Health system is in crisis

It is more than 30 years since I first had a lot to do with the health system as the mother of sons with profound disabilities.

The pressures on staff and resources then were a small taste of what’s happening now with the whole system in crisis as Sir Ray Avery wrote on Linked In:

Chris Hipkins There is a Crisis in New Zealand’s Hospital System
  
Chris Hipkins, there is crisis in New Zealand’s Hospital system and the health and wellbeing of all New Zealanders is at risk and you have to act NOW and declare a state or emergency.
 
Numerous frontline healthcare workers and associated hospital support staff have publicly stated that they can no longer provide the level of care needed to administer safe and timely clinical treatment for their patients.
 
In this Newstalk Interview a top surgeon and a paramedic state that our health system is “imploding” and are calling for rapid action and are condemning the Government for “The crap that comes out of mouths of politicians “with regard to their failure to acknowledge that our hospitals are in crisis.

 

Professor Frank Frizelle says that surgeons are being asked to make life and death decisions because the Hospital HR resources are approaching only 50% of that needed to provide safe and timely medical treatment of patients.

A frontline paramedic say’s that because there are no hospital beds available that ambulances have to wait outside A&E for between two and 5 hours and that one patient was left in a corridor and died and no one noticed for more than two hours.

Prof Frizelle is critical of Health NZ who he says have not put in place adequate planning and resources to prevent the potential complete collapse of our hospital system.

And he is right.

The latest published board minutes for Health NZ are silent on any plan to try to resolve the current crisis in our hospital system.

Chris Hipkins preventable deaths are occurring on your watch and more than 30,000 patients are waiting more than five months for knee replacement, hip replacement, hernia surgery, colonoscopy, and laparoscopic cholecystectomy surgeries.

Some people on the waiting list may die before they get treated and preventable cancer deaths will occur because of the lack of oncologists and MRI, CT technicians and laboratory technicians.

Chris Hipkins, I urge you to declare a state of emergency which would put in place strategies to provide immediate critical support for our hospital and frontline medical staff and prevent a complete collapse of our hospital system.

And my fellow New Zealanders on behalf of all our frontline medical staff who are working with little resources but still trying to provide the best care they can for their patients in what has become an A&E warzone, show them your support.

Like this post ,and share this post, because unlike the visible devastation of the recent flooding the collapse of our healthcare system is like a malignant cancer often not detectable until it’s too late.

If we make enough noise just maybe Chris Hipkins will act.

Sir Ray

It is not fair to blame all the problems on the current government. Some have been gestating for a long time and some have been aggravated by the Covid 19 pandemic.

But the government is responsible for the folly of expensively restructuring the system during a pandemic.

It’s responsible for wasting money on what it considers nice-to-haves while neglecting necessities, one of which is health.

It is also responsible for poor decisions that will have a long-lasting impact including the refusal to fund more places in the country’s two medical schools.

It’s not just more doctors we need, the health workforce is understaffed across the board.

The government keeps saying we need to do our bit to combat climate change about which our efforts will have little if any impact.

It is far more important that we do something about a world-wide shortage of medical professionals by training more of our own rather than relying on immigrants, especially when we’re competing with other countries which offer them better pay and conditions.

Sir Ray is not exaggerating, the health system is at breaking-point with impacts on wellbeing in every sector from ante and post-natal services to end-of-life care.

Rebuilding the health workforce and better funding of frontline health services must be an urgent priority.

What’s changed?

Remember in 2020 in the early days of the COvid pandemic when people on the health frontline were saying they didn’t have enough PPE and the then PM and Director General of Health were saying there was plenty?

What’s changed?

New Minister of Health Dr Ayesha Verrall says she expects improvements to staffing levels at Middlemore Hospital’s under-pressure emergency department before the start of the next winter flu season.

That is despite recent comments from frontline healthcare workers, who have said the hospital’s ED is haemorrhaging staff who are heading across the Tasman for better pay and conditions.

They were also concerned about the impact the loss of staff will have on the department’s ability to function during the upcoming winter flu season.

A spokesperson from the New Zealand Nurses Organisation and Middlemore ED staff member said the department was continually short-staffed and vacancies were not being filled in time to keep up with resignations, which was putting patient safety at risk.

But Verrall, who was promoted in the recent cabinet reshuffle, was confident Te Whatu Ora – Health New Zealand could make the necessary changes to boost staffing levels.

“I know the sector is working hard to alleviate pressures on EDs and my expectation is that improvements will be in place by this winter,” she said.

“I know Te Whatu Ora has work under way on initiatives such as increased access to telehealth and extra after hours options, including providing vouchers for some people to visit a GP rather than an ED.”

She said it was also working to boost local recruitment and attract foreign talent, including helping overseas-trained nurses complete the required assessments so they could work in New Zealand.

“I have stated that this work is to be prioritised,” Verrall said.

Really?

But Te Whatu Ora – Health New Zealand chairperson Rob Campbell said workforce shortages plaguing Middlemore’s ED would not be addressed in time for the pending winter flu season and would continue to impact services.

A new intake of junior doctors was in the pipeline and new pay equity rates for nurses would make it more attractive to work in the sector. However, it would be a “long hard road” to turn things around, he said.  . . 

Who do we believe – the people on the front line or the politician?

It looks very like we’ve got a new minister but the same old problems:

Prime Minister Chris Hipkins was right to demote Andrew Little, but changing the Health Minister will do nothing by itself to improve New Zealand’s declining health statistics,

National’s Health spokesperson Dr Shane Reti says.

“It is no secret that the health sector has been in crisis for more than a year. Instead of being supported by the Labour Government and its ministers, the sector was put through drastic changes, pulling all the attention and resources from the front line.

“Under this Labour Government’s watch, access to healthcare services are getting worse.

Wait times across every major area of health are at record highs, including first specialist appointments to surgery and emergency department wait times.

“Newly appointed Health Minister Dr Ayesha Verrall must shoulder some of the blame for the mess that the health sector is in, given that she was the Associate Health Minister.

“Dr Verrall had responsibility for maternal services, an area hit by an acute shortage of midwives, yet midwives remained off the fast track to residency pathway until two months ago.

“When Dr Verrall was asked last year if she thought midwifery services were coping in the regions that had shortages, she responded simply with a ‘yes’. An out of touch response from an out of touch Minister.

“Dr Verrall should be open and transparent and start by publishing the emergency department wait times instead of hiding them like her predecessor Andrew Little did. These have not been publicly reported in almost seven months and are of huge public interest.

“While Labour simply shuffles the deck chairs, a National Government will build the health workforce, set health targets and hold itself accountable to New Zealanders. Better access to health is needed and a change of Minister will not deliver outcomes for our most vulnerable.”

It’s unfair to expect a new Minister to have an impact immediately, but how we can expect much-needed improvements if what she says is so different from what’s really happening?

Easy to save $90m for Dunedin Hospital

National’s promise to cut spending without reducing spending on health, education and other essential services won’t be hard when there are some obvious savings to be made by, for example, ditching the light rail project in Auckland:

One of the new Minister for Auckland’s first tasks could be dismantling Labour’s flagship transport project – light rail – which has gone absolutely nowhere despite costing tens of millions of taxpayers’ dollars, National’s Transport spokesperson Simeon Brown says.

The newly anointed Minister for Auckland wasted more than $50 million on a bridge to nowhere, he’s wasting even more on the light rail that’s going nowhere.

“Labour is setting themselves up for a massive back down on light rail for Auckland with Michael Wood telling Stuff this week that the project is now up for review and failing to say he still backed the project.

“Labour has already spent more than $72 million on light rail, with more than two-thirds of this money going to expensive consultants.

“Auckland light rail is an election promise Labour made in 2017 to build from the CBD to Mt Roskill, Wood’s own electorate, by 2021. Since then, it has become a symbol of this Government’s inability to get anything done.

“After more than five years of Labour, light rail has been a gravy train for consultants, but a final business case has not even been delivered.

“With a price tag of up to $29.2 billion, National has consistently said that this project is a waste of taxpayers’ money and that the Government would be better off investing in a broader range of transport projects to benefit Aucklanders from across the city.

“If the reports are correct that Labour is finally considering scrapping the project, that should be welcomed. But if they don’t scrap it, voters can be assured that National will.”

Not spending $29.2 billion gives options for other spending among which future proofing Dunedin Hospital must be a priority:

National Party leader Christopher Luxon says Dunedin’s new hospital will be future proofed if his party wins this year’s election, and it was well aware that Southland Hospital was too small for what was needed in the province.

Speaking at a public meeting in Gore on Friday, Luxon said southern MP’s Michael Woodhouse, Penny Simmons and Joseph Mooney had all raised the issue of proposed cuts to the build of the city’s new hospital with him.

The move comes after concerns over proposed designed changes to the $1.4 billion project because of ballooning costs.

“Now lets be clear, Dunedin Hospital, started under a National Government, mucked around under a Labour Government for the last six years, construction costs have gone through the roof, and would have been better to have got it started it and built it to what we actually need,’’ Luxon said in response to a question from the audience.

“Trust us, I don’t know any of the details on how they [Labour] have done their business case or what has changed and I need to dive into that, but we will make sure that in a growing area like Southland and Otago, that we will give it the support that is needed.’’

Luxon said he was also aware that Southland Hospital was too small.

“That is a classic case of a hospital built in 2004, way too small for what its needs were, and so the danger is that if you don’t future-proof the asset and make the investment for what you will need in the future.’’ . . 

The government is making $90m worth of cuts to the planned hospital build.

It’s the only tertiary hospital in the southern South Island and cuts don’t just affect Dunedin but all of Otago and Southland.

The government managed to find $700 million to fund the continuation of the tax cut on fuel, $90 million would hardly be noticed if it saved $29.2 billion by ditching the light rail that’s so expensively going nowhere.

Auckland will be facing massive disruption and costs repairing roads after the floods. It doesn’t need the added costs and disruption of this rail project.

 

All food not equal

As the cost of living crisis escalates, the price of food is more of a problem for more people, but  all foods aren’t equal:

While fruit and vegetables may seem more expensive than junk food, perception is not reality when the latter’s impact on health and the environment is taken into account, Dr Jacqueline Rowarth writes…

Taylor also explains that, although perception is not reality, perception can become a person’s reality (there is a difference) because perception has a major influence on how we look at reality.

In this light, the statement that “fruit and vegetables at the supermarket are so expensive now, processed and junk food actually works out cheaper” deserves examination.

The words came from a survey of 5+ a day by New Zealand-based company Research First.

But fruit and vegetables are not the same types of food as “processed and junk foods”.

Fruit and vegetables are valuable sources of energy, vitamins, minerals and fibre. There is also increasing evidence of additional benefits from the range of phytonutrients they contain.

In contrast, processed and junk food (henceforth termed PJF) tend to be high in fats, sugar and salt.

This makes a cost comparison difficult because the basis of the comparison is unclear – choosing vitamins or fats would result in a different answer.

The problem of how to compare has been addressed over the years through research. Most reports come to the same conclusions as the United States Department of Agriculture Economic Research Service.

For all metrics, except the price of food energy, healthy foods cost less than less-healthy foods (defined for the study as foods that are high in saturated fat, added sugar, and/or sodium, or that contribute little to meeting dietary recommendations). 

Good health depends on a good diet which requires healthy foods not those which are high in energy and low in nutrient value.

The CSIRO (Australia’s equivalent to New Zealand’s Crown Research Institutes) has examined the typical Australian diet and come to similar conclusions about the cost of PJF but on the environment rather than the wallet. . . 

Researchers estimated that discretionary foods (anything that isn’t an essential or necessary part of a healthy dietary pattern) were responsible for almost 30 per cent of the greenhouse gases (GHG) of an average Australian diet. . . 

The CSIRO researchers suggested that reducing discretionary food intake would allow for small increases in emissions from core foods, particularly vegetables (from 2.5 to 5.5 servings a day), dairy (from 1.5 to 2.5 servings), and grains (from 4.6 to 6 servings). The nutritional benefit would be achieved at a 3.6 per cent increase in GHG, which the authors described as “small”. . . 

The nutrient value of food is far more important than its contribution to GHGs and for a growing number of people its the price not how healthy the food is that determines what they buy.

With  annual food inflation in the year to November 2022 at 10.7% , today’s announcement from Stats NZ of last year’s food inflation expected to be even higher, and Cyclone Hale destroying fruit and vegetable crops which will push prices up more,  fewer people will be able to afford healthier options even if, when nutrient value is taken into account, they are not more expensive than junk food.

 

Rural round-up

Egg shortage isn’t because NZ’s farmers are silly and lazy – Craig Hickman:

Yesterday I went to three supermarkets and various dairies in search of eggsand, just as I was about to give up, someone suggested I try the local butcher.

I hurried there and secured the last dozen eggs on their shelf, a scene that is being repeated up and down the country as some supermarkets ration eggs to customers if they haven’t run out completely.

A common refrain I hear is that silly farmers who have had 10 years to switch from battery farming, a move that was announced in 2012, have just been too lazy to make the change.

As a farmer myself I know only too well the frustration and anxiety that goes along with the never-ending treadmill of keeping compliant with new regulations, but I also know that simply ignoring new regulations and throwing your livelihood away isn’t a path favoured by the majority. . .

Bumper nut harvest makes it all worthwhile – Shannon Thomson :

Valda Muller and her late husband Otto knew they were playing the long game when they got into the nut industry more than four decades ago.

In 1981, doing their due diligence on the best crop to venture into, the couple bought land in Pearson Rd near Cromwell to use as a testing ground for growing walnuts.

They did not realise the extent they too would be tested.

A study trip to California through Lincoln College confirmed walnuts were worth pursuing and the couple bought about 30 trees from the Ministry of Works at the Lowburn Nursery to gain experience of growing walnuts in Central Otago. . . 

I can’t quite remember why I was in front of these, but still, it made a good shot! We were bringing the halfbred ewes with triplets in for dagging, so we can shear them immediately after weaning. 🐏 ✂️
👉 RAM CATALOGUE: https://t.co/P1r8hADoxY pic.twitter.com/E7dNmedJcY

— Cleardale Station (@CleardaleNZ) January 7, 2023

Firm that makes plastic fence posts from soft plastics to build Blenheim factory – Samatha Gee :

A New Zealand company that makes fence posts out of soft plastic will soon be manufacturing its products in the South Island.

That means collection points for the Soft Plastics Recycling Scheme are expected to be re-established across Nelson and Marlborough.

Future Post managing director Jerome Wenzlick said the company started making fence posts nearly five years ago in Auckland, using soft plastic waste.

“We’ve built all our own machinery and figured out how to use all the different types of waste plastic that no one else can use and get our production up so we can make a post that’s the same or better than wood, which is what we’re up against.” . . 

Renowned NZ Romney stud Wairere sells Australian operation – Emma Alsop :

NEW ZEALAND-based Romney ram breeding operation, Wairere, has signaled its intention to exit Australia by bringing its Victorian operation to the market.

Wairere has owned the 1151-hectare aggregation, also named Wairere, since 2015.

Since purchasing the properties, located near Heywood in south-west Victoria, the company has built up a flourishing Romney stud and commercial flock of 5000 ewes.

Wairere also has a cattle operation that trades up to 600 head a year. . . 

How to save Britain’s pig farms – John Lewis-Stempel:

Did you pig out on pigs in blankets this Christmas? Or perhaps you had a traditional roast pork joint with apple sauce for New Year’s Day lunch? The British pig farming industry will certainly hope so, after suffering two of its worst financial years ever. Which is saying something. I started keeping pigs 20 years ago, and exigency is the old normal.

But 2022 was a perfect (pig) shit storm. Thanks in part to the Ukraine War, the price of wheat — a main ingredient in compound pig feed — hit historic highs. Then there was the 400% hike in energy costs, and before that a post-Brexit shortage of abattoir workers causing a backlog of 200,000 pigs on farms. Some UK farmers were forced to cull their pigs: 40,000 were “euthanised” and dumped in the ground. Currently, producers face a loss of circa £30 per pig sold. Their estimated cumulative losses since autumn 2020 is £600 million, according to the Agriculture and Horticulture Development Board (AHDB).

Unsurprisingly, many pig farmers are voting with their wellies, and exiting the industry. The proof is in the contraction of the national herd. According to Defra’s June survey, the total number of pigs in England decreased by 3% to just over 4.1 million animals, a 20-year low. The figure masks a more disturbing fact: the number of breeding animals — the future of the industry — is down by 17%. . . 

Gone strawberry blonde for Hogmanay 👌🏴󠁧󠁢󠁳󠁣󠁴󠁿#arnbegfarmstayscotland #morven #highlandcow #Hogmanay pic.twitter.com/MRJ6v3KsoG

— Arnbeg Farmstay Scot (@Arnbeg) December 30, 2022

Helius launches first NZ-made THC medicines :

Two new medicinal cannabis products containing THC have been verified as meeting the quality standard. New Zealand’s Medicinal Cannabis Agency publicly advised of the verification on 21 December 2022.

This follows Helius, a week earlier, being the first New Zealand company to receive GMP certification to produce THC extracts and manufacture medicines containing THC.

“We are very pleased to bring more NZ grown, NZ made medicinal cannabis products to Kiwi patients,” says Carmen Doran, chief executive of Helius Therapeutics.

The launch of two new medicines into the New Zealand market makes a total of four new medicines from Helius in 2022. It brings Helius’ portfolio of products to six. . .

Encouraging crime

New laws restricting who can purchase tobacco and where it can be purchased will encourage crime:

Dairy owners are dismayed at maps showing where the Government will allow ‘smoked tobacco’ to be sold, which will lead to serious crime like armed holdups, car jackings and even kidnapping, given each outlet is likely to average $4 million in sales with a large percentage being cash.

“Will the government listen? No. This is fake consultation because they’ve already made up their mind as they only listen to academics and theorists,” says Sunny Kaushal, Chair of the Dairy and Business Owner’s Group Incorporated.

“Dr Verrall’s plan will put crime on steroids with more injuries, and sadly, more murders.

Working in a dairy ought not to be a dangerous job but it is and this legislation makes the job even more dangerous.

“Cigarette sales are worth around $2.4 billion, with over $2 billion of that going to the government in Excise and GST showing who really makes the most from cigarettes. It’s simple maths to arrive at average sales of $4 million per outlet, or around, $11,000 a day.

“If half of that’s in cash and the outlet at Cape Reinga, for example, is a two hour plus round trip from the nearest bank in Kaitaia, it creates thousands of incentives for a robbery. Each is called a dollar.

“As people are using cars as weapons now, murder for a cash register and assault us with machetes, what will happen with a mountain of cash? This is where carjackings, home invasion and even kidnapping gets imported into New Zealand with billions concentrated to just 600 outlets.

“Even security vehicles would become targets for armed hold ups after collecting cash in rural areas. The Government and its Wellington minions don’t understand there are few bank branches and Police are stretched. Some outlets are an hour from Police too and no good will come of that.

“This is all brilliant stuff for the gangs. Take one outlet for Mangere in Auckland. Does the government include or exclude the Airport Duty Free store and those in Wellington, Christchurch and Queenstown?

“At the Health Select Committee, a Labour MP asked why there were more cigarette outlets in South Auckland than in the rich eastern suburbs. That’s because there are many more smokers, so the gangs get a free market for “ciggie houses” with just one, or even, no outlets in Mangere.

Robbery and violence aren’t the only likely consequences of this legislation, it will also give criminals another product to sell.

“It invites the gangs to set up ciggie houses. No outlets for Patea in Taranaki, or In Northland’s Kaiwaka and Mercer, Drury and Clevedon near Auckland down to Tapanui in Southland, yet there’s six outlets between Paekakriki and Waikanae in Wellington.

“Meanwhile they map eight outlets in the deep south on SH6 after Wanaka heading to Jackson Bay on the Coast where few people are, but none for the Chatham’s or Stewart Island.

“So, is the government planning to gift the supermarkets billions more in sales? Aside from crime, it would see struggling families sacrifice food for tobacco during their main shop. That’s less of an issue with us, as people split such purchases with dairies and service stations.

“While we have a crime emergency fuelled by taxes that make tobacco worth a lot more than silver, the government’s concentration of cash and valuable stock into 90% fewer outlets will see larger and more vicious crime. Our blood is on this government’s hands,” Mr Kaushal said.

It is now 78 days (2 months and 17 days) since we met and gave our manifesto to the police minister for no reply. We have previously asked Dr Verrall to meet and never got a reply either. 

There is a much better way to discourage smoking.

Very few people start smoking as older adults.

If the purchase age was increased to 25 it would make it much harder for younger people to start smoking and most people are sensible enough by that age to choose other vices.

 

Another tragic tally

A tragic tally:

As 2022 came to a close, the Ministry of Transport’s road toll count reached a provisional figure of 378 people killed on New Zealand roads during the year.

The 2021 and 2020 final road tolls both reached 318 road fatalities in each year – meaning this year’s toll surged 60 people higher.

That increase in deaths is equivalent to about two classrooms full of people more who were killed on our roads in the last twelve months, compared to the previous years. . . 

Waka Kotahi has spent a lot on bureacratic back-patting propaganda while the state of the roads has deteriorated.

But comparing last year with the two before doesn’t tell the full story when Auckland was fully locked down for months and the rest of the country was restricted for shorter periods in 2020 and 2021.

Bryan Sherritt, the director of Road to Zero, the ambitious Ministry of Transport project to reduce road deaths told RNZ in July that New Zealand’s road toll figures were “diabolical” and “still unacceptably high”.

However comparing annual tolls year-on year was not particularly helpful, because of “natural variation year-on-year”, Sherritt said: “What you should be comparing is more around like a five-year average, how we’re tracking against that … a longer term approach.”

The final road toll five years ago (2018) was finalised at 378 deaths in that year, meaning at this point the 2022 provisional tally eerily mirrored the same figure.

Sherritt said the speed and geographic spread with which the country improves roading infrastructure and enforcement and policing of road rules were key to reducing the number of people killed on the roads in the future. As is improving the policies surrounding roads. . . .

The focus should be on potholes not propaganda.

More needs to be spent on improving the roads, including more multi-lane stretches and median barriers; and more focus on deterring drunk and drugged drivers and those who travel well in excess of speed limits.

But there’s another tragic tally that rarely makes the headlines – the toll ovarian cancer takes.

It’s the deadliest of the five gynaecological cancers.

It kills more women in New Zealand than die on the roads and most years little or nothing is spent by the government on raising awareness of the symptoms, improving access to diagnosis, and research to improve treatments and outcomes.

Signs and symptoms include:

• Bloating
• Eating less and feeling fuller
• Abdominal/pelvic/back pain
• Needing to pee more or urgently
• Changes in bowel habits
• Indigestion
• Abnormal vaginal bleeding* or discharge
• Pain during intercourse
• Fatigue
• Unexplained weight change

So how do you know if it’s something you need to pay attention to?

We call it the TWO WEEK RULE. If it hasn’t gone away for good after two weeks – you should tell a doctor. Even one symptom is enough to mention. Especially if it’s a new change, or unusual for you, or getting worse.

Most of the time, it won’t be ovarian cancer but it’s really important to get checked, because the quicker ovarian cancer is found, the easier it is to treat.

*Abnormal bleeding should always be checked regardless of duration.

You can learn more here.

#KeepTalking

RSABI has adapted Silent Night to help tackle rural loneliness:

A host of famous farming faces have united to record an adaptation of “Silent Night” to raise awareness of the potential for loneliness in the Scottish agricultural community this winter.

The adapted version of the carol was pulled together by RSABI, the charity which supports people in Scottish agriculture, as part of its #KeepTalking campaign to encourage people in Scottish farming to look out for each other this winter.

While the standard of the singing varies in the recording, the message prevails that the winter months can be particularly challenging for farmers and crofters and a visit or a kind word or two can make a huge difference.

Lyrics such as “So pick up the phone and mak’ someone’s day, It’s no the weather to be out makin’ hay” and “talk to someone – we care” are sung by famous faces including The Hoof GP, Graeme Parker; Landward presenter, Cammy Wilson from SheepGame; shepherdess, Emma Gray from This Farming Life and comedian Jim Smith.

A host of auctioneers from around the country also sing their hearts out in the recording, including Jim Craig (James Craig Ltd, Ayr), brothers Scott and Fraser Chapman and Colin Slessor (ANM, Thainstone), Graham Low (Orkney Mart) and Farquhar Macrae (United Auctions, Huntly).

Others appearing in the recording include; Graham Bruce, Managing Director of Ringlink and his team; Lucy Mitchell, Chair of Scottish Association of Young Farmers Clubs; Joyce Campbell and some of the Armadale Farm team; and Martin Kennedy, President of NFU Scotland with his daughter Katrina.

RSABI trustees Jimmy McLean and David Leggat, and staff members Mary Anne McWilliam and Carol McLaren also take part in the recording, along with supporters Christine Cuthbertson, Lorna Paterson and Kevin Gilbert.

The light-hearted video which the charity hopes will raise a few smiles, has a serious message at its core as it aims to raise awareness of people of all ages in farming communities who may be more vulnerable to loneliness and isolation during the winter months, with little daylight, freezing temperatures and worries about cost of living and rising input costs.

The song is part of RSABI’s #KeepTalking campaign which is urging people to look out for signs that someone may be struggling with their mental health and, if they spot anything of concern, to have the confidence to reach out and encourage them to get support from organisations like RSABI.

Talking about the video, RSABI Chief Executive Carol McLaren said: “We’ve had incredible support from friends and colleagues in the farming community and our thanks go to everyone who helped us record the song.

“There is no doubt that the standard of the singing varies through the verses but that is part of what makes it so special, and our hope is that it not only raises a smile but also reminds people to look around them to see who could do with some support.

“The winter months are traditionally a tough time for farming folk, with mud and cold to contend with very often working long hours on their own. It can be easy to get a bit down and we hope that watching the video will inspire people to reach out to someone they haven’t heard from in a while. Just a small gesture could make a massive difference to how someone is feeling.

“RSABI offers emotional, practical and financial support. A free, confidential support service is available 24/7, including over Christmas and New Year. Please don’t hesitate to get in touch by calling Freephone 0808 1234 555, emailing helpline@rsabi.org.uk or using the webchat service on our website.”

The Silent Night video is just one in a series of initiatives by RSABI encouraging farmers to #KeepTalking and supporting good mental health in people of all ages involved in farming and crofting this winter. RSABI is raising awareness of the ‘Carols at the Marts’ events across Scotland and is trialling a Thrive mental wellbeing app in partnership with the Scottish Association of Young Farmers’ Clubs (SAYFC).

As the temperature plummets, the charity is also reminding people about its Help for Heating grants available to people struggling with the costs of heating their homes.

 

 

 

‘Incredibly dangerous’ cuts to hospital

The government that has wasted millions of dollars restructuring the health system is downsizing the new Dunedin Hospital:

Cutting beds and operating theatres at the new Dunedin Hospital to help save $90 million has been slammed as “incredibly dangerous”.

The Government yesterday announced $110 million in additional funding for the project to address a $200 million budget blowout, with design cutbacks to the value of $90 million to make the difference.

National Dunedin list MP Michael Woodhouse was critical of what the changes would mean for the $1.47 billion project’s future ability to service the area.

The hospital will now have 398 beds, 23 fewer than the 421 beds identified in the hospital’s final business case.

Operating theatres have also been cut, from 28 to 26, while the three MRI scanners have been reduced to two and the Pet CT scanner will be installed later.

The changes will all be made to the larger inpatient building, although the pavilion building and one link bridge between the inpatient and outpatient buildings will also not go ahead.

Enough space will be set aside for 12 more beds, two more operating theatres and an additional MRI scanner to be added in future.

The southern area had a growing and ageing population, and required a bigger hospital than was now set to be provided, Mr Woodhouse said.

The planned design had been only just sufficient before changes were made.

“The 421 beds was the bare minimum to run a viable hospital for the South in the 21st century.”

The problem would have been avoided if the Government had not dragged its feet on the project as costs increased, as there had been a five-year wait already, he said.

Further delays would result in further cost increases. . . .

When Labour took power in 2017 a committee was already working on plans for the new hospital.

For purely political reasons the government sacked that group and appointed a new one which wasted time.

Then came the decision on siting the new building where Cadbury’s factory was.

The only good reason for that was proximity to the Medical School.

I can see no other for siting it between the two one-way streets which are part of State Highway 1.

It will cause traffic disruptions during construction and on-going problems for access and parking for staff, patients, ambulances, tradespeople and visitors.

Choosing this site has also incurred the extra expenses, and added time, of demolishing the factory.

Now the hospital which serves all Otago and Southland will have 23 fewer beds, two fewer operating theatres, two MIR scanners instead of three, a delay in the installation of the PET CT scanner and the planned pavilion building and a link bridge between inpatients and outpatients won’t go ahead.

Labour’s mismanagement has added costs and reduced the build which will negatively impact services and conditions for staff and patients.

Had it not undertaken the radical surgery on the health system, it would have a lot more than the $90 million that’s been amputated from the hospital build.

Falling from first world

A health system in crisis, serious failures in education, shops barricading windows and doors to protect their staff and sock from thieves, airlines told to conserve fuel for fear of a shortage, escalation in ram raids and other violent crimes. . .

That could be the norm in second-world countries, it’s not the New Zealand we used to know.

The prospects of continuing high inflation, more interest rate increases and rising unemployment add to the gloom.

The deterioration hasn’t been sudden, but the pace of it appears to be worsening and it’s beginning to feel like the country is falling from the first world.

Ask Me Anything – Rachel Smalley

On this week’s episode, Paula is joined by broadcaster and founder of The Medicine Gap, Rachel Smalley. They discuss Smalley’s time as a journalist and her year in the public service and what she learned there, before digging into her work with The Medicine Gap, highlighting the New Zealanders who are unable to access the medicines they need to treat their conditions. 

‘It beggars belief ‘

Take 608 acute mental health beds, add $1.9 billion and how many beds do you get?

When Labour came to power the country had 608 beds for acute mental health patients.

Five years and billions of dollars of health funding later, New Zealand still has 608 beds for acute mental health patients. . . 

Back in 2019, the Government announced a $1.9 billion programme to fix it up. But Newshub can reveal there are exactly the same number of acute mental health beds now as there were when Labour took office. . . 

In 2017, there were 608 beds. It’s fluctuated since then, reaching a peak of 619 in 2021, but now we’re back where we started at 608 beds.

608 + $1.9 billion = 608? That doesn’t compute.

An increase of 11 then back to where it started, how can that happen?

“It’s quite astonishing that the Government has gone and spent $1.9 billion of taxpayers’ money on mental health and we don’t have a single extra mental health bed available,” said National leader Christopher Luxon.

“You’ve gotta ask the questions, where has the money gone?”

That’s a very good question which doesn’t appear to have any very good answers.

Little said it’s “taking way longer than it should do, but there is progress now evident”.

Is it evident to the people needing beds and the people looking after them?

Is it evident to the people who expect very big things from spending very large amounts of taxpayers’ money?

Now new documents reveal it’s still so bad ministers have directed their implementation unit to team up with the Infrastructure Commission and “complete a deep dive” into each of the 16 Mental Health Infrastructure Programme projects and create a delivery plan that “ensures projects gain momentum and get moving”.

“The funding was available from 2019, the commitment was available from that time. It still beggars belief for me that it has taken this long to get those things going,” Little said. 

It beggars belief for mental health patients too. . . 

It also beggars belief for anyone who expects governments to make a positive difference with the spending they authorise.

It beggars belief that someone in charge of this debacle hasn’t been sacked as anyone in the private sector would be.

It beggars belief that after five long years, no-one in the government has learned that making announcements doesn’t magically make things happen and that they are responsible for ensuring that money spent makes a positive difference and does so in a reasonable time.

Rural round-up

Farming leader pleads with PM for more time – Peter Burke :

A dairy industry leader is calling on Prime Minister Jacinda Ardern to take the pressure off farmers and give them more time to properly understand and digest the huge raft of changes that the Government is trying to push through before next year’s election.

Ben Allomes told Dairy News that the Government has a number of things they want to achieve before the next election and he says most of these seem to be aimed at the primary sector.

These include greenhouse gas emissions, water quality, animal welfare and labour.

Allomes says this is on top of farmers trying to deal with the uncertainties around Covid, such as disrupted supply chains and increasing costs, all of which are creating an uncertain business environment. . .

The seven significant setbacks to He Waka Eke Noa recommendations – Jim van der Poel:

 DairyNZ chair Jim van der Poel outlines why his organisation is not prepared to accept the He Waka Eke Noa proposal in its current form and why it’s a poor option for the sector and New Zealand as a whole.

When the primary sector took on the challenge of an emissions pricing alternative, there was a clear goal – to secure the best possible system for farmers and the climate.

In 2019 the Government legislated to put agriculture into the Emissions Trading Scheme (ETS). We believed that was a poor option for the primary sector and for New Zealand.

We approached the Government to have the option to come up with a better proposal that was fairer, more practicable for farmers and would deliver better outcomes. . . 

Last nights photo. Forgot to get one earlier in the day. pic.twitter.com/ql2SUh8wzT

— Sharon Paterson (@Dayzie72) November 14, 2022

Kiwifruit growers fear ‘zero income’ next year after severe frost :

Some Waikato kiwifruit growers will have no income next year and others will have crops that will not cover the cost of production, following a heavy frost in October.

Waikato is a smaller growing region with about 500 hectares of fruit; an additional 100 hectares was planted this winter.

A grower with 22 hectares, Richard Glen, said it had taken until now to get his head around the full impact of the October frost event.

Glen said it was the worst frost he had seen in his 40 years of growing. . . 

Hi-tech traps on trial in fruit fly surveillance programme :

Biosecurity New Zealand’s National Fruit Fly Surveillance programme is trialling 60 state-of-the-art traps, with the aim to bolster the detection of exotic fruit fly.

“We have a world-class biosecurity system, but the growth in global trade and travel increases the opportunity for fruit flies to enter the country,” says Biosecurity New Zealand Director Diagnostic & Surveillance Services Veronica Herrera.

“Exotic fruit fly incursions could significantly impact New Zealand’s horticulture industry, so early detection is critical.”

The fruit fly surveillance programme runs from September to July each year to coincide with the heightened risk of fruit flies entering New Zealand. More than 7,800 traps are currently stationed across the country. . . 

Zespri rolls out SAP technology to support its people, processes and growers :

SAP SE (NYSE: SAP) today announced that Zespri, the world’s biggest marketer of kiwifruit, has gone live with SAP S/4HANA Cloud, private edition. The move will support Zespri’s ability to deliver the highest quality fruit to market and sustain strong returns to growers.

The go-live of this new technology, which took place on 1 November 2022, is the first phase in Zespri’s ambitious, multi-year Horizon transformation programme. The aim of the programme is to standardise and automate Zespri’s processes, increase its operational efficiency, and provide a platform for growth and innovation.

As a result of the implementation, Zespri hopes to deliver kiwifruit to customers more effectively. Ultimately a more robust, transparent and reliable process will support its entire product delivery system, from the receipt of a sales order, to payments for product, through to distribution. Zespri’s quality management solutions will include proof that the product has been grown and handled in accordance with regulatory, customer specifications and consumer expectations.

With a focus on creating global consistency, almost 1,000 full-time employees and contractors across offices in 17 countries will benefit from the implementation, with Zespri also undertaking its biggest-ever training programme. . . 

Good example of someone’s vision & efforts for shade & shelter on their farm. pic.twitter.com/TtpPgJzje3

— 🚜Paul McGill ☘🐑🌳🐂🌾🏏🌽🌲🏉🏇🏽🥐🥩🍻🧶🎾♥️🌏 (@PaulBMcGill) November 14, 2022

The fake meat scam -Dr Joseph Mercola:

• Ultra-processed foods typically have five or more ingredients, many of which are not commonly used in home kitchens. This aptly describes the Impossible Burger and Beyond Burger, including fake blood processed from genetically engineered yeast to mimic the taste and texture of real beef.
• Although the soy-like hemoglobin used in the Impossible Burger is classified as generally recognized as safe, no tests have been done by independent labs on the product’s safety. However, tests on lab rats altered the animals’ blood chemistry; the company did not follow up on the results.
• The parent companies for Impossible Burger and Beyond Burger commissioned studies to assess the environmental impact of production against typical concentrated animal feeding operation (CAFO) beef production. Not surprisingly, they found their product had a lower impact. But it’s not nearly as low as the beef production at White Oaks Pastures, which uses regenerative farming practices to produce natural beef products.
• If a plant-based, genetically engineered (GE) meat alternative is not enough of a science fiction adventure, consider the “meat” scientists are growing from stem cell cultures in the lab. Some see these alternatives as the lesser of two evils, but when holistic herd management improves the environment, your best choice is to seek food from natural sources.

Rural round-up

Middle NZ: we might not be able to see the food for the trees –  Linda Hall:

It’s a bit scary, really — thinking about what our beautiful country is going to look like in 50 years.

I won’t be around to see it, but my grandchildren will, and their children.

I wonder where they will grow their food.

Will they be able to drive between Hawke’s Bay and Dannevirke and look out on lush green grass with sheep and cows grazing? Or at paddocks full of pumpkins and sweetcorn? . .

SDC loses major legal battle against Te Anau Downs Station – Michael Fallow :

The Southland District Council has lost a four-year $1m legal battle with Peter Chartres, of Te Anau Downs Station, and now faces the prospect of costs recovery.

The council went to the Environment Court in April seeking an enforcement order to prevent any further indigenous vegetation clearance on the station, and to require significant remedial work.

Chartres welcomed the ruling clearing him of unlawful clearances dating back to 2001 and said the council’s approach had been overzealous.

“These enforcement proceedings are an example of the time and money that gets wasted when poorly drafted, unworkable rules are misinterpreted, implemented and enforced by local councils,’’ he said. . . 

Rural health network calls for action on ‘massive issue of rural inequity’ –

Hauora Taiwhenua has put together a roadmap for how the rural health service can be pulled off life support.

The rural health network’s document Christchurch Consensus was formed after the National Rural Health Conference attended by about 400 rural health professionals in September.

It includes key priorities such as streamlining immigration rules to get more health workers into the country and boosting investment in training.

Chair Fiona Bolden said the document was fuelled by the sheer frustration of health workers in the rural sector. . . 

New research by @AgResearchNEWS confirms NZ beef & lamb is among the most carbon efficient in the world. The study shows NZ sheepmeat has a cradle to grave carbon footprint of just under 15kgs of CO2 equivalent emissions per kilo & NZ beef is just under 22kgs. pic.twitter.com/u0BSoykfvJ

— Beef + Lamb New Zealand (@NZBeefLamb) November 8, 2022

Research on carbon footprint of beef and sheep meat published:

Our newly published research into the full life-cycle carbon footprint of New Zealand’s beef & sheep meat has found that it sits at the lower end of published estimates among producers globally, despite distance from markets. Read the published research here.

This research is jointly funded by the Ministry for Primary Industries, Beef + Lamb New Zealand and the Meat Industry Association; and the Beef + Lamb NZ statement today on the research – which also features the use of GWP* as an alternative metric for methane – is here.

AgResearch scientist Andre Mazzetto says:

“Accurately measuring and reporting the carbon footprint of products has never been more critical, especially for New Zealand products such as beef and sheep meat that are exported over considerable distances. Thus, it is important to understand the extent of greenhouse gas emissions throughout the various stages of the life cycle of these products. 

This Life Cycle Assessment (LCA) study calculated the cradle-to-grave (i.e. full life-cycle) carbon footprint of beef and sheep meat produced in New Zealand and exported to different markets. The carbon footprint for the cradle-to-farm gate (raising of the animals) represented 90–95 per cent of the cradle-to-grave for both beef and sheep. The meat processing stage contributed 2–4 per cent of the carbon footprint, while post-processing was 2–6 per cent. This standard LCA study showed that NZ beef and sheep meat products have a full life-cycle carbon footprint at the lower end of other published estimates globally, despite the emissions generated from transport and freight to overseas markets. . . .

Not only the frost – Peter Burke :

One long time kiwifruit business person is describing this and probably next year as the worst they can remember.

It’s an unusual situation because the Zespri averages of fruit damaged by the frost don’t paint an accurate picture of what individual growers are facing.

For example, while the RubyRed crops appears the worst affected, it’s likely that the same grower may also have crops of Green or SunGold which could mitigate some of the financial hardship.

It would be unusual, we are told, that a grower would have just one variety. . .

Our farm dam with the setting moon pic.twitter.com/E5yTHLsgcT

— David Williams (@david_vacy) November 7, 2022

Tech critical to reduce NZ emissions :

The idea that New Zealand can reach its emissions targets without relying heavily on technology and innovation has always struck the tech ecosystem as strange, NZTech chief executive Graeme Muller says.

Last week, the lack of any mention of technology in the government’s emission reduction plan was acknowledged as an oversight, according to climate change minister James Minister Shaw.

“This comes as Spark released a detailed analysis of how digital technologies could help New Zealand meet its emissions reduction targets,” Muller says.

“The study found 7.2 million tonnes of CO2 emissions, or 42 percent of the country’s 17 million tonne reductions needed by 2030, could be found by using enabling digital technologies. . . 

Mood of the show

“Just get it done!”

This was the message I heard a woman at the *Christchurch Show give to National leader Christopher Luxon and it summed up the mood of many who talked to me.

It’s three years since the last A&P show in Christchurch and the mood then wasn’t positive.

Then, two years into the Labour-New Zealand First government, there was lots of criticism of them but also reservations about National.

Three years on the mood against the government has hardened.

People are very, very angry and upset about the wasteful spending, anti-farmer and other divisive policies and disdain for democracy; and worried about how much worse things will get before there’s a change of government.

The mood towards National is much, much more positive.

Wednesday and Thursday at the show usually attract a lot of farmers and people involved in agribusiness who are more likely to be at the blue or yellow end of the political spectrum but not since the ag-sag of the 1980s have I heard such vehemence against the government and such strong support for change.

Agitation over taxing farm emissions with the threat of one in five sheep and beef farms being killed off, good pastoral land being planted in pines and 13,000 job losses – that’s the total population of Oamaru – was expected.

So too was concern over impractical regulations, the imposition of extra costs and the threat of unfair pay agreements.

But people who spoke to me were just as concerned about the crises in health and education, worker shortages and the related immigration debacles, crime and the cost of living crisis.

The radical policies of the Lange-Douglas Labour government that led to the ag-sag generated a lot of angst at the time. There are valid questions over how it was done but I don’t know anyone who now thinks it shouldn’t have been done.

Those changes were hard at the time but farming, and the country, are stronger because of them.

The changes this government is foisting on not just farmers but the wider economy, environment and society are adding long term costs without even short-term benefits.

If the mood of the show is a barometer of wider opinion, the chances of Christopher Luxon being in a position to “get it done” are good but they are not certain and the worry remains of just how much worse things will get before a National-led government can “get it done”.

*I know it’s now the New Zealand Agricultural Show, but most still call it the Christchurch Show.

Highest priority for $211m a year

Jacinda Ardern was asked what she’d do if money was not a factor.

Her answer, to make all pre-school education free was, as Lindsay Mitchell points out addressing a symptom, not a cause:

Why pose such a redundant proposition when governments are scrambling to spend less? Well, most governments.

But then I thought the answer might shed light on just how naive and ineffective the PM is.

Her big idea? Free early childhood education. 

“I’d make it completely free. Completely free. And when I say completely free, I’d also give choice to families about at what point and stage their child accesses it. Because for some we know it provides stability to kids that they might not have in their home life.”

Hang on. Back up. Isn’t this putting the cart before the horse?

Perhaps you need to address why ‘some’ kids don’t have stability in their home life.

You’ve already thrown a whole lot more money at the problem due to the first wrong diagnosis and now there are thousands more children in unemployed homes. Dare I say it, unstable homes. 

But let’s look at the evidence the PM might be inclined to take heed of. Evidence produced under her own administration.

Whether or not early childhood education improves outcomes for children is at best controversial. . . 

No-one can fault the goal of improving outcomes for children but free ECE wouldn’t be the best way to do it, even if money wasn’t a factor.

No doubt the PM was thinking about the announcement she made later on about increasing childcare subsidies.

The package included increasing thresholds for the subsidies and adjusting Working For Families for inflation.

That does beg the question of why increasing those thresholds and adjusting those payments for inflation is good when, they say,  increasing thresholds for tax brackets and adjusting them for inflation is not.

It also raises questions about priorities for Labour and its leader when money has to be a factor.

One of its priorities appears to be merging RNZ and TVNZ, the rational for which has yet to be properly explained, the cost of doing which is higher than the combined value of the two entities, and now we learn TVNZ will lose $100 million in advertising a year.

The Government’s new public media entity will witness the loss of a third of TVNZ’s existing commercial revenue, equating to about $100 million a year, within five years, according to advice from officials.

This lost revenue will need to be supplemented by taxpayer funding from the Crown, which is forecast to contribute $211m a year to the entity over 30 years, roughly half of which will be used to plug the shortfall in advertising.

The commercial details were revealed in a late draft of a business case for the Government’s RNZ-TVNZ merger, obtained by the National Party.

The party’s broadcasting spokeswoman Melissa Lee said the documents showed the Government was wilfully destroying TVNZ’s commercial model and forcing the taxpayer to pick up the tab. . . 

It’s difficult to believe anyone in the government can think this is a good use of so much money and it would be hard to find anyone in the general public who would think it is, even if it wasn’t going to be borrowed money.

It would be very easy to think of much higher priorities for $211m a year over 30 years – helping people on benefits who could work into work, which would help improve outcomes for children,  and increasing health spending to address the many factors contributing to the crisis in that sector would two of them.

‘You can’t fix a problem until you know what the problem is’

Over at The Common Room, Mike King says you can’t fix a problem until you know what the problem is:

Mental Health advocate Mike King uncovers some surprising suicide stats around the 2011 Christchurch earthquake, and shares his thoughts on dealing with bullies and drug dealers.

Red meat’s place in diet

Diana Rodgers answers the question: where does red meat fit in a modern diet?

Taxpayer talk – Des Gorman

Peter Williams interviews Professor Des Gorman at Taxpayer Talk:

On this week’s episode of Tax Payer Talk, Peter Wiliams speaks to Des Gorman – Emeritus Professor of Medicine at Auckland University – about a new paper from the New Zealand Initiative which claims that evidence for a separate Maori Health Authority is seriously lacking. Peter then reads your correspondence.

What’s happened to balance?

David Farrar has made a rare, for him, complaint to the media on reporting the results of an online survey as a poll:

Readers might not understand the difference between an opt-in survey and a poll that follows the country’s polling code and being told that one candidate is a clear favourite might influence votes.

Whether this is a deliberate attempt to help the candidate in question is moot, but deliberate or not it could and it’s not something any serious media should do.

Extensive coverage in last week’s Listener of a Nelson mayoral candidate, Matt Lawry could also be seen as an attempt to influence voters.

Four and a half pages cover him, one the other candidate, Nick Smith, gets just half a page, the other five candidates don’t get even that.

Bob Jones notes:

. . .Smith, unsurprisingly given his engineering doctorate, played a key role as a senior Cabinet Minister in the rebuilds following the Christchurch and Kaikoura earthquakes.

In the year since his retirement he’s been involved in creating a windfarm. It will be interesting to watch the outcome of this election between a talker and a doer. 

But The Listener gave more than four times coverage to the talker than it did to the doer.

What’s happened to balanced reporting? It’s important at any time and even more so in the run up to an election.