Wrong data, wrong result

January 24, 2020

The decision to close the Lumsden Maternity Centre was based on incorrect data:

The Lumsden Maternity Centre was closed last year as part of a region-wide review of maternity services by the Southern District Health Board, and replaced with a maternal and child hub.

The decision was strongly opposed by locals; a report by Ernst and Young commissioned by the board found numerous faults with how the SDHB implemented its maternity strategy.

The report’s terms of reference did not include the SDHB’s decision to create a hub at Lumsden.

That decision was the subject of the new report, which was written by midwifery academic Pauline Dawson and commissioned by Lumsden clinic operators the Northern Southland Medical Trust.

Ms Dawson said the closure went against the aims of the National Maternity Monitoring Group and the SDHB’s own primary health strategy.

‘‘This closure puts mothers and babies in this area at risk of poor short and long-term health outcomes and places additional burden of care on remote rural lead maternity carers.’’

Ms Dawson said when deciding to close Lumsden the SDHB did not correctly identify the catchment area the unit served, and ‘‘significant’’ numbers of mothers who had used it were not counted.

The SDHB had used birth numbers in its reports where it should have considered pregnancy numbers when assessing if it had met its Ministry service coverage schedule requirements, Ms Dawson said.

The Ministry itself used a document to support the decision in which travel times between centres were incorrect, and wrongly used the time to the closest primary facility rather than to a secondary service, as it should have, Ms Dawson said.

There’s a big difference between what’s available at a primary facility and a secondary one.

‘‘This error makes several locations appear as they are within service coverage schedule specifications, when they definitely are not.’’

Trust chairwoman Janese Priergaard-Petersen said the report confirmed many of the issues trustees had raised.

‘‘The decision was based on poor information and then executed poorly by the SDHB.

‘‘We don’t yet have any solid data on outcomes for mothers and babies, both in terms of births and postnatal care but we do know that mothers, and the lead maternity carer midwives who care for them, are struggling with the lack of support left by the closure of Lumsden Maternity.’’ . . .

They don’t have solid data but they do have cases where the lives of the mothers and babies were at risk because the Lumsden Centre had closed.

They include the woman whose husband drove at high speed in winter conditions while she was on all fours in the back seat; and a baby born in a car park outside the centre.

The community has questioned the decision to close the maternity centre from the time it was first mooted.

It was the wrong decision, based on wrong data.


Planet before people

January 7, 2020

Some hospitals are forgoing science in putting the planet’s health before that of their patients:

Patients’ health will suffer if hospitals cut down on meat and dairy in meals, the country’s former chief education health and nutrition adviser warns.

However, another researcher has backed the push for plants to replace meat and dairy in meals, saying our meat consumption seriously harms health and the planet.

New sustainability guidelines for the health sector include a recommendation to reduce meat and dairy, including by developing new hospital menus and encouraging plant-based diets. Some hospitals have brought in “meat-free Monday” trials.

The environment can and does impact on health but thinking that a little less meat eaten in hospitals will have an impact on climate change is ridiculous and the health and welfare of patients must be hospital’s first priority.

The guidelines have been criticised by Grant Schofield, professor of public health at Auckland University of Technology.

“We are talking about our most vulnerable, sickest people, and food is an important part of that, and we take meat and dairy out – it just utterly beggars belief,” he told the Herald.

“Hospital food is generally of a pretty poor quality anyway, it is generally pretty highly processed. If you wanted to improve hospital meals you would look at the quality of the food, and meat would be my last possible target, because it is one of the best sources of nutrition, protein, good-quality fat and vitamins and minerals. To take that out of it seems objectionable.” . . .

My experience of hospital food is that it is high on stodge and low on protein, roughage and vitamins, of which meat can be a valuable source.

Vegetarian and vegan diets can be healthy but it takes a lot of care, and usually higher cost, to replace the nutrients lost from going meat-free.

Schofield, who advocates a low-carbohydrate, high-fat diet and quit his Government advisory role over a lack of action on obesity, said cutting meat and dairy in hospital meals to counter climate change was “nonsense”.

“I think we have unfairly demonised meat and got it into our heads that it is somehow ruining the planet.”

The Ministry of Health’s sustainability guidelines were released in July, and note that agriculture accounts for almost half of New Zealand’s greenhouse gas emissions.

Sigh, a repeat of the half-baked argument that doesn’t take into account either nutrient content of what agriculture produces nor that most of the produce is exported to feed people in other countries so eating less here will have no impact at all on production.

After the guidelines were released Dieticians NZ, the professional body for dietetics, labelled the meat and dairy recommendation disappointing and not appropriate for those in hospital, who are often malnourished.

People in hospital are there to be treated for what ails them, not to be used for virtue signalling.

Not everyone agrees.

That position drew a response from Professor John Potter, of the Centre for Public Health Research at Massey University, who wrote in a blog post that even if some patients needed more protein, this could be sourced from plants. . .  

It could, but not as easily and probably at a greater cost.

A nutritious diet is an important part of healing and good health.

Decisions on what people in hospital eat should be made on the basis of the science that determines what’s best for them, not that of the planet, especially when emotion rather than science often guides the anti-meat dogma of the dark green who put the health of the planet ahead of the health of people.


Are you willing to feel your feelings?

December 29, 2019


Rural round-up

December 20, 2019

Manager no stranger to plant reality – Sally Rae:

As Alliance Group holds its annual meeting in Palmerston North today, business and rural editor Sally Rae speaks to its new general manager, livestock and shareholder services, Danny Hailes about his long and varied tenure with the co-operative.

Danny Hailes always gets a little anxious around the summer holidays.

His anxiety is understandable, for it was a Sunday morning in January 2006 when he was in Wanaka to watch his son play tennis, and got a phone call to say there was a fire at Alliance Group’s Pukeuri plant which he managed.

Quickly driving back, Mr Hailes could smell smoke in his car as he hit Peebles on the lower Waitaki Plains. . . 

Pāmu revises full year financial forecast:

Pāmu has revised its full year EBITDAR (Earnings before Interest, Tax, Depreciation and Revaluations) forecast to between $73 million and $78 million. This compares to the previous forecast of $61 million.

Chief Executive Steve Carden said the increased forecast was pleasing and demonstrated both a lift in milk and meat prices, plus a strong focus on productivity improvement on farm and securing premiums for its products.

“The improved milk price principally reflects the revision in Fonterra’s forecast milk payment to $7.00 – $7.60 per kg of milk solids, while the strong beef and sheep prices are being driven by strong global demand for protein, particularly from China. . .

Pair travelling country on Kaimanawa horses – Laura Smith:

It is an ambition of many to travel the length of the country, but wild horse is not typically the transport of choice.

In 2018, during the annual muster of Kaimanawa horses near Taupo, Jess Mullins and Bijmin Swart took on three wild horses.

The muster occurs to maintain good health within the population and protects fragile ecosystems that are unique to the Moawhango Ecological Zone.

Unfortunately, not long after they took him on, one of the three horses died of illness. . . 

Measles epidemic taking toll on Samoan seasonal workers

The measles epidemic has been “taxing” on Pacific workers in New Zealand’s horticultural industry, a co-ordinator with the Recognised Seasonal Employer scheme (RSE) says.

Jerf van Beek said many Samoan RSE workers had been affected by the impact of the epidemic on their families back home.

“Funerals are a very important part in the Samoan culture and we know it’s very expensive,” Mr van Beek said.

“We as an industry really want to support our RSE workers who are being affected by it, that they are able to come to New Zealand, earn the money and actually take it back again, under a very taxing situation.” . . 

Matakana Island joins the medical cannabis industry:

 Local whānau on one of New Zealand’s most intriguing islands have just received a licence* to grow medicinal cannabis. Grown outside in the Matakana Island sunshine, Mahana Island Therapies will be one of the only legal and naturally grown cannabis products of its kind in the world.

Matakana is a narrow, 28 kilometre-long sandbar at the head of the Tauranga harbour in the Bay of Plenty. Renowned for its unique geology, history and ecology, the island’s primary industries are forestry, dairy farming, kiwifruit and other horticultural activities. Famed for its stunning surf beach, the island is home to about 200 permanent residents. . . 

Survey reveals what kiwis eat on Christmas Day:

Lamb was voted as the meat of choice for Kiwis this Christmas as part of the Classic Kiwi Christmas Census 2019, followed in a very tight second by ham.

The poll – which was conducted by Retail Meat New Zealand in conjunction with Beef + Lamb New Zealand – of over 1,300 Kiwis covering a range of Christmas traditions, saw lamb as the go-to meat of choice with 34% of respondents. Ham was only two votes behind in second with 33% and beef came third with 13%. This represents a significant change in meat choice, with last year’s survey returning a strong mandate for ham which secured 37% of the vote versus 30% for lamb in the 2018 survey.  . . 


Labour pains, National delivers

December 18, 2019

National promised eight policy papers this year and they’ve delivered.

The government promised this year would be their year of delivery and they haven’t.

You’ll find National discussion documents here.

You’ll find the government’s broken promises here.

They include: child poverty heading in the wrong direction, the level of homelessness is appalling, elective surgery numbers have dropped, economic growth has dropped from 4% under National to 2.1%; job growth has fallen from 10,000 a month under National to just 3,000 under Labour; per capita growth is only 0.5 per cent a year compared with average of 1.7% a year during the last five years under National; the number of people on the dole is up by 22,000, the number of New Zealanders heading overseas has increased by 10,000 a year, the billion trees promise isn’t being delivered and won’t be, not a single cent of the the $100 million Green Investment Fund that was supposed to kick-start $1 billion of investment in ‘low carbon’ industries has been invested, the  commitment this year to making the entire Government fleet emissions-free by mid-2025 was dropped, the government hasn’t been able to find a credible way to introduce a royalty on bottled water exports without trampling all over trade and other agreements with countries New Zealand does business with, yet another working group was set up to address waste minimisation but hasn’t come up with anything yet, the bold goals for housing have been dropped, The 4000 new apprentices target has been quietly dropped. Only 417 have started the Mana in Mahi programme and 32% of them dropped out . . .

Rodney Hide sums it up saying the year of delivery got lost in the post:

This was supposed to be the turnaround year. Prime Minister Jacinda Ardern declared 2019 her Year of Delivery. Nothing has been delivered. Her promise has proved, like her government, empty and meaningless. 

The tragedy is that we accept it. It’s enough that politicians feel and emote; there’s no need to do or achieve anything. We should perhaps rename the country New Feel-Land. . . 

That’s the Year of Delivery done and dusted.

But there’s always next year. The prime minister has plastics again in her sights. She says it’s what children write to her about most. There are news reports she’s planning on banning plastic stickers on fruit.

I scoffed when we had government by focus group. We now have government by school project. . . 

Garrick Tremain sums it up:

What’s all that hot air doing to our emissions profile?

Reducing those is another failure, in spite of the commitment to reducing them being the PM’s nuclear-free moment, they’re increasing and will continue to for the next five years.

A new government ill-prepared for the role might have been excused a first year finding its feet but there’s no excuse for failing so badly to deliver in on its promises in what was supposed to be its year of delivery.


Legal pot winners and losers

December 5, 2019

The government has opted for legalisation of cannabis use rather than decriminalisation in draft legislation for next year’s referendum.

Key points of the proposals are:

    • a minimum purchase age of 20
    • a ban on marketing and advertising cannabis products
    • a requirement to include harm minimisation messaging on cannabis products
    • not allowing recreational cannabis to be consumed in public and only in licenced places
    • limiting the sale of recreational cannabis to physical stores
    • controls on the potency of recreational cannabis being sold
    • a state licencing regime for recreational cannabis controlled by the Government

If the legislation passed, anyone aged 20 years or older could grow up to two cannabis plants. If two people aged 20 years or older are part of the same household, the property can have up to four plants. If you grow more than you’re allowed, you could be fined up to $1000. Cannabis must also be grown out of public sight.

People could hold 14 grams of dried cannabis in a public place – the same amount that could be purchased from a licensed store. . . 

Justice Minister Andrew Little couldn’t tell Mike Hosking how many joints could be made from 14 grams.

. . . “They start at 42, go down to 21 and I have seen one at 15. I am not a user, so I’m just going off advice from officials.” . . .

This is basic information the Minister ought to know.

I’m not a user either but I found an unopened packet of dried thyme weighing 15 grams and was able to measure 14 reasonably heaped teaspoons from it.

That seems to be more than would be safe for anyone to smoke or eat in a day, given there are questions whether any amount is safe, although the purchaser won’t necessarily smoke or eat it all in one day.

The proposal is up for consultation, but whether or not changes are made as a result of that, who would win and who would lose if the referendum gets a majority in favour of legalisation, and, given it’s non-binding, the next government passes it?

Winners:

  • People who use cannabis now, including those who smoke an occasional joint the way others might have an occasional alcoholic drink.
  • People who want to use it recreationally now but don’t want to break the law.
  • Individuals and businesses who grow, process and sell cannabis.
  • The black market – the price and THC level in legal cannabis will be regulated providing a market for those wanting something less expensive and more potent.

Losers:

  • Young people who use it and suffer health and development problems as a result. Whatever the legal age for possession and use, younger people will get it.
  • Those who develop mental illnesses including psychosis as a result of using cannabis. Psychiatric nurse Peter Hurst writes on the damage cannabis does here.
  • The mental health system which will come under more pressure from those suffering from addiction and other ill effects of cannabis use.
  • Employers who have to deal with drug users in the workplace.
  • Workers who have to put up with fellow workers who are under the influence of drugs.
  • Teachers who have to deal with drug users at school (see young people using cannabis above).
  • Police who still have to deal with the black market.
  • Emergency services who have to deal with the consequences of drug-driving.

Would the wins out weight the losses?

I don’t think so.


33 avoidable deaths

November 28, 2019

The death toll from measles in Samoa is now 33.

All but four of the deaths are children – under the age of four – including one who died in the past day.

About 200 people with the disease remain in hospital.

A mass vaccination campaign is underway and dozens of New Zealand nurses are in Samoa to assist. . . 

It’s likely the epidemic came from New Zealand :

. . . Ease of travel, particularly international, and immunity gaps within New Zealand meant the epidemic was not surprising, Immunisation Advisory Centre director Nikki Turner said.

In a report published in The New Zealand Medical Journal on Friday, Turner said more action was needed to ensure better protection for the community and the elimination of measles.

Some of those steps included resourcing a national campaign targeting adolescents and young adults; the adequacy of vaccine supply and accessibility including more use of pharmacies and pop-up clinics; and support for front-line workers. 

There was a risk to both New Zealand and Pacific populations and the epidemic indicated the country’s immunisation programme fell short. The health sector’s response needed to be strengthened, the report said. 

“With multiple imports and more than 12 recognised outbreaks in the first five months of this year affecting most regions, this should appropriately be called an epidemic,” Turner said. . . 

Otago University, Wellington Department of Public Health professor Michael Baker said the only way to contain an epidemic was to rapidly fill the immunity gap.

 It would be a “very responsible step” for the country to consider extreme measures that prevented the transmission of measles, particularly to the Pacific. . . 

The epidemics in New Zealand and Samoa and the deaths that have resulted were preventable.

It started when someone who was infected travelled to New Zealand and spread the disease here and a traveller probably took it to Samoa.

New Zealand’s immunisation rate wasn’t high enough for herd immunity and Samoa’s was far lower.

Europeans brought diseases to the Pacific Islands more than 200 years ago. They had the excuse that they didn’t know the dangers and they didn’t have vaccinations.

That excuse cannot be used in the 21st century, especially when a preventable disease has already cost 33 lives.


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