Poor sick kids lose out in bid for health dollars

By EMMA DAVIES*

The fundraising arm of the Starship has, understandably, been vocal in the name-change debate. Perhaps we also need debate about the role of fundraising organisations. Who is responsible for ensuring that our children's health services are adequately funded? If we combine state and private-sector funding, there is still not enough money. The costs of healthcare are rising - the income is not.

The health of our children now ranks among the worst in the industrial world. We have a resurgence of meningococcal disease, whooping cough and tuberculosis. Too many children suffer from inadequately treated acute infections, nutritional deficiencies and dental diseases. Many suffer the consequences of unintentional and intentional harm.

The Auckland District Health Board does not set the budget for children's health spending. We do. We elect governments to spend on our behalf.

The Government appears to believe that increasing taxes to pay for an effective child public health system, including prevention programmes, would be a vote loser.

We seem to prefer to blame chairman Wayne Brown and the district health board for reducing health costs and for trying to make an unworkable budget work. The board has the unenviable task of deciding what matters most when probably most of it matters.

The Starship Foundation's choice of projects may be too dependent on the indirect advertising needs of corporate organisations. Perhaps we have no right to comment because it is not our money. But we pay for some of the marketing of the companies that we buy from and we donate money in response to their campaigns.

The money attracted to the Starship Foundation may be better spent elsewhere.

A couple of years ago, I was involved in the Safe and Sound Appeal, the result of a sponsorship deal between Sky City and the Starship Foundation to develop Puawaitahi - Central Auckland's multi-agency centre for children where there are concerns about abuse. Without their involvement, Puawaitahi might not have happened.

Sky City and the Starship Foundation created a win-win situation by using abused children and the Starship brand to market Sky City, while using Sky City's money to contribute to funding of the centre.

The Starship Foundation's role seemed to be to supplement Government funding for an essential health service, possibly at the expense of funding community agencies to provide the equally necessary community links and support services. At the same time, I also worked with an equally talented multi-disciplinary group of professionals in South Auckland, looking at ways to organise their services better for children where there were concerns of abuse.

Promoting an equivalent multi-agency centre in South Auckland, where it is arguably needed most, was not considered a good advertising strategy for a corporate sponsor. Abused children in South Auckland apparently did not have the same ring as the Starship Foundation logo. In South Auckland there was not the same ease of access to the media, to the professional fundraisers and PR consultants who are so good at their jobs.

Sadly, the legal parameters of the Starship Foundation prevented them from supporting a South Auckland centre. Nor could they support the community agencies so essential to children's health.

I argued with senior practitioners that the foundation's involvement could indirectly help to access funding for a similar initiative in South Auckland. I was naive and wrong. While not their intention, the involvement of the Starship Foundation and Sky City in Central Auckland meant the end of the South Auckland development.

One irony is that the cost of the marketing campaign could probably have facilitated the establishment of both centres.

Sky City was portrayed as doing good things for children. The company was actively promoted to its employees and potential customers as a generous-spirited and caring firm. One of the advertising campaigns depicted the Sky Tower as "a beacon of hope for abused children". This widely promoted statement felt like a cynical exploitation of abused and neglected children. I sat and cried.

Research has shown how many illnesses and injuries seen in the Starship result partly from child poverty - poverty that has increased since the political restructuring of the 1980s and 1990s. This process also boosted the wealth of socialite fundraisers and the culture that surrounds them.

It is also ironic that some of the leading supporters of the restructuring have contributed so much to the Starship Foundation over the past 20 years. Such versions of charity sit well within the framework of neo-liberalism. The excessive individualism and materialism that are the lingering heritage of new-right policies need to be replaced with a collective commitment to building systems that serve the people of New Zealand, especially our children.

Cute sick kids with rare diseases may be more marketable than poor sick kids with preventable common problems. Expensive specialised pieces of equipment may be more marketable than community programmes designed to improve children's health. Well-publicised one-off donations are probably more commercially attractive than long-term funding of prevention programmes. None are where the evidence suggests the needs are greatest.

There must be better ways of taking collective responsibility for children. Some component of fundraising using unfortunate but marketable children is probably inevitable. If conducted ethically and thoughtfully, it should be welcomed.

But the advertising needs of corporate sponsors are not a useful driver in planning health services. How we set up our fundraising structures to make maximum use of those limited fund-raised dollars is surely a matter for public debate.

It would be wiser for the Starship Foundation to put some of its significant fundraising power towards evidence-based initiatives designed to prevent children's health problems, and leave the Government to properly fund our hospitals.

A multi-disciplinary team, including public health specialists, paediatricians and experienced community practitioners, could advise the foundation on where to get maximum benefit for its money.

Given the number of names being suggested, I may as well throw one into the hat: Starship Well Children's Foundation could encourage a shift towards funding more prevention programmes.

The Starship Foundation's contribution to health funding is nowhere near as significant as that of the Government. If some of us have enough money to respond generously to these mass-media fundraising campaigns, couldn't we feel the same pride for voting in a government willing to raise taxes to fund our health system properly?

Perhaps we need some form of health tax or children's tax that demonstrates our collective commitment to the health of our nation. Perhaps it is a good time for us to look at our own behaviour and wonder why donating money in response to a manipulative marketing campaign appears to make some of us feel proud, yet donating money through increased taxes seems abhorrent.

* Dr Emma Davies lectures in the Auckland University of Technology's institute of public policy.