Election 2011: Ryall takes fight over preventive health to Labour

By Martin Johnston

Health Minister Tony Ryall. Photo / APN
Health Minister Tony Ryall. Photo / APN

National's health chief, Tony Ryall, is taking the fight to Labour on preventive health services.

Sensing an outflanking manoeuvre, the well-practised Health Minister has buttressed his bureaucracy-busting and efficiency drives with new or expanded public-health measures such as smoking cessation and controlling rheumatic fever in poor, provincial communities.

In public and preventive health, the National Government's early months were marked by cuts to Labour's obesity programmes like Healthy Eating-Healthy Action and Mission On, the rescinding of Labour's rule that prevented schools from regularly selling sausage rolls and other unhealthy foods, and a refusal to proceed with the Public Health Bill and its powers to make the food supply healthier.

Mid-term, following the worst of the swine-flu pandemic, came cuts in public health services. The Auckland Regional Public Health Service lost 12 per cent of its staff.

National had campaigned on, and has delivered, a big increase in elective surgery, shorter waits for radiation therapy patients, fewer managers and administrators in the state health system, and more doctors and nurses - although the latter is contested by the Nurses Organisation.

No one argues against the benefits of increasing elective surgery, but Labour says National's prescription is skewed towards a "narrow" agenda, with a loss of focus on prevention.

"National has taken $124 million out of public health in this Budget period," says Labour health spokesman Grant Robertson.

"That involves the destruction of the Healthy Eating-Healthy Action programme ... and a whole host of smaller initiatives. I think it is the wrong way to go. Prevention must be a priority."

He says National's focus on elective surgery has been disproportionate.

"Proportionately we want to see more money go into those other areas [prevention and children's health], so whether that requires a reduction [for elective surgery] we will have to work out when we get closer."

Mr Ryall has gone on the attack over preventive health.

His office says Government spending on public health, including nutrition and smoking cessation, has gone up from $352.3 million in 2007/8, to $486.5 million in this year's Budget. No public health programmes have been stopped, although some have been reduced. New ones include rheumatic fever, the bowel-screening pilot and additional Well Child visits.

Mr Ryall says Labour in Government listed rheumatic fever as a health priority but did nothing more about it.

Labour's main health commitments are to end National's "underfunding" of health - although Mr Robertson won't say how much Labour would spend - minimum prices for alcohol, free primary health care 24/7 for children under 6 at a cost of $10 million annually, and free primary dental care for pregnant women by 2014, extending this to other groups in the adult population "as resources allow".

The Green Party is broadly in agreement with Labour on health.

National is drip-feeding new policies during the election campaign. Main ones so far are to continue the expansion of elective surgery with an extra $12 million a year, reducing the maximum waiting time to four months by 2014, and free after-hours primary care for under-6s at a cost of $7 million a year to be funded by health-sector savings.

PARTIES' POLICIES ON HEALTH:

National: Maximum wait for elective surgery to be reduced from six months, to four by 2014. Cancer chemotherapy within four weeks of referral. Every district health board to have a dedicated stroke unit. Free after-hours primary care for children under six.

Labour: Free primary health care 24/7 for children under six, free dental care for pregnant women by 2014. Greater focus on preventive health care, which will receive greater share of funding. Commitment to end National's "underfunding'' of health. GST off fresh fruit and veges.

Greens: Ban direct-to-consumer advertising of medicines. Develop plan to encourage healthy eating by children. Significantly increase aged and disability care funding. Expand free and low-cost primary care for low-income families.

NZ First: Rebuild public health service. Health to be viewed as "critical investment'' in human resources, not a balance-sheet item.

Maori: Introduce plain-packaging for tobacco. Remove taxes from prescription medicines. Provide more obesity surgery. Promote marae-based health clinics.

Mana:Tobacco to be sold only by pharmacies initially and would eventually be banned from sale. Free dental. Tax on fast food and soft drinks, GST abolished.

Act: Reduce taxes so people can buy health care and insurance, target primary health care subsidies to those on lowest incomes, and encourage competition between public and private health sectors.

United Future: Increase funding for sexual health/contraceptive programmes, and subsidise primary dental care for those on low incomes.

- NZ Herald

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