Stuff and nonsense: the tale of a woman who can’t get publicly funded genetic testing in a hurry – but she can get private testing

‘No one cares’: 25-year-old with extensive family cancer history can’t access genetic testing

That’s the headline on a Stuff report which alerted the public to the experiences of a woman who was pregnant with her first baby when she found out she was likely to be at higher risk of developing cancer.  But she was placed on a formidably long waiting list for the genetic tests she then sought.

But a serious shortage of staff and resources to undertake the tests does not necessarily mean “no-one cares”.

The headline claim that she “can’t access genetic testing” more obviously is bollocks because the report says she will be getting treatment – from the private sector at a price – in a few months.

Here’s what readers were told about Annalise Buchanan’s grievance (and her concerns are understandable): 

Mahuta’s Three Waters law was promoted as a health measure as well as a cost-saver – but whose figures should we use?

After the Water Services Entities Bill passed its third reading in Parliament, Local Government Minister Nanaia Mahuta said it was the first of three bills that will ensure affordable drinking water, wastewater and stormwater services can be provided to New Zealanders now and into the future.

Everyone agreed that change was needed to ensure communities have safe, reliable drinking water at an affordable price, she said.

“We are already seeing what is at stake with over 34,000 New Zealanders getting sick from drinking water each year.”

Point of Order has been dipping into the most recent data we could find on the Massey University-based Environmental Health Intelligence NZ website.

This provides information and intelligence on how the environment affects the health of New Zealand’s population.

We focused on a factsheet (dated May this year) headed Notifications of potentially waterborne diseases.

Graham Adams: Did Pakeha really crush traditional Maori medicine?

 

Jacinda Ardern claimed in Parliament in 2021 that her government was driving “foundational change”. As Exhibits A and B for this project — which would allegedly “make a long-term difference to how we see ourselves” — she cited the Matariki public holiday and the new compulsory school history curriculum that focuses largely on the Māori experience of colonisation.

The curriculum will be introduced to schools from next year but there is a much more pressing need for compulsory history lessons to begin immediately for our politicians, journalists and health leaders. After all, schoolchildren usually don’t get the chance to write columns in newspapers or take part in television programmes that — wittingly or unwittingly — mislead thousands of their compatriots.

Last Friday, an article by Rawiri Waititi appeared in the New Zealand Herald to mark Māori Language Week. It included:

“Part of colonisation and imperialism is to assert the dominance of the colonial culture and language. Colonisation meant that the whole system of Māori self-belief had to be attacked and derided. The Tohunga Suppression Act of 1907 is merely one example of our spiritual leadership being outlawed.”

Long Covid: less about health, more about politics?

Covid doesn’t grab British headlines these days.  Recent coverage instead picked up on heat-related deaths from July’s scorching weather.

Shame that there wasn’t more probing into that data set.  Because there was some good news.  The – deep breath now – age standardised mortality rates for England and Wales in the year to date are at almost their lowest-ever level.

That seems worth a bit of celebration, even if it is what you might expect with the pandemic’s passing.

But hang on, the Financial Times’s diligent John Burn-Murdoch has been able to dig a little more out of the government statistician’s recent mortality data.

He notes that excess deaths (i.e., those which exceed historically-based expectations), which were overwhelmingly attributable to Covid during the pandemic, are now increasingly non-Covid related.  

“Between July and December 2021, England recorded 24,000 more deaths than in a typical year, but only two-thirds of these could be attributed to Covid. And this year, less than half of the 10,000 excess deaths accrued since May were Covid-related. In total, there have been just over 12,000 additional non-Covid deaths across the two periods.”

Astute readers will no doubt be struggling to reconcile low and falling mortality rates with continuing excess deaths.  Among other things, it might have something to do with using the best years for the baseline.

Burn-Murdoch is particularly interested in the possible correlation between non-Covid excess deaths with growing A & E waiting times.    

All seems to be going well, until he leaps – perhaps a little too quickly – to a familiar villain, namely the government’s “… failure to address the failings of a chronically under-resourced and overburdened system”.

To be sure, the Socialist Worker was fulsome in its praise.  And quick to argue for strikes in Britain’s National Health Service as a final solution to the excess-death problem (this might be sounding a little more relevant to New Zealand readers).

But really, has there ever been a time when a free health system has not been “chronically under-resourced” and overburdened by its patients.

Before drawing a single striking conclusion from statistically-based calculations during an abnormal public health event with data attribution challenges, it might just be sensible to look a little more closely at the flexibility of the health system’s response in switching resources during and after the pandemic; and examining just how much of the continuing excess mortality is due to the delay and even cancellation of other treatments during the pandemic. Burn-Murdoch has an honourable record in this line of work.

It might be that the health business is one of many in which degraded service quality is symptomatic of policy-driven lack of flexibility and loss of productivity.

Which would have worrying implications for everyone.

In times of rising living standards – like those pre-Covid years – we all too easily forget that this benign state of affairs depends on us all getting more productive in our job; or, if we don’t, losing it and getting another; and then making sure our children get even more productive jobs than we had.

In most places, it seems to be dawning that something went wrong with this during the pandemic.  

The next shoe to drop is that adjustment to the new reality is necessary.  And it’s not feasible in the long run for the government to pay us for work we have not done and compensate us for changes we need to tackle ourselves.

Sadly, Burn-Murdoch’s article also reminds us that no government has had much success applying this analysis to the health sector.  Even so, the gradations of failure are quite important.

New Zealanders facing some whopping price / quality adjustments (for example, those desperate to get out of the country) might also wonder if their government has been slower than most in twigging the need for adjustment. Better hope the Ukraine war does good things for commodity prices to support the always “chronically under-resourced” health system.

When all that money is being pumped into health (as the PM insists), we may wonder why the system is so badly strained

Opposition Leader  Christopher Luxon  has  shown  he  is  a  fast  learner.  Where   earlier  he  often ended  on  the  receiving  end  in exchanges  with  the  Prime Minister in Parliament, now  it  is the Prime  Minister who who can be seen back-pedalling,

Take,  for  example, pressures  in the  health  system  which are causing  so  much anguish  to  New Zealanders.

The  National Party  has  turned  the  spotlight on emergency departments which are facing high demand and staff shortages, with at least one district health board delaying planned surgeries for weeks.

Luxon  had  laid  the  groundwork  for his questions with  an earlier  statement that he would commit to delivering and improving health outcomes.

The government

“… confuses and conflates spending announcements with actually securing outcomes”, Luxon said.

“This government cannot get anything done, it doesn’t matter which portfolio you pick up, they’re actually spending more money, hiring more bureaucrats and getting worse outcomes.”

Willie Jackson ridiculed Shane Reti on Maori longevity gains – but guess whose numbers were right (and show great progress)?

If  Dr Shane Reti happened to insist the world is not flat, would RNZ see much merit in reporting  he had come under fire from flat earthers?

We ask because a recent RNZ report was headed Shane Reti stands firm in face of criticism of Māori health comments

Oh dear.  What did he say?

The opening paragraphs inform us:

National’s Health spokesperson Dr Shane Reti is under fire for comments he made comparing Māori life expectancy to the 1840s.

It follows his appearance on The Hui where he said the life expectancy for Māori was 30 years in the 1840s but today it is around 73.4 years.

Was Reti really obliged to defend himself, saying he was trying to argue how the life span of Māori has increased over time?

Luxon’s health-reform (and co-governance) predictions are dismissed as “misinformation” – but shouldn’t we wait and see?

On the Māori Television website, a contretemps involving National leader Chris Luxon is innocuously described as Te Ao with Moana, Series 4 Episode 7.

There’s a bit more information.  It happened on Monday this week:

Moana sits down with the leader of the National Party Christopher Luxon.

But she did not down to chat with him – or, necessarily, to conduct an interview.

What transpired is better summed up on Newshub:

Veteran Māori broadcaster Moana Maniapoto accused National leader Christopher Luxon of “misinformation” during a fiery debate about co-governance. 

We can argue about whether Luxon was guilty of spreading “misinformation”, “disinformation” or neither. But let’s put that aside for now.

Luxon raised Maniapoto’s hackles while explaining his opposition to the Ardern Government’s centralised co-governance arrangements, like the new Māori Health Authority.

“We’ve had co-governance in the past-National government that’s been bounded around Treaty claims and iwi managing local natural resources essentially working with local government,” Luxon explained. 

“What we now seem to be talking about is co-governance with respect to the delivery of public services and my issue is I believe a single system with innovation and components around targeting people on the basis of need and partnering through devolution and through localism with iwi and through local government, to actually get better outcomes.”

The Newshub report notes that the Maori Health Authority is a key component of the Government’s health system reforms.  The country’s 20 District Health Boards are being replaced by a new centralised entity, Health NZ, and a Māori Health Authority is being established.

The Māori Health Authority was decided after the Health and Disability System Review found that Māori health outcomes were “significantly worse” than those of other Kiwis.

The review said those outcomes represent a “failure of the health and disability system” that did not reflect Treaty of Waitangi commitments.

Luxon has committed his party to scrapping the Māori Health Authority if National wins the election next year.

Maniapoto plainly believes this is a bad policy commitment, regardless of the financial costs or whether the money spent on setting up the Maori Health Authority – and keeping it going – might be better spent on supplying treatment rather than administration.

“Isn’t Māori health in such a crisis that we do need to pile more money in and be very brave and bold in our thinking?” Maniapoto asked Luxon. 

He replied: “All we’re going to do is amalgamate and centralise and build a massive bureaucracy that will end up competing with Health New Zealand.”

Luxon presumably meant to say that all the Ardern government was going to do was amalgamate and centralise and build a massive bureaucracy that will end up competing with Health New Zealand.

But rather than seek clarification, Maniapoto disputed what Luxon had said and unabashedly became a spokesperson for the government:

“No, we’re not. That’s misinformation,” she said.

And:

“You want the one system that you suggest will work for everybody. In the last 40 years, there have been massive attempts to address inequities within the health system,” Maniapoto said.

“Everybody, all the experts – the Heather Simpson report, the Māori health advisory group, all the NGOs that wrote to you and David Seymour last week, the Waitangi Tribunal with its interim recommendation – they all say that we need an independent Māori authority that will work in a certain way. Why do you not trust expert advice?”

Luxon replied: “I think we’ll create a massive amount of bureaucracy.”

The Newshub report was written by Zane Small, described as a “digital political reporter” for Newshub based in the Parliamentary Press Gallery.

He explains that the Māori Health Authority will commission kaupapa Māori services and work alongside Health NZ to develop system plans and commissions for primary and community services.

He does not delve into the question of which authority will get what portion of the health budget or how their claims for bigger budgets will be resolved if money is tight.

He does acknowledge that a Māori Health Authority was recommended in the controversial He Puapua document, “a think-piece report” commissioned by the Government in 2019 that sets out a roadmap to co-governance between the Crown and Māori by 2040.

Māori have been consulted on what should be done with the He Puapua agenda. Wider public consultation will begin later this year.

Let’s get back to Maniapoto, who told Luxon in the interview – sorry, heated debate:

“You’re not helping with that conversation. You’re using words like separatism.”

He replied: “I’m not.”

Small’s report points out that Luxon’s predecessor, Judith Collins, did talk of “separatism”.

He recalls her accusing the Government of “separatism by stealth” for introducing the Māori Health Authority and scrapping the ability for Māori wards to be overturned by a local poll.

But the point of this recollection is open to question, because any notion that Luxon should be bound by everything Collins said while she was National’s leader is absurd.

Moreover, Newshub goes on to report:

“I’m up for that conversation. That’s why I’m here with you today. I’m coming on your show because you want to discuss these issues,” Luxon told Maniapoto. 

“I’ve given you a different perspective. I appreciate it’s not your perspective but I’m putting forward what I think and what we think.”

Then Luxon said the Government needs to be clear about its co-governance intentions. 

“I don’t think the Government is being very clear about co-governance and I think if you went outside on the street and asked an everyday New Zealander: what is co-governance? They’d be unable to explain it.”

Luxon’s suggestion was to focus on former Prime Minister and National leader Bill English’s ‘social investment model‘, “targeting support on the basis of need”.

“A good example for me would be the COVID story. Initially, the Government said we’ll just run everything centrally from Wellington and it wasn’t until they engaged with Chinese communities with language issues to get vaccination rates up – the same happened with Māori/Pasifika – that we were able to use local community organisations to get to those communities.”

As for Luxon’s “misinformation” – well, according to dictionary.com,

Misinformation is “false information that is spread, regardless of intent to mislead.” Put a flag in the second half of this definition…

For example,

“… say a party starts at 8pm, but you forget or misread the invitation and tell your friends it starts at 9pm, you are supplying them with misinformation. But don’t fear: we’re not calling the fact police on you! The key, here, is that you unwittingly spread false information around; you didn’t mean to, or even might have thought the information was true.”

“Misinformation doesn’t care about intent, and so is simply a term for any kind of wrong or false information.”

On the other hand:

“Disinformation means ‘false information, as about a country’s military strength or plans, disseminated by a government or intelligence agency in a hostile act of tactical political subversion.’ It is also used more generally to mean ‘deliberately misleading or biased information; manipulated narrative or facts; propaganda’.

“So, disinformation is knowingly spreading misinformation. Our first definition of this word gives one major reason why a person or group might want to spread wrong information, but there are many other nefarious motivations lurking behind the creation of disinformation.”

In the case of Labour’s health reforms, Luxon is predicting they will result in a burgeoning bureaucracy.

The government is in the predicting caper, too, by insisting our wellbeing will be improved by its restructuring of the health sector.

We won’t know who is right – Labour, Luxon or his bellicose interviewer – for some time.

Covid divide in 2022: you ain’t seen nothing yet

As the Omicron wave washes through, it’s hard, even with the seasonal perspective, to reckon what things might be like in say a year’s time.

But perhaps necessary.

Because the day-to-day measures seem less and less meaningful – except where they provide a pointer to the direction of long-term policy.

In Britain, Christmas locks itself down

Experience suggests one should only call a turning point after it has actually – well – turned.

That said, it might be wise to keep an eye on developments in the UK over the Christmas and New Year period.

While Europe is fast locking down for fear of Omicron, Britain’s cabinet is the fulcrum of a political battle over whether any policy response would be meaningful.

Boris: Bad reaction to Omicron

British politics is proving a fine laboratory for times of transition.

Boris Johnson’s enemies are exultant at his latest woes: a crushing by-election defeat and a parliamentary vote in which he endured the biggest Conservative party rebellion since – well since the Brexit horrors a few years ago under his predecessor Theresa May.

But oddly enough, it looks like he might keep on standing.