The Asthma Foundation asked the political parties in parliament a number of questions related to the Children's Learning Study and respiratory health in Aotearoa more widely.

The CLS, an Asthma Foundation funded piece of research, was conducted by a team of Canterbury and Otago University researchers in Christchurch from 2005 to 2008 and involved 298 children.

In a world first, the study showed a connection between asthma in very young children and relative underachievment in learning to read.

This does not mean that children with asthma will necessarily have problems in learning to read, but in the CLS groups there was a connection in a number of cases.

We asked the parties the following questions:

1. The Asthma Foundation believes that New Zealand families with children with asthma have the absolute right to the best care and treatment for their children so that their children are not educationally disadvantaged.
 
Do you agree with this statement? 

2. If so, please state what your party would do to support the absolute right referred to being fulfilled. (Please list relevant policies in your answer).

Here are their answers:

ACT

In New Zealand there is no absolute right to any care or education for any group. Additionally it would be remiss for any Government to have absolute rights, as there are always circumstances where one group may have to be prioritised over another.

If so, please state what your party would do to support the absolute right referred to being fulfilled. (Please list relevant policies in your answer).

ACT believes NZ should have a first class health service but is being hindered in this goal due to the under performing economy and inefficiencies in the system. The research linking asthma severity and relative underachievement in learning to read, points to not only the need to improving the child's condition through excellent health care but also increasing the assessment of asthmatic children in the education system to ensure they do not fall behind. Parents should discuss this research with their school principal. 

ACT believes that the best way to lift the standard of healthcare is to introduce greater choice and competition into the sector. We believe that individuals and families should have much greater control over the kind of care they choose to access and that the policy focus should be access, rather than a focus on the absolute retention of a government monopoly over health. care delivery is getting less efficient. Between 1999 and 2008, health funding more than doubled in real terms yet the outputs did not keep pace with this increased funding. As our relative economic performance continues to decline, we are losing more professionals to Australia and our ability to attract and retain healthcare professionals from the wider world is becoming more difficult. New Zealand cannot continue to borrow $300 million weekly to fund our social services; we must improve our economic performance   

In the short term ACT will encourage greater use of the private sector by DHBs so that people can get treatment as soon as they need it. ACT believes there are productivity gains and improved communication in the better use of information technology – eg sharing of patient data/ files etc between primary and secondary care as well as public and private practices. ACT supports moves by the National Government to put more resources into front line staff rather than back room bureaucracy and we believe primary health care subsidies should be targeted at those on low incomes. 

In the longer term ACT supports lowering taxes so people can keep more of their own money and fund more of the costs of their own health care. This means people will have greater autonomy and choice and it will drive efficiency gains in the sector.

World-class healthcare is very expensive. So it is vital that the NZ economy grows at a healthy rate so we can also afford to keep up with technological advances and improved pharmaceuticals.  Without sensible economic growth policies we won’t be able to fund the kind of world-class health system New Zealanders deserve. ACT is focused on addressing the economy as a top priority.

Green Party

Green Party response to questions from Asthma Foundation

With the General Election approaching, we are writing to the health spokespeople from New Zealand’s political parties about their policies associated with respiratory health. The answers that the spokespeople give to the questions in this email will feature in the November 2011 issue of our magazine – The Asthma Foundation…keeping in touch.
Late last year, a research project that the Asthma Foundation funded, called the Children’s Learning Study, made headlines around the world. In a world first, the study linked asthma in young school children and relative underachievement in learning to read. Conducted in Christchurch between 2005 and 2008, and involving 298 school children, the Children’s Learning Study was undertaken by a joint University of Canterbury/University of Otago research team, led by Associate Professor Kathleen Liberty from Canterbury.

At the New Zealand Respiratory Conference earlier this month, Associate Professor Liberty in her plenary speech talked about how the survey data also showed a strong link between asthma severity and learning to read among the children in their first year of school.

The Asthma Foundation believes that New Zealand families with children with asthma have the absolute right to the best care and treatment for their children so that their children are not educationally disadvantaged.

Do you agree with this statement?
Yes, we do.

2.   If so, please state what your party would do to support the absolute right referred to being fulfilled. (Please list relevant policies in your answer).

Our response is two-fold. Firstly, we need to address the social and environmental factors that are causing our children to develop asthma in the first place. See answer to question 3 for more on what preventative steps the Green Party would take to reduce asthma rates.

More broadly, the Green Party wants a strong public health system that functions effectively, delivers a high standard of patient care, and has sufficient funding for service delivery, administration, and ongoing research and development. The Green Party will continue to improve health care resources, to ensure that the public health system is
effective and accessible to all New Zealanders. Read our full health policy here.

In particular, we need to improve access to primary healthcare for our most vulnerable communities. We know for example that Maori children have twice the rate of hospitalisation for asthma than Pakeha children do. The Green Party would fund PHOs to prioritise working proactively to bring services to those with the greatest needs. This would involved providing more community and marae based health services.

To improve the health of New Zealanders we have to improve environmental, economic, and social conditions. The causes of ill health in New Zealand include economic, social and environmental conditions such as air and water pollution, toxins, pesticide contamination, bad diet, poverty, unemployment, poor education, poor quality housing, and poor social cohesiveness.

The Greens would focus more resources on health promotion and illness prevention. We would increase the share of Vote Health going into Public Health to 10%, with a particular focus on working with other sectors, such as education, social welfare and housing, to reduce inequalities and improve health outcomes in vulnerable communities.

We know that a well insulated, warm, dry energy efficient home can reduce the asthma rates of the occupants by 50%. Our $323 million home insulation scheme has made more than 100,000 Kiwi homes warmer and drier. In total, the four-year Heat Smart programme, which is part of our memorandum of understanding with the National Party, will improve 200,000 New Zealand houses. Extending the scheme to an additional 200,000 houses is part of our Green Jobs priority for the 2011 election.

For those living in rental accommodation, we'd create minimum performance standards for rental properties which would ensure warm, healthy, homes for thousands of children. See our End Child Poverty plan for more details on this.

Fine particulate air pollution is also a known cause of asthma in children. The Green Party would reduce air pollution through mandatory vehicle emission testing and cleaner diesel and petrol. We would also work with schools and communities make walking and cycling safer for children. Initiatives such as walking school buses can reduce air pollution around schools, as well as reducing traffic congestion and improving exercise levels.

Labour

Labour believes that New Zealand families with children with asthma have the absolute right to the best care and treatment for their children so that their children are not educationally disadvantaged.

Labour will adopt a whole-of-government approach to reduce and eliminate inequities in health, including through coordinated policy approaches covering issues such as fairer taxation, education, housing, employment, poverty eradication and income inequality.

Cold unhealthy rental properties result in high power costs and poor health outcomes for families. Labour will require all rental properties to be insulated to meet the NZ standard for insulation by 2016.

Labour will set a range of nationwide health targets for priority areas such as immunisation, oral health, elective services, cancer waiting list times, avoidable hospital admissions, diabetes and mental health, healthier lifestyles, smoking cessation and efficiency in services.

We will adopt a life-course approach to ensure that the causes of poor health outcomes are addressed, with a particular focus on ensuring children receive the best start in life.

The health of our children reflects the complex nature of our society and the interactions they have within it. The outcomes for today’s children will determine the future success or failure of our nation. We need to build the resilience of young children and enable them to control their own lives and health status. We need to ensure that schools, families and communities work together to reduce inequities and promote well-being for all children.

We have seen a number of reports in recent times that the cost of accessing primary healthcare is meaning that some children are not getting the treatment that they need.  This is particularly so in terms of access to affordable after-hours care. Labour will make child health a priority, and increase the proportion of health sector spending on services for children aged up to six years. We will also extend free access for under sixes to after-hours medical services, meaning 24 hour, 7 day a week free access for under six year olds.

A focus on addressing the social determinants of health and access to healthcare will not only improve health outcomes, but will also prove cost-effective and good for economic growth over time as the need for expensive interventions and treatments reduces. 

Maori Party

Do you agree with this statement?

Actually I do not agree with the first statement. I don't believe children who have learning problems are likely to suffer worse asthma. I base this on whanau asthma experience with our children and mokopuna. 

I certainly agree that children who live in insulated warm homes are less likely to have as many asthma episodes. It is also important for doctors to ensure that our children have spacers, preventers and ventolin, to negotiate a management plan and at the same time build up their resistance to allergies. Effective asthma management would also involve teaching them how to take their medication properly and how to measure their breathing capacity also teaching them the buteyko breathing method.  We must accord priority to asthma prevention, treatment and management.  
 
If so, please state what your party would do to support the absolute right referred to being fulfilled. (Please list relevant policies in your answer). 
 
The key thing about asthma is the need for effective education to know how to manage symptoms when they emerge, or how to prevent episodes from occurring by either medication or self-management
 
The Maori Party has been pleased to be associated with programmes which promote better awareness of asthma and how to manage it, including, helping whanau with personalised asthma management plans, and providing them with resources such as reference manuals and story books.    

A specific programme is The Space to Breathe – He Tapu Te Ha programme developed collaboratively by Pharmac, Tui Ora Ltd, Piki Te Ora Nursing Services, Te Aho Associates, Best Practice Advocacy Services and Tihi Ltd  in Taranaki.   There’s also been some great work done on identifying these issues by groups like Te Rôpû Rangahau Hauora a Eru Pômare and the Asthma and Respiratory Foundation.  Investment should be targeted to public health promotion and primary health care treatment.

 We want our whânau to be the best that they can be and to be supported by an equitable, sustainable health system.   Accordingly we will:

·        Advocate for free preventive health care to under-six year olds
·        Establish a health workforce project for pay parity to retain Maori nurses in iwi providers.
·        Investment in development pathways for the non-regulated workforce (community health workers).
·        Refocus Maori Provider development to focus on outcomes in areas where services need to grow.
 
To ensure all children get the best possible start in life, we support a shift in the emphasis of health investment towards primary care. We will invest in a sustainable well-paid health workforce in public, non-government and not for profit sector.
 
We would like to introduce wellness checks / warrant of fitness, 6-monthly minimum, dependent on degree of risk; and regular checks for diabetes, asthma, cardiac and chronic disease. 
 
But our key policy is in the rolling out of Whanau Ora across government departments with a separate appropriation for each financial year.   The starting point is the belief that whânau hold the key to determining the wellbeing of all its members. he prevention, management and treatment of asthma is most effectively undertaken within the whanau.  Another aspect is the transformation of social services delivery to focus on the needs of the whânau.

National

Have a look at National's health policy on facebook.

New Zealand First

New Zealand First absolutely agrees with this statement and we will do everything in our power to make it become reality.

Our Parties founding principle is that Health and education are an investment in the future of New Zealand and all New Zealanders. We buttress this having secured free medical care for children under six, a policy that has saved many lives and it is our intention to extend New Zealand First's initiative (1997) of free doctors visits and prescriptions to include all primary school-aged children, and after hours and weekends;

Other relative policies include:

• introduce the Teen Health Check Bill to require DHBs to make provision for health checkson all Year 9 students and other measures to better co-ordinate health and social services within the school system
  
• establish and implement a national strategy for addressing cancer treatment, men's healthissues including prostate cancer, diabetes, osteoporosis, arthritis, asthma, obesity,dementia, and other diseases and health concerns where a national strategy is clearly needed and incorporating improved screening programmes and strategies, and health education initiatives
  
• support the introduction of a nationally co-ordinated immunisation register as part of a strategy to stamp out third world illnesses; continue to focus upon family health, and particularly early intervention, by expanding such programmes as "Family Start" and home based support
  
• ensure that essential health and safety products such as sunscreens are subjected to independent evaluation and/ or control
  
• expand the services and family support of the 0800 advice line, including over the Christmas period
  
• restore emphasis on preventative measures and health education and ensure the nationwide health screening of all children under one year
  
• ensure that all New Zealand pre-school and school children receive adequate dental care
  
• fully implement a national strategy that includes a shake-up of the state funding of     teenagers dental treatment
  
• Improve access to high quality oral healthcare services
  
• provide additional resourcing for child and youth mental health services, and the necessary resources and funding to address the continuing appalling state of
  mental health services by completing the full implementation of the recommendations of the Mason report
  
• facilitate the improved co-ordination and integration through PHOs and other organisations of community health, dental health, disability support, family health,  Maori health, maternity, mental health, and public health services and overcome the debilitatingeffects of a health system that lacks cohesion and common standards of delivery
  
• use a range of measures to ensure the adequate recruitment and retention of health professionals in rural areas including: consideration of student loan abatements; fees reductions; scholarships and bonding schemes; amending the definition of "rural" in relation to the rural GP premiums and lifting the levels of primary healthcare premiums
• the development of a robust peer support programme for rural practitioners
• an alternative route for the registration of family doctors
• the supply of locums to enable ongoing training, support and a sustainable quality lifestyle; and resources for visiting specialists
• maintain rural health services and ensure good access to basic healthcare equitably throughout the country including the immediate development of a rural and provincial health services plan with a view to early injections of health funding to ensure the continuity of essential services
• increase the use of technology to reduce isolation (e.g. mobile services, helplines, telemedicine) and consider the appropriate expansion of the health centre model
  
• ensure a high quality 'rural service' specialisation is available in our medical schools
  
• require consistency in the provision of emergency health services such as ambulance and helicopter services and ensure the adequate funding of a core of fulltime employees
  
• increase resources to achieve the objective of the National Travel Assistance Policy to provide transport assistance to those whom, for reasons of cost and/or distance, cannot easily access hospital medical appointments
  
• ensure that there is adequate funding for, and improved access to palliative care services
  
• ensure an ongoing commitment to the funding of health research, research institutes, and for training
  
• legislate for clear labeling of all genetically modified food (GMF) products and ban all imports that do not meet these requirements
  
• consult with the natural health industry and other stakeholders to introduce an appropriate regulatory regime for complementary medicines.
  

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