NZCCSS’ submission was guided by our mission and values, and a strong view that social justice should be the primary motivation behind any social investment approach incorporated into the draft strategy.
“Human distress and frailty, often the result of persistent material deprivation and ‘limited choices’ due to inadequate family/household income, is not a financial liability; it is a moral failure“. [Pg 3]
NZCCSS’ submission supported the Ministry’s review and general direction of travel signalled in the consultation documents with particular reference to opportunities to:
strengthen already existing work to integrate a broad range of health services into communities
develop an early investment approach across age spectrum
strengthen of inter-agency collaboration to improve the lives of vulnerable people
engage technological advancements to empower people to be actively involved in their health.
At the same time, our submission raised the following points:
The health system needs to include in its planning specific actions to manage New Zealand’s ageing population. NZCCSS refers the Ministry to its recent comments on the Review of the Health of Older People Strategy.
NZCCSS supports a focus on ‘building the capability and diversity of the workforce to meet the demands for more integrated health care’. This focus raises a number of health workforce issues particularly for the older people (and disability) sector. Finding solutions to ensure the fair funding of the workforce is intrinsic to ensuring good health outcomes for older people.
NZCCSS acknowledges the benefits of digital technology but cautions that face-to-face access to medical services/information should remain available to those who are more effectively supported in this way.
The digital divide is narrowing but there remains some population groups that do not have digital access to health information.
The effectiveness of the health strategy to reduce inequities would be greatly improved if family/household income is raised. There is an abundance of evidence that supports the relationship between low income and poor health outcomes [Marmot 2010].
NZCCSS supports the consideration of a more refined mechanism for procurement of health and investing in services that achieve the ‘best’ outcomes. The mechanism for procurement, however should ensure that the broader ‘community outcomes’ achieved by local/community-based health services are included in funding decisions. NZCCSS refers the Ministry to Outcomes Plus – the added value from community social services, Nielson with Sedgewick and Grey, 2015).
The status of the document From Cost to Sustainable Value: An Independent Review of Health Funding in New Zealand, 30 June 2015] and its relationship to the implementation of the health strategy is unclear. More information is needed on any changes to the way DHB funding decisions are made.
NZCCSS agrees that good health begins at home and supports an approach that increases the availability of services, information and support as close as possible to home. This approach will be particularly beneficial to children and families/whānau with limited transport, along with older people who live in the community and are reliant on public transport, and those who live in provincial centres where public transport options are very limited or non-existent.
NZCCSS supports the application of technological advance to the health sector and agrees this change is likely to empower people to be more involved in their health, particularly young people. The collection, storing and sharing of personal information is a complex area however and raises important issues around privacy and confidentiality that will need to be fully addressed. There are likely to be some increased costs associated with implementing new IT and reporting systems. NZCCSS would like to see some recognition of the cost of introducing new IT and reporting systems in contracts to ensure the quality of service delivery is not compromised.
All government ministries are currently grappling with the same need to provide more robust data to meet population health, social and welfare targets set by government. It is critical that the Ministry of Health works in partnership with other ministries to develop common reporting mechanisms (reporting measures and portals) whenever possible to reduce the administration burden for community organisations and practitioners.