Paul Hutchison: Next PM should pick up child health plan agreed by all parties

Interventions early in life have a better chance of helping children go on to healthy, fulfilling lives. Photo / 123RF

Opinion

• Dr Paul Hutchison, a former National MP, was chair of the health select committee. This article is endorsed by Auckland University professors Lesley McCowan (obstetrics and gynaecology) and Innes Asher (paediatrics, child and youth health) and Professor Gregor Coster, dean of health at Victoria University.

If in New Zealand we truly want all our children to achieve their full potential, and to break cycles of disadvantage and minimise child poverty, there is need for exceptional leadership and a combined will to invest in policies we already know about. Election 2017 provides that opportunity.

Which political leaders are prepared to step up and make the commitment to fully implement a way forward for children that is already published and agreed on by the political parties including National, Labour and New Zealand First?

In November 2013, Parliament's health select committee published a cross-party, essentially unanimous, set of recommendations after a two-year inquiry into improving child health and preventing child abuse, with a focus from before conception until three years of age. The template is waiting for our next prime minister to fully grasp.

The committee called on the Government to take "an early investment approach, to put more focus on an investment into the preconception period to three years of age, and take a health promotion, disease prevention approach (based on scientific evidence) to improving children's outcomes and diminishing child abuse".

The work of Nobel Prize winning economist James Heckman and many others has built up compelling comprehensive evidence that investment in the very early years will yield a significantly higher return for every dollar compared to delayed investment, provided the investment is high quality and evidence-based.

Any New Zealand government with the will could start implementing, "world's best practice" policies from preconception until three months of life and then extend in six-month intervals as finances allow. Just imagine New Zealand being best in the world for children.

The economic rationale is based on the principle that since resources are limited, investments in interventions should be made where they have the best chance of long term success and the best return for every dollar. It is a no-brainer. It will result in more children leading healthy lives and progressing to meaningful jobs.

Productivity will be increased and money will be saved, an early investment approach is a win for children and a win for the economy.

Ideally adults should take full responsibility for the care of children, and there should always be clear signals and incentives for that to happen. In reality, many children miss out for reasons beyond their control.

New Zealand evidence from the internationally regarded "Dunedin study" by Professor Richie Poulten and the Prime Minister's Chief Science Advisor, Sir Peter Gluckman, overwhelmingly backs the early investment approach.

The committee's report had 12 major recommendations ranging from; the economics of early intervention in children, preconception care and reproductive and sexual health (including timely access to effective and affordable contraception), nutrition and obesity, alcohol, tobacco and drug harm, maternity, socioeconomic determinants of health including housing, research on children, collaboration, to leadership.

There were 130 specific recommendations with practical details of how to achieve benchmarks, along with time lines.

Substantial progress has been made, as evident from the better public services programme, the white paper for vulnerable children, the children's action plan and the wide range of initiatives in the health, education and social sectors for children and their parents. More recently, the Government has initiated a child obesity plan and established the Ministry for Vulnerable Children. These are a step in the right direction but a bolder more holistic approach is urgently needed.

After the health select committee report in July 2016 and the Government's response, the select committee was due to report on what it believed had been achieved to date, but ironically its time and energies were dominated by the "assisted suicide" debate. That madness of prioritisation could be put right by our next prime minister.

While significant efforts have been made by the Government to improve the status of children in New Zealand, there clearly remains huge unmet need if we are to become one of the best places in the world for all children, not just the lucky 80 per cent.

To improve some of our appalling statistics regarding children, their place needs to be elevated to be of national importance along with the economy, housing, transport and immigration.

The power of the select committee report was that it was cross party and essentially unanimous. It was informed by some of the best brains in the country. There is a widely acclaimed and agreed upon blueprint to implement.

The committee's recommendation on leadership read, "We recommend to the Government that the Prime Minister accept the formal role for developing and implementing a whole of government action plan for improving outcomes for all children including a specific early intervention action plan, covering preconception to three years of age".

The Prime Minister's responsibilities should include defining the economic and general evidence base behind the action plan, monitoring and measuring outcomes and reporting how the government proposes to make improvements in a transparent annual or biannual plan."

Which political leader(s) have the courage to make this commitment for our children in election 2017?