Is the Ministry of Health playing a sick joke?

OPINION: The Ministry of Health (MoH), presumably supported by the Government, has decided to celebrate the 5 year anniversary of the Feb 2011 earthquake by applying business-as-usual funding models, which were never set up to deal with the impact of New Zealand's largest natural disaster.  

On a per head of population basis, Canterbury is receiving the second lowest level of funding in NZ for mental health services.  It has been indicated that this funding is about to be reduced further.

International evidence overwhelmingly shows that the stress from natural disasters leads to a major increase in the mental health needs of the community, and that this will continue for ten or more years. The Canterbury figures are showing just this. Since 2011 there has been :

•         a 125 per cent increase in mental health presentations to the emergency department 

•         an 60 per cent increase in new child and adolescent mental health service cases

•         a 77 per cent increase in new adult rural mental health service cases.

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One of the most concerning features is that the number of our young people needing help continues to increase. Unprecedented numbers of both children and adolescents are now presenting to mental health services with significant issues. The number of children and adolescents needing help would be higher were it not for initiatives such as the CDHB's work in supporting 88 schools.

These young people are our future and yet as health professionals we are struggling to ensure they receive the care they need. 

A study looking at natural disasters in South America shows that young children are the most vulnerable to natural disasters and suffer the most long-lasting negative effects on their health, wellbeing, learning and development. These profoundly harmful effects are not only carried through to adulthood but are also passed on to the next generation. This will have serious economic implications for the future of our country.

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The increase in mental health needs also puts pressure on other acute health services.  In addition, as reported by Stuff on January 20, the Police responded to more than 2800 attempted suicide calls last year – double the Auckland rate and well up on the pre- earthquake levels.

We see our colleagues exhausted, trying to give the very best care to this group of vulnerable Cantabrians. Most worryingly, the demand continues to increase, which threatens our ability to provide safe and effective care. 

The Parliamentary Select Committee was told last week that many mental health services are becoming very stretched.  Despite this Canterbury is well ahead of other areas in the country with innovative, community-led, "connected up" mental health services, and the MoH acknowledges this. However rather than support these initiatives, the MoH claims they don't fit the funding model and so penalises Canterbury for these innovations.

Of further concern is the lack of a post disaster health plan. Such a plan is strongly supported by international evidence, and health professionals and management in Canterbury have been asking for such a plan for the last 5 years. 

Why has a post disaster health plan not been developed and implemented when it is standard practice throughout the world to do so?  What does this say about how the people of Canterbury are regarded by the MoH and Government?  Not only would the development of a post disaster health plan help address the health needs of Canterbury, but such a plan could also be used as a blueprint for future natural disasters.

Gerry Brownlee led a delegation to Japan in March 2015 and signed the Sendai Framework agreement on behalf of the NZ Government. This agreement stressed the need for rehabilitation – and yet the Government is insisting on a 'business as usual' model for funding of health in Canterbury.

This model allocates more money to deprived areas. When highly traumatised people from East Christchurch are forced to relocate to wealthier suburbs, they immediately lose health funding, because the model no longer compensates for their extra health needs. This is despite their needs being even higher because of their added stress. 

Anyone can see that this simply doesn't make sense, and yet MoH officials are unable to grasp the absurdity of using the population based funding formula in the post-earthquake setting.

Our health and community leaders are doing everything they can, but their efforts are persistently stymied by MoH officials who appear Emperor-like in their inability to see and hear the mass of evidence before them. 

The Government has supported Canterbury with the rebuild of our damaged facilities, but the MoH is undermining this support by the approach it is taking to funding health services.  We acknowledge the $16 million in additional funding that was provided late last year, but this funding is not ongoing.

Our needs are urgent and increasing, and any suggestion of a reduction in funding would be utterly unforgivable. 

We want to make it clear that we stand by the people of Canterbury who need health care, and we stand against the approach that the Ministry have chosen to adopt. We are asking for better funding of services for people, including our young people, who need support to get through the recognised and predicted consequences of the earthquakes – and we need this right now.

Paediatrician Dr John Garrett  writes on behalf of the Canterbury Hospitals Medical Staff Association, which represents 575 senior doctors in the Canterbury region.

 - Stuff


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