discretionary Fund. 

This fund will help communities respond to acute issues such as a surge in overdoses or deaths.

It will can also be used to help people make lasting change to their lives to tackle issues that might be driving their use of drugs, such as homelessness.

If you’ve got thoughts on how we could advance this work, further information on how to apply for this money will be available soon on the Ministry of Health website.

Funding will also be used by the Ministry of Health to purchase specific initiatives, including the establishment of a Drug Early Warning System, and an Addictions 101 training course. 

There’s no question that more investment in addiction services than this will be required over time.

But I believe our response to the synthetics problem clearly demonstrate this Government’s focus on harm reduction and supporting people to live healthier lives.

This focus is also lies behind our decision to fund new alcohol and drug detoxification beds at the Auckland City Mission.

This will allow for the integration of health and social services in one location, making a range of help available to the vulnerable seamlessly and at the right time

And I’ll mention a couple of mental health initiatives for good measure before I close.

We’ve also recently launched Piki, the Integrated Therapies pilot, in the Wellington, Hutt and Wairarapa DHB regions. This three-year pilot will provide free mental health support to 18 to 25 year olds by providing a suite of targeted evidence based interventions.

We are making good progress with the Mana Ake - Stronger for Tomorrow programme, which provides support to improve the mental health of primary and intermediate school children in Christchurch, and Kaikoura.

And we’ve extended the nurses in schools programme to cover all public decile 4 secondary schools. Once the roll out of decile 4 schools is complete, over seventy seven thousand (77,865) students at 250 schools will have access to School Based Health Services.

Closing remarks:

In closing, we have much more work to do.

The Prime Minister has signalled that 2019 is the year for delivery. 

We need you as leaders in the addiction treatment sector to make your position clear not only on a response to the Inquiry report, but your priorities for investment, and to bring others along with you. 

The focus of your discussion today is about implementing the recommendations and the spirit of the Inquiry.  I understand that some of you may also be attending a meeting tomorrow on managing change and sustaining that change past implementation.

If we do this well, if we really grasp the opportunity, and the momentum, then the outcomes will have far reaching consequences for not only mental health and addiction, but for all New Zealanders, including those without a voice. 

I hope today’s kōrero is productive and fulfilling for you all. 

Strengthen your networks and your ideas, we have a big journey together ahead of us.  

Nō reira, tēnā koutou, tēnā koutou, tēnā tatou kātoa.