And welcome to my website. My name is David Choat and I’m the Care not Cuts representative recently elected to the Capital and Coast District Health Board.
Care not Cuts advocates for a quality public health system and is concerned about the impact of Government cuts in the health sector.
You can read my profile here. For more information or to discuss any issue important to you, please contact me on David_Choat [at] yahoo.co.nz or phone me on 385 9440.
Regards,
David Choat
I have previously written about what an important job the Newtown Union Health Service does for disadvantaged communities in South Wellington and about the concerns raised about anticipated funding cuts to be signed off by our Board.
This led to a community meeting on May 3 about the implications for Newton Union’s services and fees. I wasn’t able to make it to that meeting, but it prompted me to raise the issue at the May Capital & Coast district health board meeting on May 11.
I put forward a motion, “That the Board recognises the importance of the services provided by Newtown Union Health and agrees that it will not face any funding cuts in the next financial year”.
I want to acknowledge and thank my colleague Helen Ritchie who seconded and voted for the motion.
Unfortunately no one else did. All the other board members voted against this motion, except one who abstained, so it was defeated seven votes to two.
I’m really disappointed in my Board. This is the ‘austerity’ agenda (marketed as ‘living within our means’) that the Board has meekly signed up to, brought to its inevitable conclusion. Here’s a clearcut case of a service supporting people with high health needs, doing exactly the sort of thing we claim to believe when we talk piously about ‘reducing disparities’. And yet we won’t stand up against alleged* proposals to cut their funding.
It’s just not good enough.
(Let me anticipate a counter-argument here: some board members objected to me bringing this up in public session and singling out Newtown Union for support. Without being able to discuss the details*, I can nonetheless say that I am entirely confident that it is appropriate to focus on Newtown Union specifically. And I make no apology for forcing Board members to take a stand publicly rather than vote anonymously behind closed doors.)
I’d encourage Care not Cuts readers to show their support for Newtown Union Health Service by ‘liking’ their Facebook page. They also have another Community Advisory Group Meeting coming up on 12 June.
This isn’t over.
* As I’ve complained previously, supposedly-democratic DHBs discuss all of their key budget decisions in secretive ‘public-excluded’ sessions, which I’m not allowed to tell you about. Hence, my statements about Newtown Union can only reference what has been claimed publicly by others, such as Newtown Union itself.
Just a quick post to note three points about tomorrow’s Board meeting:
Our May board meeting is coming up on Friday. Hopefully the Board will support the following set of recommendation from Regional Pubic Health, which were endorsed by our Community & Public Health Advisory Committee (CPHAC) at its meeting last month:
1. CPHAC acknowledge the important role Hutt Valley and Capital and Coast DHBs have in addressing health inequities.
2. CPHAC agree that planning and service delivery reflects an ongoing commitment to reducing health inequities.
3. CPHAC considers the following menu of options to address health inequities and improve health outcomes for our populations:
a. Equitable and fair fiscal and social welfare policy that ensures that everyone has a minimum income for healthy living.
CPHAC consider making submission on the welfare reforms currently before Parliament
b. Ill-health prevention that addresses risk factors contributing to health inequities,
CPHAC consider the opportunity for Hutt Valley DHB and Capital Coast DHB to become role models within their communities, as seen through the early adoption of Smokefree campuses. There is a strong case for extending this ‘role model’ to include healthy food policies and practice for the foods available on site, and for continuing their stance on addressing the harms from alcohol.
CPHAC consider the role that the DHBs’ clinicians can take in treating illness goes beyond treating the presenting condition to addressing the underlying causes of these diseases. This applies particularly to long term conditions such as diabetes, cardiovascular disease and cancer.
c. Maintaining and enhancing investment in early childhood.
CPHAC consider implementing the action proposed in the joint DHB submission on the Green Paper on vulnerable children.
d. Aligning climate change, sustainability and pro-equity policies,
CPHAC consider continuing the excellent work already done on supporting healthy housing for our most vulnerable populations, further building relationships with local authorities to create environments that support healthy choices such as walking and healthy food.
e. Ensuring fair employment and safe and healthy workplaces,
CPHAC consider the role, as major employers in the region, that DHBs play in creating a fair, safe and healthy workplace especially for the more vulnerable sections of the workforce.
f. Maintaining and enhancing M!ori, Pacific and Asian policies and programmes.
CPHAC consider the role that DHB policies play in either reducing or increasing health inequities.
g. Ensuring health services are equitable,
CPHAC consider putting in place further measures to assess the equity of health outcomes for the populations of the two DHBs.
There was quite a robust debate about this set of recommendations and the Regional Public Health paper that they were included within, with some members seeming very uncomfortable with this kind of analysis — including the referencing of The Spirit Level!
But in the end (and after a couple of members had had to depart), when I and Helene Ritchie moved and seconded putting the recommendation to a vote, the Committee voted unanimously in support.
The Capital and Coast District Health Board meets tomorrow at 9.30am. The papers are here.
Notable items and/or papers on the agenda include:
And on Monday at 9.00am in Lower Hutt the Community and Public Health Advisory Committee (CPHAC) is meeting. The papers are here. The agenda includes presentations on ‘The Health Passport’ (p. 13) and ‘Population Health Programmes and Intersectoral Linkages’, and there is a paper from Regional Public Health on ‘Health Equity’. (p. 21).
This is from last Tuesday’s Nine to Noon on Radio New Zealand:
Community Health Programme Funding Cuts
A Wellington health organisation says it’s being forced to scrap several important community health programmes due to funding cuts. (19′52″)
When I decided to stand for election to Capital & Coast District Health Board, I wanted to establish a blog to record my experiences and reflections and act as a form of accountability to the people who elected me.
I don’t feel that our DHB does a particularly good job of involving the public in the issues and decisions we face — although I should add I don’t have a sense that we’re any worse than most other DHBs in that regard. So I wanted to do my bit, and perhaps learn a few things about what works in terms of communicating with the public about these matters, which I might be able to use to contribute to the DHB’s wider efforts in this area.
Given all of that, I was very pleased last night to discover another blog in existence that talks about what goes on in a DHB: Counties Manukau District Health Board’s CEOBlog, written by chief executive Geraint Martin. It can be found at http://cmdhbceoblog.wordpress.com/, and in particular the post Going Public discusses the decision to make what was originally an internal blog (only accessible to the DHB’s staff) available to the wider public.
CEOBlog’s focus is much more operational than this one, which comes from a governance perspective and looks at the politics underpinning health policy decisions; and the posts are rather more detailed. But I think underlying both of our blogs is a conviction that there is an interest out there to learn about what’s happening in our district health boards, and that we have a duty to meet that interest.
Good on you, Mr Martin!
A few notes on Friday’s meeting (papers here):
I congratulate Capital & Coast DHB for the strong performance improvement achieved this quarter, up to 82 percent. This is excellent progress and evidence of your hard work and commitment to improving acute patient care and flow. it has been great to see your progress continue to improve into quarter three, although I note this has slowed during February. I look forward to meeting with you in the near future to find out more about the reasons for this.
Last month I reported that the Board had had some unofficial indications about the government’s Zero GP Fees for Under Sixes after-hours election promise. It seemed like only one provider in each territorial local authority (TLA) area would be funded to offer free after-hours care.
In the CE report in our papers for this month’s meeting (p. 14), we were told the following:
No new information has been received form the Ministry of Health (MOH) with respect to free under 6s.
Staff are awaiting clarification of expectations and indications; a verbal update will be given at the meeting.
But at the meeting we were advised that there was nothing more to report, as no further information had been forthcoming. Despite the fact that, supposedly, this initiative is to come into effect from the middle of the year.
Not very helpful.
Capital & Coast’s board meeting this month is on tomorrow (Friday) at 9.30 in the Level 11 board room of Grace Neil Block.
The main items for public discussion are:
The papers are available online at: http://www.ccdhb.org.nz/Meetings/boardpapers/2012/2012_03_09/Board%20papers%20-9th%20March%202012%20-Public%20-FINAL.pdf
Discussions in secret will include: Annual Plan; Service Change for Mental Health; and Community Pharmacy Contract.
We also have a Community & Public Health Advisory Committee (CPHAC) meeting (joint with Hutt Valley) on Monday at 9am, at the same venue.
The main items for public discussion include both DHBs’ six monthly reports and our proposed submission on the Mental Health Commission Blueprint II.
There will be presentations on ‘A Pacific Perspective on Health Equity’ and ‘The Health Passport’.
The papers are available online at:
Last month I was privileged to be invited to speak at the AGM of the Newtown Union Health Service (NUHS).
Located in behind the Lychgate Shopping Centre on Riddiford Street (and also accessible via Hall Ave), NUHS is a Wellington institution.
It was founded in 1987 out of the union movement’s desire to find a better way to ensure that those most in need received the highest level of primary care available. It is a not-for-profit, community-owned, primary health service that provides affordable health care to a population of approximately 6700 predominantly low-income families and individuals living in the South Wellington area, many of whom have high health needs.
It is selective in its enrolments, prioritising those with the greatest needs. Consequently, it caters to a diverse ethnic range – Europeans make up less than 20% of its population, with Pacific Islanders the largest group at 21.7%, and there are also Middle Eastern (17%), Maori (15%), Asian (15%) and African (12%) patients.
NUHS employs a range of health professionals including general practitioners, practice nurses, social workers, and midwives. It has regular “suitcase clinics” in a housing complex and in a community centre. Health workers are encouraged to involve community members in developing programs and advocacy related to health determinants such as housing, employment and recreation, based on issues identified by the community it serves.
In many ways it provided the blueprint for the primary health care strategy that the previous (Labour-led) government brought in a decade ago and which is still a central part of our health system.
At the AGM, I said (speaking as an individual Board member rather than on behalf of the Board) that NUHS did important work, and out to be valued and supported by the our Health Board.
Unfortunately, at the same AGM, members and supporters of NUHS were advised that funding for the service was to receive further cuts. More to come on this.
