Failure to lift the wellbeing of our public health service helps explain slippage in Labour’s poll support

Diabetes amputations  top 1000” :  so ran a headline in  the  NZ  Herald over a  report  on  what   is becoming  one of the  public health disasters  in this   country.

Public health  is the  science  and art of preventing  disease, prolonging  life and promoting health  through organised  efforts of  society, says Professor Sir David  Skegg, one of  NZ’s most respected  epidemiologists.

Unfortunately NZ’s performance  in this is even less adequate  than its treatment services”.

He cites   weak leadership and a  lack of  political  will as fundamental problems  for public health in  NZ.

Point  of Order  contends  that the lack of any significant progress by  the Ardern  government in delivering major improvements  in health services — -or even to signal  they are   preparing them — helps explain why its poll  ratings  are sliding rapidly.

Health services are  chronically underfunded,  meaning that patients miss  out on treatments  which could  increase  their well-being—but also hospitals  have to care for people with advanced  disease that could have been avoided.

Sir  David  finds  it “ puzzling”  why a  government  with a prime commitment to well-being  could shrink  from one of the  most obvious and remediable  challenges  to the  well-being of its citizens:  to limit the  enormous harm that excessive alcohol consumption inflicts on families, communities and  health.

He  also points to  insufficient action relating to the  epidemic of  obesity.

Point of  Order   sees  gene editing  as  another   area   where  the   health system  is being handicapped   from the top.

The  21st  century  revolution in genetics has  been  as  dramatic  as that  seen in computer technology. The  first human genome   to be  sequenced  took  13  years:  it can now  be  done in a  day.   There are  conditions  – particularly rare  diseases, such as childhood  development  disorders  – where  genome  sequencing is extremely beneficial,  and may even be life-saving  in some   cases.

While   Australia  has  deregulated  gene editing in human cell lines, animals and plants,  NZ  is  still  held back  by  the restrictive  2003 legislation.

The  National Opposition  has signalled it will  overhaul  the  act  regulating gene editing, if it  becomes the government.

What  the  current  Health Minister  David Clark plans to do about it is  not known,  though   one of  his  more intelligent colleagues,  David Parker,  has said  he has   requested

 … officials to advise me  where lower regulatory hurdles ought to be considered to enable medical uses that would result in no inheritable traits, or laboratory tests where any risk is mitigated by containment. The recommendation to clarify conflicting or inconsistent definitions across the regulatory framework will also be considered”.

Parker made his comment  in  response  to the Royal Society Te Apārangi releasing papers   which spelt out  “the considerable benefits that gene editing can bring to our lives, particularly in health.”

He  says   he’s  “aware” there are instances where gene editing techniques could be applied to improve the lives of NZers and   and even agrees with the Prime Minister’s Chief Science Adviser  there is a spectrum of genetic modification.

Although New Zealand takes a precautionary approach, advancements in gene editing are not prohibited. There are already instances where the EPA has approved the use of modified organisms, for example Pexa-Vec currently used in clinical trials for the treatment of liver and kidney cancer”.

Contrast  the  NZ  situation   with that in the  United Kingdom,  where  much of the  available  genome  data  comes from the  UK government-backed 100,000 Genomes Project, which has  sequenced  genomes  from  NHS patients  affected by rare  diseases or  cancers.

In  a feature on  medical  research, The Guardian  last week  reported  there is any  army  of biotech companies looking to get a foothold  in the ever-expanding  health market  of  “precision medicine”.

It  notes  privately owned laboratories  offer personalised reports  based on genome sequencing. Others focus on a selection of conditions  for  which there are known genetic markers, such as type 2  diabetes, breast cancer and  coeliac disease.  One,  Dante Labs,  through  a  genetic  testing service offers users   a  full check-up for all common and rare  diseases.

NZ – which  used to pride itself  on being in the forefront  of  medical developments – has a  long way to  catch up.

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