Cannabis poll: high support for use, not for supply

The NZ Drug Foundation has just released the results of a cannabis poll, carried out from 2 July 2018 until 17 July 2018

Participants stated whether an activity should be illegal, decriminalised, or legal.

Growing and/or using cannabis for medical reasons if you have a terminal illness

  • 10% – illegal
  • 17%  – decriminalised.
  • 72%- legal

Growing and/or using cannabis for any medical reasons such as to alleviate pain

  • 13% – illegal
  • 17%  – decriminalised.
  • 70%- legal

So high support for use of cannabis for medical reasons.

Growing a small amount of cannabis for personal use

  • 38% – illegal
  • 29%  – decriminalised
  • 32%- legal

Possessing a small amount of cannabis for personal use

  • 31% – illegal
  • 32%  – decriminalised
  • 35%- legal

More wanting to keep it illegal for personal (recreational) use but still about two thirds in support for legal change.

Growing a small amount of cannabis for giving or selling to your friends

  • 69% – illegal
  • 18%  – decriminalised
  • 12%- legal

Selling cannabis from a store

  • 60% – illegal
  • 9%  – decriminalised.
  • 29%- legal

Here there is much higher support for staying illegal for ways of getting cannabis apart from growing your own.

Source: NZ Herald Cannabis issues poll

The poll was conducted by Curia Market Research

943 respondents agreed to participate out of a random selection of 15,000 phone numbers nationwide

Major review of health system

This one is called a Review but it seems to be similar to the scores of working groups and committees and inquiries set up by the Government.

A major health Review, to be chaired by Heather Simpson, senior staffer for Helen Clark when she was Prime minister and also in when working for the UN, and I think also assisting the current prime Minister’s office, will report back by January 2020.

That is unlikely to leave enough time to make any major changes prior to the election, but will likely provide for a  basis for Labour-Green campaign policy.


Major review of health system launched

Health Minister Dr David Clark has announced a wide-ranging review designed to future-proof our health and disability services.

“New Zealanders are generally well served by our health services, particularly when they are seriously unwell or injured. Overall we are living longer and healthier lives – but we also face major challenges,” says David Clark.

“The Review of the New Zealand Health and Disability Sector will be wide-ranging and firmly focused on a fairer future. It will look at the way we structure, resource and deliver health services – not just for the next few years but for decades to come.

“We need to face up to the fact that our health system does not deliver equally well for all. We know our Māori and Pacific peoples have worse health outcomes and shorter lives. That is something we simply cannot accept.

“We also need to get real about the impact of a growing and aging population, and the increase in chronic diseases like cancer and diabetes. Those issues in turn create pressure on services and the health workforce that need to be addressed for the long term sustainability of our public health service.

“The Review will include a strong focus on primary and community based care. We want to make sure people get the health care they need to stay well. Early intervention and prevention work can also help take pressure off our hospitals and specialist services.

“People rightly have high expectations of our public health service. As Health Minister I want to ensure we can meet those expectations now and into the future,” says David Clark.

The Review will be chaired by Heather Simpson, who is perhaps best known as Chief of Staff to Helen Clark from 1999-2008 but also has a background in health economics. The Review will provide an interim report by the end of July 2019 and a final report by 31 January 2020.

 

The review would culminate in a report to Government, including recommendations, on:

  • How the health system can improve accessibility and outcomes for all populations
  • Whether the health system promotes the right balance between availability of services,
    (particularly tertiary services) population density and proximity
  • Whether the current system is well-placed to deal with environmental challenges such as climate
    change, antibiotic resistance and technological advances
  • Whether there are changes that can be made to the health system that would make it fairer,
    more equitable and effective
  • How the technological and global healthcare context is evolving, what opportunities and risks
    this rapidly-evolving context presents, and whether there are changes that would support the
    health system to adapt effectively given the rapid changes underway.

In examining the points above, the review would consider the following:

  • Demographic impacts – what the predicted population changes are, their potential impacts
    upon service demand, workforce availability and risks that may need to be managed
  • The international landscape – what New Zealand might learn from examining where health
    systems are heading internationally and what the impacts are, including input from relevant
    international organisations such as the OECD, World Health Organisation and the
    Commonwealth Fund
  • Decisions around distribution of healthcare resources, capacity of the health system to deliver
    care and clinical effectiveness (quality and safety) – e.g. how does the current geographic
    distribution of services help or hinder the system as a whole
  • Funding – how financial resources applied to health funding could be altered to provide
    greater flexibility in allocation, better transparency of return on investment, better support
    innovation in service mix/design and investment in key enablers, and reduce inequities
    through targeting those in need
  • Investment practices – providing a nation-wide view of how much infrastructure will be
    needed, over what timeframe and the balance to be struck across service provision and
    delivery
  • Ways to support the increasing priority of the role primary care and prevention has within the
    wider heath service
  • Potential opportunities and risks associated with rapidly emerging technological advances and
    the implications for, including but not limited to, clinical tools and settings, communication and
    transport
  • Institutional arrangements – roles and responsibilities, funding, accountability and delivery
    arrangements.

[DRAFT] Health and Disability Review Terms of Reference.pdf

Middlemore mould, health budget hole, the budget

Since the new Government took over there seems to have been a reduction in stories about hard done by beneficiaries and people living rough. But there has been a lot of lobbying going on before new Minister of Finance Grant Robertson’s first budget – nurses want more money, so do teachers, and health is always short of funds.

The Government is faced with a difficult decision over a new prison to cater for growing prisoner numbers. They have committed to a number of costs like benefit increases, the the ‘winter heating’ handout, free university fees, NZ First has been given a billion dollars a year to dole out to regions, and a major shift in transport funding has just been announced.

There’s been a number of curious things coming out about health and hospitals, perhaps not coincidentally leading up to next month’s budget. Is the public being prepared for a policy switch to justify increased health spending? More tax or more debt?

Suddenly it seems it has been discovered that there are major mould problems with multiple buildings at Middlemore Hospital.

Earlier this week – Ardern: Don’t blame us for health sector problems

The Prime Minister says National would have known the shortfall in the health spend when they were in government.

Jacinda Ardern says there’s a hole of around $10 billion – and that’s one of the reasons why her Government cancelled planned tax cuts scheduled for this month.

“I would have thought a minister of health would probably know that,” Ardern says.

Ardern says for National to claim they knew nothing about things like the mould at Middlemore Hospital is disingenuous.

Staff at Middlemore have also claimed they knew nothing about it.

“One of the latest emerging problems is the news that the buildings at Middlemore Hospital have become rotten and infested with a toxic black mould. I found out in the middle of a late-night ward round from a Radio NZ journalist who phoned seeking comment – I had none, because it was news to me. The next morning, the rest of our staff and all of New Zealand heard the story and over the next few days there followed a confusion of detail about the extent of the problems and who knew what when.”

https://thespinoff.co.nz/society/03-04-2018/the-toxic-mould-and-rot-of-middlemore-is-the-legacy-of-a-crisis-in-values/

So has the mould information only just come out, or did the last Minister of Health keep it a secret for this long?

Ardern:

“It is worse than we thought, when we look at the capital needs of hospitals and health in particular, [and] also the deficits DHBs are facing, it is worse than I anticipated.”

Blaming the previous Government is normal, as is acting surprised about higher costs than anticipated.

If people don’t pay as much on tax they can afford to spend more on health perhaps.

I would have thought that Steven Joyce would have proved the $11.7 billion hole existed if he could. Was he right, but hid details?

Or is Labour now trying to claim they have been duped?

It’s hard to know whether some of this is part or a PR plan or not, softening the public up for ‘unexpected’ increases in budget costs, and a sudden need to fund this through more taxes. National sort of did that by increasing GST, but they also decreased personal tax rates and had a Global Financial Crisis to deal with.

It’s hard to trust either Labour or National as they throw around blame and claims and money.

Talking of $11.7 billion, this may be just a coincidence, but the same number was noticed here:

 

 

Trans-Pacific Partnership “may affect people’s health”

On climate change, health implications, and  ‘a fairer society’.

Newsroom has an article by two academics on Trade agreement may affect people’s health:

The new Trans Pacific Partnership agreement will have an undeniable influence on the future health of New Zealanders and needs the full attention of the nation’s health professionals.

The rebranded Trans-Pacific Partnership Agreement (TPPA), now known as the Comprehensive and Progressive Agreement for TransPacific Partnership (CPTPP) pays lip service to broader social and environmental concerns, but privileges transnational and foreign investors over human and environmental health.

This article focuses on the CPTPP in the context of the global climate crisis and its potential impacts on health.

There is scientific consensus on the harmful effects of climate change on health – so much so that it is identified as the most serious threat to global public health this century. Direct impacts include death, illness and injury due to extreme weather events. Indirect impacts include shifting patterns of infectious disease, air pollution, freshwater contamination, impacts on the built environment from sea level rise, forced migration, economic collapse, conflict over scarce resources and increasing food insecurity. Mental health impacts are also significant, particularly within indigenous and socioeconomically disadvantaged communities.

Fast forward to their final statement:

Such an assessment is particularly critical as climate change poses such clear risks to the health of New Zealanders, and the constraints on climate action conferred by the CPTPP (as presently formulated) would prevent important steps to protect our health and create a fairer society.

Fair enough to consider health implications, even if contentious.

But I view very subjective considerations like “create a fairer society” from academics with some suspicion.

This was from:

Associate Professor David Menkes is from the Department of Psychological Medicine and Dr Rhys Jones is from Te Kupenga Hauora Māori, both at the University of Auckland’s Faculty of Medical and Health Sciences. The original, more extensive version of this article appeared in New Zealand Medical Journal on 9 March, co-authored by Wellington solicitor Oliver Hailes and two Christchurch-based doctors, clinical microbiologist Joshua Freeman and forensic psychiatrist Erik Monasterio.

Health funding ‘crisis’

Health spending has always been under pressure.Is it now a crisis? ‘Crisis’ suggests an unusually critical situation, but health under funding has long been an ailment.

Health care has increased substantially over the last half century, but so have the costs. Drugs and technology have improved and cost a lot more, and a growing and ageing population puts further pressures on budgets.

What the Government does on health in next month’s budget will be interesting. More money is likely (the previous government kept spending more) but it is unlikely to be enough.

The prime Minister and the Minister of health have both been sending out signals that spending may be compromised. They are claiming health ‘underfunding’ is worse than they thought.

Dave Armstrong has some details in Toss a healthy bit of funding at DHBs and voters will turn a blind eye to almost anything

I’m not sure about that, health doesn’t seem to play an obviously significant part in elections.

It has also been revealed that necessary spending on infrastructure has been delayed by a number of district health boards because they were under such pressure from the previous government to show an operating surplus

That’s why buildings at Middlemore Hospital with toxic mould and sewage leaks behind asbestos walls will need $123 million to be repaired. It seems that the mantra of the last government regarding health infrastructure was ‘a stitch in time causes an operating deficit that looks bad so please don’t ask for money or there’ll be trouble’.

Middlemore is just one example. The Clinical Services block at Dunedin Public Hospital has had leaking and asbestos problems for years. A replacement hospital in Dunedin has been delayed, and now it is over to the new government to try to keep an election promise.

Even though the Labour Party pledged $8 billion to health during the election campaign, Health Minister David Clark thinks that won’t be enough. It is estimated that $14 billion will be needed over the next 10 years for infrastructure alone.

Jacinda Ardern has found health finances are even worse than she expected. She identified $10 billion worth of capital expenditure needed whereas the previous government set aside just $600 million.

I don’t think it is unusual for incoming governments to discover costs that they hadn’t taken into account when making election promises.

The previous National government would rightly argue that it spent billions on health. Spending increased under its watch, but was it enough to meet rising demand? With failing infrastructure and frustrated salary workers who haven’t had a raise of ages, I would say no.

Despite disingenuous claims by Labour health funding kept increasing under the National government. But health funding is never enough.

So what’s the solution? Ask most health professionals and they would suggest a substantial investment in infrastructure and pay rises for hospital staff, especially nurses and those at the bottom. But given about 60 per cent of health expenditure is for salaried staff, that is a considerable cost.

Nurses are currently negotiating for wage increases, and are threatening to go on strike.

And that is the problem for this Government. They may want nurses and others to be paid fairly, but where is the money coming from? During the election campaign, Ardern and Grant Robertson were at pains to point out they wouldn’t touch the corporate tax rate or John Key’s 2008 tax cuts for the wealthy.

This reticence to change the wealth distribution might have helped them get elected but now they either have to find the money elsewhere or disappoint underpaid nurses, many of whom would have voted for them.

So that’s the unenviable health dilemma that this Government faces over the next three years.

The immediate dilemma is the budget currently being finalised. We will find out how much of a boost health funding will get next month.  The only certainty is that it won’t be enough.

Woodhouse appointed to Opposition health role

A National shuffle was required after Jonathan Coleman announced his resignation from Parliament. Simon Bridges has appointed Michael Woodhouse to replace him as Opposition spokesperson for Health.

Michael Woodhouse.jpg

After studying commerce and accounting Woodhouse worked for an accountant, at Dunedin Hospital and for ACC before becoming CEO of the private Mercy Hospital.

He was elected as a list MP in 2008, and became a minister in the National Government in 2013.

It’s interesting (for me anyway) that the current Minister for Health, David Clark, and the new Opposition spokesperson for health have both contested the Dunedin North electorate. Especially so with the ongoing delays in announcing plans for the replacement of the Dunedin Public Hospital.

Woodhouse was ranked 10 on the National list for the 2017 election, but is currently rank #13 after Bridges’ recent appointments. That may change slightly after Coleman leaves Parliament.

1 News: National Party appoints Michael Woodhouse as new Health spokesperson

In two other National Party changes Nikki Kaye has been appointed Sport and Recreation spokesperson and Scott Simpson has been appointed Workplace Relations spokesperson.

Peters: “Filthy Rumour, Dirty Campaign”

A press release from NZ First on Friday – odd that the quotes are not attributed to anyone, but the headline gives an indication who it is.

Peters: Filthy Rumour, Dirty Campaign

Filthy Rumour, Dirty Campaign

“I was approached by a senior journalist this afternoon, whose opening question was: How is your health?

“I made it very clear to him that if he, or any other party, thinks that spreading malicious rumours will not be met with the full force of the law available to me then he, and they, would be very mistaken.

It is unfair and unreasonable for anyone to make accusations or insinuations about any candidate standing for election where there is no proof available to back it up.

So please don’t make any such comments here.

Anything patently unfair and unsupported by facts, or anything that may put this site at legal risk, will be deleted.

“For the record, this has been a long campaign in which we have worked seven days a week and I am looking forward to enjoying political life after the election.

All party leaders in particular have had very hard and demanding campaigns, especially those of opposition parties who have been campaigning for months.

If NZ First are in a position where they are included in coalition negotiations after the election then political life may continue to be torrid for some weeks.

If negotiations are successful and NZ First is a part of the next government then the hard work will continue for three years.

“PS: I was warned some time ago that this would be the next line of vicious attack.”

That sounds similar to Peters’ claim he had been pre-warned about the super leak in advance – but he has produced no evidence.

Source: http://www.scoop.co.nz/stories/PA1709/S00191/peters-filthy-rumour-dirty-campaign.htm

Q+A: health debate – Coleman & Clark

On Q+A this morning: Who has the best policies for our health system?
Watch our health debate – Political Editor Corin Dann with Labour’s Dr David Clark and National’s Dr Jonathan Coleman.

Image may contain: 2 people, people smiling, glasses

Coleman and Clark also featured on The Nation yesterday (repeated this morning at 10:00 am).

Labour on health:

Health

Additional $8 billion investment in health over four years

See the details in our fiscal plan here.

Cut GP fees by $10 a visit with $8 GP visits for Community Services Card holders

From 1 July 2018, Labour will lower the cost of GP visits by $10 through:

  • Lowering the VLCA fee cap by $10 to $8 for adults and $2 for teens (under 13s are already free), with a funding increase to VLCA practices to cover this
  • Increasing government funding for all practices that lower their fees by $10, low (show all)

Continue reading →

National responded to Labour’s $8b:

Labour’s mythical $8b extra health spend

The Labour Party has been trying to pull the wool over everyone’s eyes with its mythical $8 billion extra health spend, National Party Health spokesman Dr Jonathan Coleman says.

“The ‘$8 billion more’ health spending argument is smoke and mirrors. They are simply rolling out normal baseline increases and comparing them with a mythical situation of an alternative government that apparently doesn’t add a single dollar to health expenditure for four years. That’s laughable and has simply never happened,” Dr Coleman says.

“The Labour massive extra spending myth also shows up in the amount of new budget money they propose to add each year. Labour is planning to add less in health for each year in the next four years than the National Government has added in the last budget alone.

National new budget operating spend (actual):

  • 2017/18        $879 million

Labour proposed new budget operating spend:

  • 2018/19        $847 million
  • 2019/20        $689 million
  • 2020/21        $826 million
  • 2021/22        $795 million

“The reality is every government makes big increases to the health budget. Of course it’s all about what you do with the money rather than the money itself. And the National Government has an absolute focus on lifting results from the health investments we make.

“The irony is that whether you measure by our respective history of results or just the dollars, when you compare Labour’s proposed plan with National’s track record New Zealanders would receive less from the health sector under Labour.”


The Nation: Coleman v Clark on health

 

There will be a debate this morning on The Nation on health spending, between the Minister of Health Jonathan Coleman, and Labour’s health spokesperson David Clark. These two have clashed a number of times in Parliament.

Health is on of the biggest issues of concern to New Zealanders. In the latest Herald-ZB-Kantar TNS online survey of 1000 voters…asked which of eight issues was most likely to affect their vote:

  • Economy 25%
  • Health 16%
  • Housing 12%

You need a healthy economy to provide good health care (and housing).

Providing healthcare is very expensive. here will never be enough money to provide all the health care wanted. Governments have to balance health spending against need and against other spending demands.

Labour have claimed that health funding has been effectively cut.

Stuff: Frustration, disappointment over health funding in Budget 2017

Patients and healthcare workers say they have been left frustrated and disappointed by “inadequate” funding for health in the 2017 Budget.

They said the Government’s announcements on Thursday would not go nearly far enough in addressing concerns about overworked staff, access to new medicines, and access to mental health treatment.

The Government said total health spending would be a record $16.77 billion in 2017/18 – an increase of $879 million, with an overall increase of $3.9b over the next four years.

However, the record claim does not take inflation into account, and sidesteps the fact that almost half the spending will go toward mandated wage increases as part of the pay equity settlement.

Budget 2017: Health funding to record levels with $1.7b injection to DHBs 

A strained health sector is set to receive a record $3.9b shot in the arm, with $1.8b going to District Health Boards (DHBs) alone.

While DHBs funding is above the $1.7b figure Labour claims has been stripped out of the health service, the Council of Trade Unions is warning the devil is in the detail.

The increase to DHB funding has built on previous years – going up to $1.8b across four years, up from $1b last year. As a yearly figure, DHBs will get $439m, up from last year’s $400m.

 

Economy the top concern in survey

It has long been thought that the thing that makes up the minds of voters the most when it comes to election crunch time is the economy. Other issues get aired and appear to get traction with the media and possibly the public, but a stable and strong economy seems to sway more than most.

The latest Herald-ZB-Kantar TNS online survey asked “which of eight issues was most likely to affect their vote”:

  • Economy 25%
  • Health 16%
  • Housing 12%
  • Poverty 10%
  • Immigration 9%
  • Environment 8%
  • Education 8%
  • Unemployment 3%
  • None of these issues 9%

This isn’t surprising as the economy impacts on each of the other seven issues. You need a strong economy to be able to afford to deal with the rest.

The economy was the top pick for both genders and across employed, self-employed and unemployed voters although housing slightly edged out the economy among young, urban voters in their 20s.

Young voters are most affected by escalating house prices but they are also the lowest voting age group.

Overall there is quite a spread of views on what should be done about house prices.

There were different concerns in Auckland to other areas.

Unsurprisingly, housing was more important to Aucklanders than other New Zealanders in the survey. It was the second most important issue in Auckland chosen by 18% of Aucklanders compared to 9% of those in the rest of the North Island.

A higher proportion of Aucklanders also selected immigration as a big issue than those living elsewhere. It was a big issue to 12% of Auckland respondents compared to 9 % overall.

The survey of 1000 was conducted from July 19-26 and the margin of error is plus or minus 3.1 per cent. It is an online survey by ConsumerLink which runs the Fly Buys panel of 120,000 active members, one of the largest in New Zealand. The sampling was nationally representative and post-weighted by age, gender and region to match the population.

Because it has only started surveying recently and asks different questions to other polls it’s hard to compare the Herald-ZB-Kantar TNS online surveys, so hard to evaluate how accurate they might be.