The Manukau District Health Board is paying pregnant woman to not smoke. The payment is in the form of vouchers for groceries, petrol and movies.
The mum-to-be is tested each week to determine whether she is smoke-free and the total payment available over the 12 weeks of the programme is $300. It's not a lot of money.
As a health initiative, it could well prove the best $300 the health system spends. The birth is safer, baby is healthier and has fewer health problems later in life.
The benefits of the programme will outweigh the costs.
But the programme is nonetheless disturbing because of what it tells us about the value system and basic ability of the mums-to-be. It's also disturbing because it makes you wonder where such a programme will end up.
It's not the money. I would happily throw $300 into a hat if I thought that would mean a pregnant woman somewhere, somehow, stops smoking. I cannot think of a better use of $300.
But surely there can't be a woman in the country who doesn't know that smoking is bad for her baby? If perchance there is, then her ability to process the basic information necessary to having and raising a child successfully must seriously be in question. The problem is then a bigger one than smoking and bigger than an investment of $300.
The more likely possibility is that the mum-to-be knows smoking is bad for her baby but is nonetheless struggling to give up. I can understand that. Nicotine is a powerfully addictive drug.
But the cost benefit of the programme is disturbing. The prospect of mum-to-be's baby being healthier won't have her going through the pain of not smoking but the promise of a bag of groceries does.
That's a perverse value set. The mum-to-be cares more for a few groceries then her baby's health? That's what is disturbing. In my world there is no greater power than a mum's love for her baby. There is nothing a mother wouldn't do or suffer for the health and well-being of her baby. Mother's love is powerful, wonderful, and it's why we are all here.
A bag of groceries? A tank of gas? Movie tickets? More powerful than a mother's love and care for her baby-to-be?
There is something twisted and sick about the very calculation.
And if we are bribing mums-to-be to not smoke, why not bribe them to give their children breakfast and to ensure they are not abused?
Or why not bribe them to not have children at all?
Where does an initiative such as this one end up?