Ministerial Advisory Group for health

The Minister of Health, David Clark, has announced “the urgent establishment of a new Ministerial Advisory Group on the Health System”.

Advisory groups, working groups, committees and commissioned reports are all things that are used in Government to kick the can down the road, to bury a promise, to deliberately delay.

For example the Tax Working Group seems to be a device to get advice that the Government wants to hear. After nine years in Opposition one could wonder why Labour hadn’t already done all the research needed to inform adequately on reforming our tax system.

But I think the health Advisory Group may be justified. Clark is not very experienced in Health, and it is one of the most demanding portfolios, with one of the biggest responsibilities. Life and death is at stake, costs are escalating, as is the age of the population, so it is difficult to get the right levels of care to balance on a budget.

New Ministerial Advisory Group established for Health

Health Minister Dr David Clark has announced the urgent establishment of a new Ministerial Advisory Group on the Health System.

“Since becoming the Minister of Health, it has become increasingly clear to me that all is not well within our public health system. Nine years of under-resourcing and neglect have taken their toll.

“New Zealanders deserve better and the Labour-led Government will not sit back while the public is short-changed by a health system operating under such stress. We have a significant health agenda to roll out, including in primary care, mental health and disability services.

“We’re committed to investing an extra $8 billion in health, and it is vital to have a health system in its best shape possible to ensure all New Zealanders can access quality health and disability services.

“The Ministerial Advisory Group will help ensure that investment makes a positive difference to people’s lives. It will provide fresh perspective and independent advice about how we can improve our health system and deliver better services to New Zealanders.”

Dr Clark has appointed Sir Brian Roche as chair of the group. Professor David Tipene-Leach, Muriel Tūnoho, Dr Karen Poutasi and Dr Lester Levy have also been appointed members for a term of two years. They will report directly to the Minister of Health.

“These five individuals are extremely experienced and highly regarded in the health and disability sector.

“I’ve asked them to advise me on lifting the Ministry’s performance and leadership, strengthening relationships across the sector, and helping to deliver the Government’s strategic direction for health. This work is critical to improving the quality of our health services.

“There are good people nationwide working hard to improve people’s health. Both they and the public deserve the highest standards of leadership and performance,” says Dr Clark.

Background Information:

The Ministerial Advisory Group on the Health System is a Ministerial Committee established under section 11 of the New Zealand Public Health and Disability Act 2001.

Chair Sir Brian Roche has extensive governance and management experience, a former Chief Executive of PWC NZ, oversaw a significant transformation of the New Zealand Post Group as Chief Executive and is an experienced chair of numerous entities, both Crown and private.

Professor David Tipene-Leach is a Professor of Māori and Indigenous Research at the Eastern Institute of Technology. He has a distinguished medical practice and academic history, and has led innovative public health projects on prevention of long-term conditions, particularly diabetes.

Muriel Tūnoho is president of E tū, one of New Zealand’s largest unions and national coordinator for Healthcare Aotearoa, which represents many community and iwi controlled primary health providers. She is also involved with Hutt Union & Community Health Service and is an executive member on the Living Wage Movement Aotearoa board.

Dr Karen Poutasi is a former Director-General of Health. She oversaw the establishment of district health boards and the amalgamation of the former Health Funding Authority with the Ministry of Health. She has extensive experience at both a governance and management level, with deep knowledge and networks in the health system.

Dr Lester Levy has extensive knowledge of the health sector. He is Chair of the three Auckland district health boards, and has a wealth of experience in other private and government governance roles.

The best possible advice is essential for making decisions on health, and this group should the Minister.

David Farrar gives it a tick in Clark pushes out Chuah:

I don’t know all the members but Roche, Poutasi and Levy are well regarded and could well play a good role in improving the performance of the Ministry of Health.

Clark dines pushing Chuah: Outgoing health boss ‘not pushed’

Labour has been highly critical of Chai Chuah in the past but it was his choice to resign, David Clark says.

Hobson’s choice perhaps, but as Farrar said, Clark needs to have confidence in the Health boss.

In Parliament yesterday Clark responded to patsy questions (and one from the Opposition) with some of his expectations.

12. Dr LIZ CRAIG (Labour) to the Minister of Health: Why has he established the Ministerial Advisory Group on the Health System?

Hon Dr DAVID CLARK (Minister of Health): Today, I announced that I have established a ministerial advisory group because it has become increasingly clear to me that all is not well within our public health system. I require strong, independent advice about how we can lift the ministry’s performance and leadership, to begin to address the challenges facing our health system and, in particular, to rebuild the relationships that were seriously strained under the previous Government.

Dr Liz Craig: Thank you, Mr Speaker. What does he expect the ministerial advisory group will do to improve New Zealand’s health system?

Hon Dr DAVID CLARK: I expect that the ministerial advisory group will provide the strategic advice required to deliver on this Government’s commitments in health and ensure that the $8 billion we have committed to investing in health will make a positive difference in people’s lives. This will include, for example, improving access to primary care by lowering the costs of visiting a GP.

Dr Shane Reti: Isn’t it more correct to say he’s set up the ministerial advisory group to tell him what his health plan in health should be, because he doesn’t have a plan?

Hon Dr DAVID CLARK: No.

Dr Liz Craig: Will the ministerial advisory group improve relationships across the health sector?

Hon Dr DAVID CLARK: One of the first things I expect the ministerial advisory group to do will be to rebuild relationships across the health sector. Strong and productive relationships are required to deliver the healthcare New Zealanders expect and deserve. I’m confident that the ministerial advisory group will be able to do this, and I have no doubt that its members will be talking and listening to district health boards, primary health organisations, and others up and down the country.

A line up of doctors, with both Craig and Reti having worked in health roles. That’s not necessarily all positive, the last Minister of Health, Dr Jonathan Coleman, seemed to lack in communication skills, something that’s essential in this portfolio.

I wish Clark and his Advisory Group well – I may need their help some time in the future, and there’s been some scary bad health stories coming out of Dunedin Hospital – the hospital whose case for replacement has been kicked down the road for a while now.

Minister of Health on colonisation and youth suicide

In an interview with NZ Herald new Minister of Health David Clark linked youth suicide with colonisation – New Health Minister David Clark on youth suicide: We have a problem and we need to talk about it

Labour campaigned on mental health and pledged the return of the mental health commissioner and an inquiry into mental health.

Terms of reference and other details around the inquiry were yet to be settled, Clark said, but forecast it as wide ranging, considering issues of colonisation and poverty.

He spoke of “hardship, or the after-effects of colonisation, or trauma in their own lives or personal histories”.

He was questioned about this in Parliament yesterday.

Hansard transcript (slightly edited):

7. Hon Dr JONATHAN COLEMAN (National—Northcote) to the Minister of Health: What quantifiable health service improvements, if any, will his policies deliver?

Hon Dr DAVID CLARK (Minister of Health): This Government is committed to providing affordable access to quality healthcare for all New Zealanders. This will happen in many ways; there are too many examples to list. However, to pick just one, I can tell the member that more people will be able to access affordable primary healthcare.

Hon Dr Jonathan Coleman: By exactly how much will he lift the number of elective surgeries above the 174,000 delivered in the past year, given his commitment to increase access to elective surgery?

Hon Dr DAVID CLARK: I will not be rushed into committing to specific targets. I want a health system that is honest and transparent with targets not like the previous Government’s one, which was pumping statistics by performing Avastin injections and skin legion removals that could have been done in primary care.

Hon Dr Jonathan Coleman: I raise a point of order, Mr Speaker. It was a very direct question. If he doesn’t have an answer, he should just say so.

Mr SPEAKER: No. I probably was a bit slack letting him go on after he answered the question in the first sentence.

Matt Doocey: By how much will he reduce the suicide rate over the next three years now that his Government has taken responsibility for the rate, as reported in the New Zealand Herald yesterday in the article entitled “… New Health Minister pledges change on youth suicide”?

Hon Dr DAVID CLARK: One suicide is one suicide too many. I do not believe it will be possible to eliminate suicide in the first term of this Government, but we are committed to lowering the rate of suicide in New Zealand, and I am looking forward to beginning the mental health inquiry.

Dr Shane Reti: What did he mean exactly by his statement to the New Zealand Herald yesterday that addressing colonisation will be an important part of his mental health inquiry?

Hon Dr DAVID CLARK: That is one factor that I said to the New Zealand Herald I expect will come up in the inquiry.

Hon Dr Jonathan Coleman: Can he explain the improvements his policies will have on the link that he believes exists between colonisation and youth suicide?

Hon Dr DAVID CLARK: This Government will commit to a mental health review—an inquiry, a ministerial inquiry—and that inquiry I have asked to be broad. It will cover a variety of topics, including the one the former Minister has raised, and I expect it to provide answers that will help us to provide mental health services that New Zealanders need.

It was a topic that the Minister raised in his interview with the Herald.

New Zealand has an alarmingly high level of youth suicide, and of all types of suicide. The annual suicide toll is now over 600, far higher than the road toll that has had huge funding to try to reduce it.

It is an urgent problem that needs action faster than a general mental health review, and the causes of suicide are much wider than just mental health. Many of those who commit suicide are never in the mental health system.

“I do not believe it will be possible to eliminate suicide in the first term of this Government” – it won’t be possible to eliminate suicide in any time frame.

“…we are committed to lowering the rate of suicide in New Zealand…” – as was the last Government, without success.

“…and I am looking forward to beginning the mental health inquiry” – I’d like to see more urgency and action than that.

Unseemly stoush over youth suicide

Of all things youth suicide is one of the worst issues to become a victim of unseemly political niggling, but that is what has happened between the new Minister of Health David Clark and the previous Minister, Jonathan Coleman.

Coleman had problems with diplomacy and public relations, but Clark seems to have not graduated fully from being in opposition yet.

NZH:  New Health Minister David Clark on youth suicide: We have a problem and we need to talk about it

Labour campaigned on mental health and pledged the return of the mental health commissioner and an inquiry into mental health.

Terms of reference and other details around the inquiry were yet to be settled, Clark said, but forecast it as wide ranging, considering issues of colonisation and poverty.

He spoke of “hardship, or the after-effects of colonisation, or trauma in their own lives or personal histories”.

Past practices of shutting down debate on suicide did not deal with an issue that was persistent, Clark said.

“I think we need a public conversation about this. We can’t avoid it as a country. We have a problem and we need to talk about it.”

But he also challenged media to tell stories of survival and recovery, and not to dwell only of those who had taken their lives.

Not talking about it has failed so talking about it makes sense – as long as it is sensible talk. However continuing a political slanging match is not a good place to start.

New Health Minister Dr David Clark has leveled a stinging accusation at the previous government and his predecessor Dr Jonathan Coleman, saying funding and priority shortfalls led to more victims of suicide. Clark made the comments during an interview with the Herald as part of its Break The Silence campaign on youth suicide.

The interview charted the new Government’s hopes for greater suicide preventions and a pledge that more would be done to save the lives of those contemplating taking their own.

Our teen suicide statistics are the worst in the developed world and we have the second greatest number of self-inflicted deaths among those aged 25 and under.

The latest suicide statistics had the highest number of suicides ever – 606 people took their lives. And the figures were little better measured against an increasing population showing little movement in the last decade.

It is a problem that has proven difficult to deal with.

Clark was critical of Coleman and the previous government during the interview, saying officials were “frustrated” over the failure to develop a new Suicide Prevention Strategy after the previous one expired a year ago.

He also criticised Coleman for failing to match an increase in people seeking mental health support with funding.

Political bickering is not a good start to trying better ways of dealing with it.

Asked if that cost lives, Clark initially said it was “very hard on an individual level to say that somebody died because of a lack of funding”.

He then said: “The proposition you’ve put is one that seems reasonable to me, that if you don’t support people, more people are going to take their own lives. I don’t think we can deny that.”

Asked how he felt about there being no current suicide prevention policy, Clark said: “I have expressed publicly frustration with the previous minister. I don’t think there’s much point dwelling on that now. I feel the burden of office that I have picked up. I want to make sure we are in a position as government to find solutions.”

A response: Jonathan Coleman says he’ll hold new health minister to account over suicide target

National’s former health minister Dr Jonathan Coleman says he will be holding the new health minister to account if New Zealand’s suicide rate does not drop.

Coleman declined to be interviewed by the Herald for the story but spoke to Newstalk ZB’s Larry Williams this afternoon.

He told Williams he was surprised Clark was personalising the issue.

“Dr Clark is now signalling he is going to take personal responsibility for the suicide rate from this point on with a zero suicide target … I think he’s making a real rod for his own back,” he said.

“Of course we want to get the suicide rate down … it’s an extremely tragic and difficult area and I’m just very surprised that he’s prepared to talk like this – he’s not doing himself any favours.”

Coleman defended his record on mental health, saying the National government had put an extra $300 million of funding for mental health in the 2017 budget, with $100 million going into spending on portfolios like social welfare, housing and education that impact on mental health.

It’s too soon to know if that extra funding will make any significant difference, and it can easily be argued that it is too little, too late (that can always be argued in politics).

Asked by Williams if any government was accountable for New Zealand’s suicide rate, Coleman said it was “foolish” for the new health minister to say so.

“I genuinely wish Dr Clark well in improving that suicide rate because he’s now set the target, he’s said he will taking personal responsibility and I will be holding him to account over that,” he said.

“I hope he does succeed because this is people’s lives – but clearly if he doesn’t he will be failing to deliver on one of biggest things he campaigned on.”

It’s disappointing to see both Clark and Coleman making this issue political and personal. It is far too serious and important to be overshadowed by bickering.

Health is a very difficult portfolio to manage, because there will always be deaths, and there will always be demands and pressures on funding.

Youth suicide – and don’t forget middle aged suicide which is as big a problem – deserves better from both the Minister and the ex Minister.

Bad health in Parliament

The Minister of Health has a very demanding job, but that doesn’t excuse being an arrogant ass.

It’s a serious issue. for many. A lot of people have good cause to have serious concerns about the delivery (or often non-delivery) of health care.

7. Dr DAVID CLARK (Labour—Dunedin North) to the Minister of Health: Why did he say yesterday in the House, “I do not need to check with DHBs around that”, when asked if he was sure about his claim that every other district health board is currently “managing to deliver the operations that are needed”?

Hon Dr JONATHAN COLEMAN (Minister of Health): As I said in the House yesterday, I do not need to check with district health boards (DHBs) around that, because it is a fact that we are delivering 50,000 more operations than 8 years ago.

Dr David Clark: What assurance will he give that IT glitches, like the one that stopped medical professionals accessing patient letters this morning at Counties Manukau for 2½ hours, are not impacting on delivering the operations that are needed?

Hon Dr JONATHAN COLEMAN: That sounds deeply operational. I am surprised that at this time of the political cycle the member is not trying to raise his game to a more strategic and political level, but be that as it may; I will go back and ask a question about that. At the same time, I will be able to assure him that there is an extra $470 million of money that has gone into Counties Manukau, as well as a lift of 4,500 operations at Counties Manukau, an increase of 34 percent compared with 8 years ago when that crowd was running the system.

Dr David Clark: I seek leave to table a message to Counties Manukau DHB staff relating to clinical letters being unavailable to medical staff for 2½ hours due to an IT glitch this morning—to help the Minister out.

Mr SPEAKER: I will put the leave. Leave is sought to table that particular letter to staff. Is there any objection to it being tabled? There is not. It can be tabled.

Document, by leave, laid on the Table of the House.

Dr David Clark: Does he believe there are enough hospital beds for patients to meet demand pressures when at the beginning of August, 2 weeks ago, Middlemore Hospital was at 116 percent full capacity in medical, surgical, adult rehabilitation, and health of older people wards, with 358 patients going through the emergency department in one day and 52 patients left sitting waiting for an in-patient bed?

Hon Dr JONATHAN COLEMAN: Of course, history shows I always have to check that member’s numbers, but be that as it may, of course winter is a busy time in our hospitals. It has been an especially vicious flu season, despite 1 million vaccines being distributed, but the member will be really pleased to know that, actually, we do have the capacity in our DHBs to absorb this sort of situation.

Dr David Clark: I raise a point of order, Mr Speaker. I will assist the Minister again. Actually, one of them was 128 percent over, and I have the—

Mr SPEAKER: Order! [Interruption] Order! If the member is now seeking to raise a point of order, then he does it. What is the point of order?

Dr David Clark: I seek leave to table an internal email detailing just how overfull the Middlemore Hospital was.

Mr SPEAKER: Leave is sought to table this particular internal email. Is there any objection to it being tabled? There is not; it can be tabled.

Document, by leave, laid on the Table of the House.

Dr DAVID CLARK: After 9 years in Government, what is he doing about the fact that the most recent figures show that once eye injections, skin lesion removals, and other quick operations traditionally done outside the hospital setting are removed from elective surgery figures, year on year fewer elective surgeries were being done in Counties Manukau?

Hon Dr JONATHAN COLEMAN: I find that extremely doubtful. I am not sure where the member is going with this line of questioning. These are very important operations. If he removed every important operation they were doing at Counties Manukau, none would be being done. Across the system as a whole, even if you removed these very important eye injections and skin operations, some of which have to be done under general anaesthetic, we are still doing 30,000 more operations per year than when that crowd was managing it.

Dr David Clark: After 9 years, how much longer will people have to wait when he says “[T]here is no doubt that in health there is always more to do.”, when all the wards in one of our largest hospitals in New Zealand are fully staffed and are in need of close to 70 extra beds before patients arrive each day?

Hon Dr JONATHAN COLEMAN: I think the member needs to just reread his question in his mind, because, frankly, the whole thing just does not make sense, but despite that what I would say is that 9 years on, across the hundreds of services that our health system provides you would struggle to find more than a handful that are not performing better than 9 years ago. There are 50,000 more operations, 150,000 more appointments, and 7,000 more doctors and nurses in the system, and, yes, maybe from time to time the IT system might go down for 2 hours at Counties Manukau. If he thinks that is bad, he should try the IT system in Parliament for comparison.

Dr David Clark: After 9 years, what does he say to clinicians across the country who are pleading for their hospitals to be given more operating theatres, more specialist doctors, and more funding; and is this the “health system that’s the envy of the world” that he envisaged?

Hon Dr JONATHAN COLEMAN: The member needs to start becoming a bit more positive about New Zealand and our health system, because, actually, it stacks up pretty well. I can tell you that if you look at the facilities we have built in health across the country—$1 billion of health rebuilds in Christchurch, West Coast is being done, Dunedin is next, 6,900 more doctors and nurses in our hospital system, 50,000 more operations, and 150,000 more specialist assessments. What I would say to those specialist doctors is that if this guy was ever running the health system, they would be in really big trouble.

Mr SPEAKER: Order! We do not need to go there.

Coleman a growing risk for National

At the worst possible time for National there are growing sides that Minister of Health Jonathan Coleman is highlighting the Achilles Heel of multi-term governments – arrogance and ineptitude.

Stuff: Treasury found Minister of Health’s mental health strategy not ‘coherent’ two months before Budget

An “incredibly damning” Treasury report criticised the Minister and Ministry of Health’s (MOH) failure to deliver an effective mental health strategy.

A report published online shows Treasury officials pushed Finance Minister Steven Joyce to shelve Health Minister Jonathan Coleman’s strategy two months ahead of Budget 2017.

It sparked a new cross-agency approach, but Opposition parties say the report show the ministry and minister “don’t understand the mental health sector”, which is unacceptable. Coleman says mental health is a “complex area” and it is Treasury’s role to provide independent feedback.

The report comes as a potentially damning State Services Commission performance review of the embattled MOH is in the works and after the ministry’s $38 million budget blunder caused chaos for several district health boards (DHBs) around the country.

A March 2017 report briefing Joyce on Budget 2017’s health package highlighted the ministry’s failure to put forward a coherent mental health bid.

Even perceptions of ineptitude can be damaging. It isn’t helped by Coleman’s arrogant defences and fobbing off.

Coleman said: “The drivers of mental health and addition are complex, and there is no simple answer as to why across the world we are seeing increased demand.”

“We have taken a cross-agency approach to this issue. I expect to have more to say on the details of the new initiatives being funded in the coming weeks.”

Mental health has been an obvious and serious issue for a long time. The coming weeks will be dominated by election campaigning, and it’s far too late to be trying to talk about new initiatives.

Health in general and mental health particularly are complex and difficult to deal with. Costs and demands keep rising.

As well as competence something important to see in a Minister of Health is empathy, and Coleman does a poor job of showing that.

He stood for National leadership last year. At least he didn’t win that, but he is making things difficult for Bill English in an election campaign.

Mental health workers claim decent pay

Mental health care is a real and growing problem for the National Government and for New Zealand Society.

There was a major move from institutional mental health care late last century.

It was correctly decided that many people with mental health problems could be better cared for in the community. The problem is that proper community care has never been adequate. And the problems seem to be getting worse.

Part of the problem is the shortage of resources, mainly mental health staffing levels. It is a demanding and sometimes very stressful field of work, and community care pay rates have been pathetic.

Aged care and supporter workers campaigned for and eventually won a significant pay rise, due to take effect next month.  They succeeded through the courts by proving that  their workers were underpaid because the majority were female.

Mental health care workers are trying to do the same.

RNZ: Mental health workers lodge equal pay claim

Christchurch mental health support worker Vicki Harmon works for Pukeko Blue, an organisation which provides community care for those with mental health needs.

She works at one of the 12 residential homes in the city, which provide 24-7 care for seven residents.

It’s tough and demanding work, for which Ms Harmon is paid $16.50 an hour – 75 cents an hour more than the minimum wage.

One of her clients is a woman with an intellectual disability who has spent the last six weeks in the grip of mental illness, something she describes as “exhausting” and “very demanding”.

“Having somebody with a dual diagnosis – an intellectual disability and mental health – means that you are constantly aware of their mental state, not just their intellectual disability, that’s the same every day.

“But you need to be aware of their mental state, it can go up in two days and then it will come back down in two days. You’ve go to be vigilant all the time,” she said.

Auckland mental health worker Pollyanna Alo agreed the job could be challenging.

“There have been occasions where I have been spat on, verbally abused, even had a knife thrown at me,” she said.

Both women are among the 3000 to 4000 community mental health support workers who were left out of the historic pay equity claim for care and support workers, because the government wouldn’t include them.

While they have similar experience, qualifications and responsibilities to their colleagues in the disability support and aged care sector, in a fortnight’s time they can expect to be paid about $6 – $7 less an hour.

Today, two of the country’s largest unions – E tū and the Public Service Association – will lodge an equal pay claim with the Employment Relations Authority.

E tū’s assistant national secretary John Ryall said this was the third group left out of the historic settlement and is similar to a group of workers employed in vocational services with the Ministry of Social Development, which the union is also negotiating.

Mr Ryall said the government needed to support this claim and move swiftly to avoid the impending crisis.

“If the authority decides that, then the government as the funder of the sector needs to either pay the money or watch these places shut.

“We think the job these people do is so important, that it’s important the government gets involved in it,” he said.

Ms Alo said reducing the number of mental health workers would place more stress on district health boards, which were already struggling.

It was inevitable that other sectors would try to benefit from the success of the Care and Support workers.

The problems facing mental health care are probably greater. Pay rates need to be raised, but more workers are also required to deal with the growing demand.

More funding was made available in last month’s budget but it was criticised as not enough.

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.

There are growing demands right across the health sector. On mental health:

The government committed $224m in funding for mental health in this year’s Budget.

That includes $100m for a new cross-government social investment fund that will “target innovative new proposals to tackle mental health issues”.

A further $100m will go to District Health Boards to support local mental health and addiction services, with funding also earmarked for Maori suicide prevention.

Mental Health Foundation spokesperson Sophia Graham welcomed the funding announcement as a “really positive step in the right direction”.

“It seems like a lot of money, but we need to see a commitment to sustained increases in funding,” she said.

Meanwhile, mental health workers and union representatives said the funding was only a fraction of what was needed to adequately respond to demand.

Social worker Andy Colwell said he expected to see the gap between demand and funding get even worse as a result of Budget 2017.

“As a mental health worker, seeing families struggling with life-threatening situations not being seen as urgent is incredibly frustrating, and knowing it will get worse is incredibly distressing,” Colwell said.

“It’s critically important to look at how the money is spent, and make sure we don’t just keep doing the same things that don’t work.”

Graham said key measures for success would be a reduction in the number of suicides, and a reduction in the number of people presenting critically ill at mental health units.

Health Minister Jonathan Coleman acknowledged there had been an increase in demand for mental health and addiction services in recent years.

“Cabinet will soon consider a new mental health and addiction strategy, which will include our new approach to dealing with mental health issues,” he said.

Mental health was covered on Sunday last night: Trouble in mind

Has a mental health crisis put our police under siege? Police officers say the number of emergency callouts for mental health related emergencies is skyrocketing. And they are struggling to cope. Police officers, patient advocates and a frightened family affected speak out.

Coleman wouldn’t comment for that programme but said he was taking a proposal to Cabinet soon. At least with an election looking there may be some urgency.

Clark v Coleman on mental health funding

Labour’s health spokesperson David Clark versus Health Minister Jonathan Coleman in Question Time on Tuesday – this approach doesn’t help the mental health debate.


Health, Minister—Statements on Authors of People’s Mental Health Report

11. Dr DAVID CLARK (Labour—Dunedin North) to the Minister of Health: Does he stand by his statement about the authors of the People’s Mental Health Report, “they’re very left-wing, anti-Government protesters”; if not, when will he apologise to the 500 people who wrote their own stories about experiences with the mental health system as part of the report?

Hon Dr JONATHAN COLEMAN (Minister of Health): Yes, and my statement distinguished between the genuinely motivated story submitters and those ActionStation organisers with some political agenda. My quote was: “When you look at the people behind it, [you know] they’re very left-wing, anti-Government protesters.” As I say, ActionStation is back on Thursday with another, separate, anti-Government protest within the health area, and it could be back week after week with different topics. And just for the record, the ActionStation campaign coordinator is Mr Rick Zwaan, the Green Party’s Wellington election campaign coordinator, who used to work as Kennedy Graham’s researcher. [Interruption]

Mr SPEAKER: Order! [Interruption] Order! Supplementary question, Dr David Clark. [Interruption] Order! I have asked for less interjection from everybody so that Dr David Clark can ask his supplementary questions.

Dr David Clark: Has he read the report; if so, does he accept that its aim, as recorded in the executive summary, is to give space to the stories of what is really going on and going wrong in our mental health services?

Hon Dr JONATHAN COLEMAN: Yes, I have read the report, and especially the executive summary, the first line of which is a totally false premise. It talks about $140 million being cut from health funding. Well, actually, health funding has gone up by $300 million, which kind of proves the point that this is a political document.

Dr David Clark: Does he think the contribution of Robbie, who described support services as expensive and inadequate, and which, he says, “almost drove him to take his own life”, should be dismissed as the experience of a left-wing, anti-Government campaign?

Hon Dr JONATHAN COLEMAN: I have already answered that. Look, I think Robbie’s experience is worth listening to, but that does not change the fact that this report is produced by a group of people who are permanent anti-Government protesters. If the member does not believe me, go and look at their website. They will be back here, week after week, on subject after subject after subject, because they do not like the Government.

Dr David Clark: Does he think the contribution of Mike King, who “describes despair and hopelessness in the face of inadequate access to mental health services”, should be dismissed as the experience of a left-wing, anti-Government campaigner?

Hon Dr JONATHAN COLEMAN: Look, I think the member needs to speak to Mrs King about how you think on your feet. I have answered that question already. The organisers are from ActionStation, and it is the permanent anti-Government, left-wing protester. Mr King is a very good man—Mike King, as opposed to Mrs Annette King—who is genuinely motivated, and I do not detract from his efforts. But, as I say, when you have people like Mr Rick Zwaan, who used to work for Kennedy Graham, and his friends from the Green Party, I think it is pretty obvious that this is political.

Dr David Clark: Does he think the contribution of “the many parents who submitted in regard of their children’s experience of huge waiting lists and lack of funding” should be dismissed as the experience of a left-wing, anti-Government campaign?

Hon Dr JONATHAN COLEMAN: I point out to the member that he does not have to take all his supplementary questions, and if he cannot think of new material in response to the answers, he should just stop. [Interruption]

Mr SPEAKER: Order! We will deal with them one at a time.

Chris Hipkins: I raise a point of order, Mr Speaker. For two answers in a row, the Minister began by insulting the questioner rather than addressing the question. But the main substantive point is that despite the abuse in that last answer, he did not even address the question that was asked.

Mr SPEAKER: On this occasion—[Interruption] Order! I have been increasingly worried about the interchange between these two members and some of the answers that have been given on occasion by the Hon Dr Jonathan Coleman, but, on this occasion, when I consider the three questions that were asked, they were, effectively, the same question each time. Therefore, I can understand the frustration of the Minister in having answered the question the first time—he, effectively, gets the same question for the next two occasions.

Dr David Clark: I raise a point of order, Mr Speaker. That question, in my view, was not addressed, because he had talked about ActionStation, which is the compiler of the report. I am asking a specific question about the comments from the parents within the report. That is a very specific and non – politically loaded question.

Mr SPEAKER: Order! I would like to assist the member, but when I consider the answer that was given to, I think, the second supplementary question, that, effectively, was an answer that was then quite suitable for the rest of the questions the member asked, which were, effectively, just drawing on the experience of someone else within the book. The Minister was quite clear in saying he is not in any way critical of the experiences that were detailed in the report; he was certainly critical of the authors who put the report together.

Hon David Parker: I raise a point of order, Mr Speaker. With respect, is the problem with that not that the Minister is trying to write this off as being a left-wing conspiracy—that is the essence of his answer? I think it is quite proper for members of the Opposition to put instance after instance after instance that paint a different picture. I think the Minister should have to address each of those instances, rather than just cast aside a political insult telling him he should learn how to ask different questions.

Mr SPEAKER: Order! I do not agree that it was a political insult. The question was answered. There was no attack on the various contributions that were made within that report by the Minister. There was certainly a feeling that the authors were not of the same political persuasion as the Minister. That is acceptable.

Dr David Clark: To clarify—

Mr SPEAKER: No. [Interruption] Order! [Interruption] Order! Would the member please resume his seat. [Interruption] Order! Would the member please resume his seat. I have ruled on that matter. The member is now starting to challenge the Chair and debate with the Chair. That in itself will lead to gross disorder in this House. Question No. 12—Melissa Lee—[Interruption] Order! [Interruption] If I hear a further interjection from Carmel Sepuloni while I am in the Chair today, she will be leaving the Chamber. She has been consistently interjecting throughout question time in a very—[Interruption] Order! If the member wants to go now, I can make that arrangement very easily. I expect cooperation, particularly from whips, and the level of interjection that has been coming from Carmel Sepuloni throughout question time is unacceptable. When I rise to my feet, for those interjections still to continue is just not acceptable to this House.

 

Labour’s ‘fresh approach’ on mental health

Labour has announced policy on trying to deal with difficult mental health issues.


Fresh approach on mental health

Labour will introduce a pilot scheme of specialist mental health teams across the country in government to ensure swifter and more effective treatment for those who need urgent help, says Labour’s Leader Andrew Little.

“Mental health is in crisis. It needs a fresh approach so we can make a difference quickly because what we’re doing now just isn’t working.

“This is something you can’t put a bandage on and a Labour Government will make it a priority to better equip our health system to cater for those crying out for help.

“Health professionals and those needing treatment tell us it’s hard to find the front door to access mental health services. The present service is over-stretched and fragmented with little co-ordination of the care people need.

“What the new mental health teams will do is offer free, accessible help for those in need and ensure their care is co-ordinated and effective.

“One in six New Zealanders will be diagnosed with a mental health problem in their lifetime. There’s been a 60 per cent increase in Kiwis accessing mental health treatment since National came to power but spending on this sector has only increased by 28 per cent.

“A quarter of all suicides are people who have been in contact with mental health services in the past month.

“Under the two year pilot specialist mental health teams will operate from eight sites across the country and work with doctors, NGOs and District Health Boards. One of the sites will be in Christchurch reflecting the city’s particular needs.

“We expect the teams will be able to help nearly 40,000 people each year at a cost of $43 million over the pilot.

“This is a small investment that we’re confident will make a big difference to those who struggle today to access the services they need. It will be funded through Labour’s budgeted commitment to reversing National’s $1.7 billion of health cuts and is in addition to Labour’s review of the mental health system.

“We believe early intervention and continuing care will help people avoid significant mental health distress and better assist them to live their lives to their fullest. It’s the right thing to do,” says Andrew Little.


This is a timely policy announcement by Labour given Health Minister Jonathan Coleman’s reaction to a mental health report.

The Spinoff: Jonathan Coleman’s attack on ‘anti-government’ ActionStation is a smokescreen. And it’s nonsense

The minister of health has dismissed a report on mental health claiming the authors are ‘left-wing anti-government protesters’. ActionStation’s Marianne Elliott responds.

You know the saying: ‘Don’t shoot the messenger’?

Well, the message is that New Zealanders are deeply concerned about the state of our mental health system, and heartbroken about the family and friends we lose to suicide every year. We’re just the messengers.

The “we” in that sentence is the ActionStation community of everyday New Zealanders, hundreds of whom shared their stories with the People’s Mental Health Review, and 12,800 more who added their names to an open letter asking the government to consider the findings of that review.

So when the minister of health, Dr Jonathan Coleman, dismissed the recommendations of the People’s Mental Health Report on Tuesday because “the people behind the report” were “left-wing anti-government protesters”, that is who he was dismissing.

Attacking the messenger is a classic diversionary tactic when you don’t want to face up to the message itself.

That’s how it looks – not good for Coleman.

Coleman needs to ditch the reactionary petulance and be seen be genuinely dealing with obvious mental health care shortcomings and difficulties. Otherwise voters may choose to go with Labour’s approach.

I’ve always been aware that ActionStation has some close connections with the Greens, and their regular petitions can seem a bit pointless and easy to ignore, but their mental health report was much more substantial and pertinent to current difficulties many people face.

And this from Parliament doesn’t help the metal health debate either: Clark v Coleman on mental health funding

First DHB funded Sativex

A post from MZaNZ:

BREAKING NEWS: First Patient in NZ Successfully funded for Sativex by DHB

A woman who may have otherwise died from her regular severe seizures has been granted approval for medical marijuana funding.

Alisha Butt, 20, has the mentality of a toddler and is unable to speak.

Her seizures had presented a huge problem for specialists who were unable to adequately treat her, leading to the possibility she could end up in a coma from one and die.

But thanks to medicinal marijuana extract Sativex, Alisha is able to live a more comfortable life.

“Since being on Sativex for over 4 months, she has shown a great improvement,” mum Sushila Butt said.

“Her seizures have decreased immensely and now, after long last, Alisha has been able to enjoy a better quality of life without the disturbance of erratic and continuous prolonged seizures.”

A big relief to see a significant improvement.

Then, in September, Alisha was approved by the minister of Health to receive Sativex – which contains Cannabidiol with Tetrahydrocannabinol, or THC, the main psychoactive component of cannabis – but the family had to fund the $1000-a-month treatment themselves.

It wasn’t until January 22 that the Government agreed to fund the medicinal marijuana as a prescription.

“It’s completely covered now,” Sushila said. “It will be fully funded for my daughter.

A funding breakthrough. Until now Sativex wasn’t funded and was costing something like $1000 per month, too much for many parents.

Full post at MCaNZ:
http://mcadvocacynz.org/2016/01/28/breaking-news-first-patient-in-nz-successfully-funded-for-sativex/

“Teen in coma for 57 days needs legal access to cannabis oil”

Seven Sharp had an item on Alex Renton, the 19 year old who had a major seizure and has been in a coma in Wellington Hospital for 57 days. So far treatment has been unsuccessful, and his life is at risk.

His family want to be able to try using cannabis oil (CBD) which has been successful in reducing seizures in some cases.

Today, two weeks after a recommendation from Alex’s neurologist that CBD be tried, the Wellington DHB has put in an application with the Minister of Health requesting approval to be able to use it.

TVNZ News only seems to have this available online via this video; “Teen in coma for 57 days needs legal access to cannabis oil”

Mike Hosking: On a day where we found out that the courts weren’t in a position to help Lecretia Seales, what did the judge say, it’s really only Parliament’s job who can do that, we want to introduce you to a young man who has a similar vexed battle on his hands.

Nineteen year old Alex Renton, he’s been in a coma for fifty seven days with a mystery illness.

Nadine: The drugs haven’t fixed him but his family is holding out hope, because they believe Alex’s saviour could be cannabis oil. Problem is it’s illegal. So could a law change in this case save a life?

It’s use is allowed with the approval of the Minister of Health, according to the NZ Drug Foundation:

@PeteDGeorge @metiria The law doesn’t actually need changing. The minister right now could simply give approval… if he/she wishes.

Jehancasinader: (voice over video of his family celebrating Alex’s birthday in hospital):  Alex never expected to celebrate his nineteenth birthday in a coma. The pair of shows a present from Mum, for the day she hopes he’ll walk out of here.

Alex was as fit as a fiddle, until one seizure tipped his life upside down.

Alex’s doctors are stumped, their diagnosis uncertain. Meanwhile his brain is inflamed, and rocked by constant seizures.

Alex’s family believes there’s one last hope.  Cannabis. It’s illegal of course, but advocates say the oil can fire up neurons in the brain.

Rose (Alex’s mother): We’ve been offered the oil from overseas, clinically tested oil.

The oil is extracted from special strains of the cannabis plant that are very low in the intoxicant THC.

Jehancasinader: Last year we showed you how desperate Aussie families have relied on it to save their kids lives. It needs special approval. Rose says hospital officials are dragging the chain.

Rose: They seem to be frightened.

Jehancasinader: Until now Rose says drugs haven’t been a part of Alex’s life.

Rose: This isn’t about recreational marijuana, this is about medicine.

Jehancasinader:  Now Alex is being given Ketamine.

Rose: They choose to pour chemicals into him, but they will not choose a natural herb extract.

Jehancasinader: Rose believes time is running out for her boy.

Rose: A petition of twenty five thousand people have supported this treatment for Alex, and still we wait, he waits, because one hospital thinks they know better.

Mike Hosking: Jeez it’s been a tough day in so many respects hasn’t it Jehan, even to you, you’re with us live, just tell us how is Alex doing and what seems to be the hold up, what seems to be the problem here.

Jehancasinader: Well Mike I visited Alex here at Wellington Hospital late last night with his Mum. It was pretty tough actually seeing him lying in that bed unable to move and unable to talk.

Now you heard Rose saying that story that she believes the hospital has been dragging the chain on this, and we have the proof tonight.

The Ministry of Health says that it still hasn’t even received an application from the hospital for this cannabis treatment to be given to Alex.

Now this is two whole weeks after the neurologist said look we really need to look at this as an option. He is deteriorating.

Now within the past hour I finally heard from the DHB and they’ve confirmed that today they’ve decided to put that application in to the Minister of Health. He will have the final say on whether the cannabis treatment is granted and meanwhile Alex is spending his fifty seventh night in that hospital behind me.

Associate Minister of Health Peter Dunne will now have responsibility for this decision.