Archive for ‘Health’ Category
Maybe the outrage expressed by David and others of his ilk is somewhat justified. This is not a grey, respectful, nominally-neutral sort of a work; it’s an impassioned and at times ideological work of advocacy arguing that New Zealand society, and in particular its governments, ought to be ashamed at the circumstances many of our children live in, and a significant portion of that burden of shame can be directly linked to the policies of National governments. It airs four days before the general election. The Labour and Green parties bought lots of advertising during it.
So if David or anyone else wants to bring a BSA complaint against the broadcaster, or — as David implies by calling it a “free hour” for Labour — if he wants to complain to the Electoral Commission that the documentary should have included an authorisation statement as a campaign advertisement, then I think they should do so. Fair enough, if they can make something stick.
But consider the response: a documentary about child poverty, covering the appalling housing, health and nutritional outcomes borne by children in our society, and the immediate response is to launch a ideological defence of the National party and deride the work as nothing but partisan propaganda. But an interview Bruce gave to Glenn Williams (aka Wammo) yesterday, before the screening, contained the following exchange:
Yeah, it’s election week, and yeah, Labour are emphasising their poverty alleviation focus on the back of this documentary. But I haven’t heard a peep out of National about what they plan to do about the problems since it aired. Isn’t it more telling that National and its proxies immediately and reflexively go on the defensive, rather than acknowledging the problems of child poverty and renewing its commitment to resolving them? As Bruce makes clear to anyone who actually watches the film, the root cause is a bipartisan commitment to trickle-down neoliberalism over the past 30 years, and indeed, the illness and malnutrition that affects these children did not happen in the past three years; these were problems under the last Labour government as well.
But National are the government now, and their defensiveness, I think, signals that they know they bear some responsibility for child poverty. And yet they’re apparently not willing to do much about it, beyond the tired old saw of “a rising tide lifts all boats”, and announcements that they will further constrict the welfare state to force the parents of these sick children to seek jobs that aren’t there. (And yes; National bought time during the documentary as well: the “cracking down on benefit fraud” ad was a particularly cynical form of irony.)
They’d rather whinge about media bias and electioneering, casting themselves as victims, than concede the problem and tell us what they plan to do about the victims of their policies. That’s what I call impoverished.
Today I was waiting in my doctor’s waiting room and, as my older daughter played with the water machine, I espied in the hands of a kindly, grandmotherly looking woman, a copy of the July edition of Investigate magazine — the one about how Obama is going to eat everyone’s babies. But also the one with the article about whether North & South got their recent report on vaccination right.
The North & South June edition, which contained the report on vaccination, was also on the magazine table. I’ve read it, and it’s sound investigative journalism about an important topic: how some diseases we thought were dead and buried are enjoying a resurgence because some otherwise sensible people decide not to vaccinate against them. I haven’t read the Investigate article in question, because my life is short enough as it is, and at any rate I refuse to fund Ian Wishart.* But the Investigate editorial position on vaccination — pretty well documented in previous articles which I have read — is just the sort of thing which raises the spectre of doubt in the minds of parents already nervous about having to hold their little treasures down so a nurse can stick a needle in them. Finding such a hysterically anti-science tract as Investigate in a doctor’s surgery bestows upon it a medical legitimacy it does not deserve. There’s a time and a place for this sort of material, but a medical context is not appropriate. It’s like the proverbial smoking doctors whose habits were supported by Big Tobacco in exchange for reassuring their patients that smoking didn’t do them any harm.
The other daughter? At the time, she was in the nurse’s office getting her jabs. I had a word to the nurse about it; she was almost as alarmed as I was and said she’d remove the offending rag. That’s something.
* I’m sure this entitles me to a free bout of Wishartian pig-wrestling and not-at-all-veiled implications about the standard of my professional work such as Scott received, but I’ll pass, thanks all the same.
Late last year, when the ACC ructions were underway, the professionals working in the sector warned that people would die as a consequence of the reforms mandated by the new Clinical Pathway on the assessment and treatment of sexual abuse victims.
Since then, and on the basis of the pathway, ACC has taken to declining claims despite publicly claiming consistently throughout the past six months and as recently as today that there was no cost-cutting imperative. This has resulted in a drop of more than 90% in the number of claims approved year-on-year. Explain that, if you can. Nick Smith couldn’t, though he tried to do so during Question Time. It has also caused a chilling effect in which people are simply not applying, since they’d have to undergo the trauma of the exhaustive documentation and excessive review required by the pathway only to have their claims declined.
It’s impossible to separate these reforms from the overarching government plan to privatise — partially or wholly — ACC, and when viewed in this light it becomes clear what’s going on: this is how insurers make their profits. And, just lilke it said on the box, people are dying. It’s a good thing there’s going to be a review, but what’s better is that the sector is organising their own review in parallel. Should make for an interesting compare-and-contrast. I am aware that certain senior National party MPs are aghast at the conduct of ACC, so there may begin to emerge some pressure from within the party for change, as well as from outside. We’ll see.
I was reluctant to post while I had the chance on ANZAC day, since there was such a good debate going on, and now I’ve (temporarily) run out of time again. So just a few quick observations.
Ok, so not so brief after all. Discuss. I’ll dive back in as I can. You can treat this as an open thread as well: post what you want to talk about.
I have received the following communique originated by NZ Association of Psychotherapists member Kyle MacDonald; an easy means for you to tell the Minister for ACC what you think about sexual abuse recovery rationing:
Grass Roots Political Action, a step by step recipe.
“The death of democracy is not likely to be an assassination from ambush. It will be a slow extinction from apathy, indifference, and undernourishment.”
Update: There’s also a petition, for what that’s worth.
Grass Roots Political Action Part II – Gather Support.
“In a democracy dissent is an act of faith. Like medicine, the test of its
Dear friends, colleagues and supporters of counseling and therapy in
Many of you will now be aware of attempts by ACC to change the Sensitive
Now there is something you can do to help! Follow this link to an online
Please also circulate this petition as widely as you can to friends, family,
Thank you for your time,
This morning the New Zealand Association of Psychotherapists delivered an open letter to the Minister for ACC asking him to explain and justify the proposed changes to ACC’s sensitive claims policy. This issue was covered by Anjum last week and is now picking up steam.
Briefly, the proposals (which are due to come into effect in September) would change both the nature and amount of entitlement of treatment to which sexual abuse or assault victims are entitled. The changes represent a move from a therapeutic model mostly operated by psychotherapists and counsellors to a symptom-management model mostly run by the mental health system. Victims’ entitlement to treatment will generally be reduced to a maximum of sixteen hours, essentially meaning that many victims of the most severe abuse will not be fully treated. In addition, victims will need to explain themselves to as many as three different assessors in order to access this limited treatment, with each assessment a form of revictimisation. As if that wasn’t enough, knowing that many cases simply will not be treatable in the mandated 16-hour timeframe, some psychotherapists have indicated that they will refuse on ethical grounds to begin the work, knowing that they cannot finish it, on the basis of the ‘first, do no harm’ principle which underscores their practice as clinicians.
This means the already-high barriers to effective treatment of sexual abuse trauma are about to get higher. In effect, they are being rationed so as to exclude the ‘worst’ cases who require the most work (and therefore the most cost) to treat. However the revictimisation of repeated assessments and the uncertainty of treatment form a strong disincentive – not wanting to open a wound without being sure it can be closed, many people will simply not seek treatment, and many counsellors will simply not be able to provide it on ethical grounds. This chilling effect will lead to sexual abuse being pushed further underground and the problem fading from the public view to a greater extent than it already is, with potentially catastrophic long-term social consequences. At last count, sexual abuse cost NZ about $2.5 billion per year including the costs of crime, imprisonment, drug and alcohol, other health issues, unemployment and the cycle of abuse which an absence of treatment sustains. For the cost of a few million dollars in treatment, how much will that be allowed to increase?
The most absurd thing is that these are cuts to front-line services for victims of serious crime; the very thing the government said it would be increasing. ACC’s Sensitive Claims Unit costs $30m or so annually to deliver $20m of front-line services, and these cuts will shift that balance much further toward the back-office by relying more heavily on already-overworked case managers and the top echelons of the practice – psychiatrists and clinical psychologists who currently do 10% of the work – rather than the relatively cheap and numerous psychotherapists and counsellors who do the other 90%.
For the inevitable conspiracy theorists, this also isn’t a matter of psychotherapists feathering their nests – for most, ACC work is a small part of their practice, and not an especially lucrative part of their practice, since most can charge (much) more on the open market than what ACC will pay.
Expect this to be a fairly big deal in the coming weeks. It is an issue which is deeply embedded in many policy fields: justice, victim’s rights, human rights, child abuse, crime, drug and alcohol abuse and mental health are just a few. It’s not going away, because sexual abuse is not going away.
Disclosure: I was involved to a small extent in the process around this open letter. I have family members on both ends of this issue – both providing and receiving treatment. You probably do, too, even if you don’t know it.
Posted on 11:02, June 1st, 2009 by Anita
In the United States on Sunday George Tiller, a doctor, was shot and killed as he attended church. Tiller, who ran one of only three remaining clinics providing late term abortions in the US, had been shot in 1993, his name has been on anti-abortion assassination lists and his clinic was bombed in 1985.
In New Zealand we have never had an abortion doctor killed, but we have had doctors, nurses and clinic staff threatened, attacked and harassed. I pray that no further anti-abortion violence comes to New Zealand, and at the same time I pray that we will progress the issue to give women the right to control their own bodies and that we will find a social consensus for a woman’s right to choose.
But right now the cost seems very high, and all I can do is pray for the safety of everyone ensuring women continue to have access to the limited choices they are given. George Tiller was a great man whose personal actions gave more to women than I could ever hope to.
I try to not end too many posts with lyrics, but today I can’t help posting a section of Ani DiFranco’s Hello Birmingham. With an echo of Pablo’s recent posts, she is talking, at least in part, of the powerlessness of electors to make the changes that matter.
Tony Ryall has, once again, taken the moral low road and is refusing to ban cigarette displays in shops despite evidence that cigarette displays increase teenage smoking. This in a week that a similar ban was announced in Northern Ireland, joining bans in Ireland, Canada, England, Wales, much of Australia… oh shall I just call it “most of the developed world”?
Why does this matter? (Other than caring about the lives and health of New Zealanders)
In case you don’t have a copy of The Hollow Men to hand, I offer you some highlights:
Sweet eh, politicians and industry working hand-in-hand – that must be the “pragmatism” John Key talks about.
The Standard and Kiwiblog last night, but not for the first time, crystallised what it is to be two sides of the same political coin. Both covered Health Minister Tony Ryall’s removal* of Richard Thomson from the Otago DHB chair using, respectively, the verbs to sack the old one and to appoint the new one. The difference in emphasis couldn’t be clearer.
For what it’s worth, DPF’s headline is more correct. Ryall didn’t actually fire Richard Thomson, he has been removed from the chair but will remain a DHB member (though the Herald article referenced in the Standard post also uses the `sack’ terminology). On the other hand, I think Tane’s analysis is more correct – Thompson has been removed from the post for political reasons more than for reasons of governance. However the governance failure was bad enough that Ryall was on safe ground in doing so – he’s got two birds with one stone here.
* see how hard it is to avoid partisan terminology?
[Edit: Silly me for believing the Herald - it's spelt Richard Thomson - changed.]