Slack and late

04/06/2021

Oh dear, government rhetoric isn’t matched by performance yet again:

Newshub can reveal just over 60 percent of a group labelled ‘high-risk’ by the Government are yet to receive their first vaccination to protect them against COVID-19. 

They include frontline health workers, those in long-term care, and older Māori and Pacific people. 

And only half of another high-risk group – those who live with border workers or managed isolation and quarantine (MIQ) employees – have received their first jab. . .

When it comes to getting vaccinated against the virus, the public messaging has been clear: we’re exceeding Government goals and doing well. When it comes to getting vaccinated against the virus, the public messaging has been clear: we’re exceeding Government goals and doing well. . . 

But Newshub has obtained Ministry of Health data that tells a different story when it comes to some of our highest-risk groups. 

“I think we’ve seen a lot of self-congratulatory talk by the Government,” said Otago University public health professor Nick Wilson.

“We should be really pushing the vaccination programme at a much faster rate.” . . 

The government’s claim to have gone hard and early in its response to Covid-19 was debatable.

The glaring gap between what they say and what’s happening with the vaccination roll-out is even worse – it’s both slack and late.

That poses a health risk to everyone who is unprotected and leaves us all with the threat that, like Taiwan and Victoria, we could be subjected to another lockdown.


Are we surprised?

19/05/2021

We might have sympathy for a ‘technical anomaly’ that requires a law change because the government’s approval of the Pfizer vaccine went beyond what the Medicines Act allowed.

But that sympathy doesn’t extend to two other health related news items:

Auditor-General John Ryan has raised major doubts about whether everyone will be vaccinated for Covid-19 by the end of the year.

He has released his review of the government’s roll out plan, outlining several shortcomings in the government’s plan.

He outlined worries about enough supply, about the number of vaccinators, about reaching remote communities and about confusion among district health boards.

“Problems were inevitable for a rollout of the scale and complexity of this one,” Ryan said.

“I am not yet confident that all the pieces will fall into place quickly enough for the programme to ramp up to the level required over the second half of 2021. There is a real risk that it will take more time than currently anticipated to get there.”

The lack of vaccinators posed a “significant risk” to getting the rollout done on time, and the Ministry of Health should get moving on the non-regulated workforce – non-medical workers who would be trained to immunise, Ryan said. . .

It’s not difficult to share the AG’s lack of confidence when persisting issues with our contact tracing capacity, with staff during the so-called Valentine’s Day cluster at risk of burnout despite dealing with just a handful of cases.

Emergency planning documents from the February outbreak have been obtained, which show concerns were flagged about “limited resources” almost immediately. 

At the peak of the outbreak, with just 15 active community cases and 160 people to follow up within a day, the majority of staff were not working sustainable or appropriate hours. 

It’s raised concerns with how we’d cope with a significant outbreak – like what Taiwan is currently experiencing, with 700 local cases over the past week. . . 

It’s also raised concerns, added to by the AG’s report, that assurances that everyone who wants to be vaccinated by the end of the year will be.

If the Ministry can’t cope with a relatively small and localised challenge, how can we have confidence it will cope with a nationwide roll-out of the vaccine?

And are we surprised this looks like another government initiative where the promise won’t be matched by the delivery?


Does this give you confidence?

08/04/2021

The ODT reports that setting up the southern Covid-19 vaccination system has taken staff away from other immunisation programmes and is using people who might otherwise be contact-tracing.

Covid-19 vaccination centres in Dunedin’s Meridian Mall and in Invercargill began injecting frontline health workers last week, and have also been delivering second doses of the vaccine to port workers.

Public Health nursing and immunisation vaccinators and administration staff were doing much of the work at present, southern vaccine rollout incident controller Hamish Brown said.

This was affecting the Southern District Health Board’s MMR vaccination catch-up campaign, B4 schools check, HPV vaccinations and other school-based programmes.

“This is also using staff who would also support contact-tracing work for Covid-19 cases.” . . 

Does this give you confidence that any of these programmes are being, or will be, done well?

“There have been a few teething problems, as you can imagine with an operation of this scale, but our teams have been able to resolve issues as they have cropped up, and on the whole the clinics have run very smoothly,” Mr Brown said.

However, in a report to be considered by the Southern District Health Board on Thursday, Mr Brown said a national Covid-19 vaccination booking system was at least a month away and southern health officials were relying on electronic diary Outlook calendar in the interim.

“There is currently no robust booking system in place, and the existing hospital booking system does not meet the requirements for the programme.

“An interim booking system…has been put in place to manage the immediate need to book in household contacts for the next few weeks.”

Southern and other DHBs had worked together to find a suitable booking system and discussions were ongoing with a possible provider, Mr Brown said. . . 

We were told months ago that we’d be at the front of the queue for Covid-19 vaccinations. We aren’t, and that has given more time to get the logistics sorted so that the programme runs smoothly.

If there are all these problems this early, when a relatively small number of people are being vaccinated, how confident can we be that they will be solved when mass vaccination is under way, and that other programmes, including annual ‘flu vaccinations, won’t be compromised?

Chris McDowall’s report on the Ministry of Health’s opaque and messy handling of public health data on Covid-19 vaccination progress.

. . .  Without published statistics, media briefings are our only source of truth about how the rollout is progressing.

Slip-ups and an absence of detail detract from public confidence, potentially creating space for anti-vaxxers and conspiracy theories.

We will continue to request data about the vaccine rollout from the Government and follow up outstanding questions. We hope the Government will start making this data freely available.

And then there’s this:

Not only is New Zealand second bottom in the OECD for the number of Covid-19 vaccinations but in information leaked to National we are nowhere near where the Government planned for us to be back in January, National’s Covid-19 Response spokesperson Chris Bishop says.

“Leaked data shows that at this point in the vaccine roll out, a cumulative total of 390,413 vaccine should have been administered, but only 90,286 have been so far, a pathetic 23 per cent.

“After promising New Zealanders we were at the front of the queue for Covid-19 vaccines, nearly every other country in the OECD is now ahead of us, with just Japan behind New Zealand.

“We aren’t at the front of the queue – we are at the back.”

As of yesterday, New Zealand has administered just 1.9 doses per 100 people in our population.

The countries ahead of us include Australia (3.31 per 100 people), Singapore (25.95), the United Kingdom (54.52) and the United States (50).

“Australia has recently been criticised for the slow pace of its vaccine roll out, but New Zealand is even worse and there’s no sign we’re picking up the pace,” Mr Bishop says.

“National is deeply concerned about the vaccine roll out.

“Three of the four necessary IT systems for our roll out aren’t ready, DHBs are contracting their own booking system solutions with disastrous results, the Government refuses to set a target for the percentage of the population to be vaccinated, and we’re still unclear who will be vaccinated when.

“The Government hasn’t even begun a proper communications campaign to educate New Zealanders about the vaccine. New Zealand’s economic and social future is relying on a successful vaccine roll.

“The public should have daily access to how we are progressing in our Covid vaccine roll out, they shouldn’t have to rely on leaked information to Opposition parties.

“As more countries vaccinate their populations New Zealand risks being left behind. They will start opening up trade and travel to each other while we, a country where our prosperity depends on international connections, will lag behind.

“The elimination of Covid-19 in New Zealand should have been an opportunity for us to recover more quickly than the rest of the world. We are at risk of wasting this through a slow and ineffective roll out.”

The government, ministry and DHBs need to urgently improve the logistics of the vaccine roll out, and data releases, to ensure we can all have confidence in what’s being done, that it will be done well, and to provide no space for anti-vaxxers and conspiracy theorists.


Is the ‘flu vaccine late?

31/03/2021

Last week I went searching for news on the ‘flu vaccine programme and came across a page with the Ministry of Health policy:

From 2019 the Annual Influenza Immunisation Programme (the Programme) will start from 1 April each year.

This start date differs from previous years when the Programme started as soon as the influenza vaccine became available, generally by early March. The Ministry has considered a range of factors in making this decision including: emerging evidence on the effectiveness of influenza vaccines, influenza surveillance data, the impact of the start date on service delivery and feedback from the sector.

The start date from 1 April will be subject to the vaccine being available for distribution across New Zealand by then. Changes to vaccine strains can result in longer manufacturing lead time and the arrival of vaccines in late rather than early March.

Duration of influenza vaccine protection

New evidence shows that vaccine effectiveness begins to decline after influenza vaccination. Maximum protection from influenza is observed around two weeks after vaccination and starts to decline by about 7 percent every month. . . .

Influenza activity may occur throughout the year with the peak incidence during the winter months. New Zealand’s surveillance data shows that the peak has moved to August in recent years. Influenza surveillance data and the shift in peak influenza activity, in conjunction with declining vaccine effectiveness supports a change in the start date. The programme start date from 1 April ensures better protection against influenza during the peak incidence particularly for our most vulnerable populations.  . .

That all seems reasonable but yesterday I checked the MOH website and found this:

The 2021 Influenza Immunisation Programme will commence on 14 April 2021, with a two-week priority period for people eligible for a free influenza vaccination. These dates are dependent on approval by the regulator. 

We ask vaccinators to focus on immunising those who are eligible for a funded vaccination for the first two weeks of the programme to protect as many of those who are at greatest risk first, well ahead of the influenza season.

The first week of the prioritisation period is only for adults aged 65 and over and there is an additional vaccine this year that is specifically intended for this population.

The second week of the prioritisation period, from 21 April, extends to all those eligible for a funded vaccination.

Vaccination can then be extended to include the general population from 28 April 2021. . . 

April 14 is two weeks later and April 21 three weeks later, than the policy to start the programme on April 1.

That probably won’t matter for the people on the priority list.

But if the general population doesn’t start to get their vaccinations until 28th of April and the vaccine doesn’t reach maximum effectiveness for two weeks, are most people going to be at risk of contracting the disease before they’re protected?

Perhaps I’m being paranoid when there are so few people coming into the country, the risk of ‘flu might be much less than it would have been pre-Covid.

But this is the Ministry that bungled the measles vaccination. It’s also the Ministry that swore black and blue that there was plenty of stock for last year’s ‘flu vaccination rollout while those on the ground who were supposed to be administering them were saying there wasn’t, and they were eventually proved right.

It’s also the Ministry that’s in charge of the Covid-19 vaccination programme, for which we haven’t been told a plan, and for which there is no target:

National is calling on the Government to make a statement of intent about protecting New Zealanders from Covid-19 by setting a target of having at least 70 per cent of the adult population vaccinated, National’s Covid-19 Response spokesperson Chris Bishop says.

“New Zealand is one of only a few countries in the OECD that doesn’t have a target for how many adults should be vaccinated. The others are Colombia and Mexico.

“Almost all countries are setting a vaccination target – usually 70 per cent of the adult population – and a date for achieving that target. New Zealand isn’t doing this either.

“The best the Government can say is that it wants all New Zealanders to be offered a vaccine by the end of the year. This isn’t good enough.

“We should be setting an ambitious target and going for it. A target will make sure the health system is focused, and means vaccination progress can be meaningfully tracked.

“Targets exist for the measles and flu vaccines. Not having one for Covid-19 suggests the Government doesn’t want to be held to account on this.

“If KiwiBuild taught us anything, it’s that the Labour Government isn’t great at hitting targets. But that shouldn’t matter. Our Covid-19 vaccine rollout is too important not to have one.

Mr Bishop also criticised the slow pace of the Government’s vaccine rollout to date, and the lack of transparency about how many vaccines are being administered in New Zealand.

“Most countries are doing daily, or near-daily, updates on how many people are being vaccinated. New Zealand has to settle for sporadic updates, randomly announced by Chris Hipkins or Ashley Bloomfield.

“New Zealanders should be getting near-daily announcements, published by the Ministry of Health, so everyone can see how our vaccine rollout is going. This isn’t rocket science – it already happens with testing and tracing.

“New Zealand started slow on vaccinations and we’re falling further behind the rest of the world. The latest available public information shows we have administered just 0.56 vaccines per 100 people, while Australia has administered 1.21 vaccines per 100 people.

“We weren’t at the front of the queue for receiving vaccines, like the Government said we were, and our vaccine rollout started slow because of this. It needs to gather pace.”

Call me cynical if you like, but the government is always keen to tell us the good news.

That it has made no mention of this year’s ‘flu vaccination programme, is being quiet about how many people have received the Covid-19 vaccine, has given only vague details about its roll-out to the general population, and appears to have no plan to set targets feeds the suspicion that it doesn’t have any good news about any of this.

 


Who’s responsible?

05/03/2021

Another day and yet more evidence of confusion over Covid-19 information:

The Department of Prime Minister and Cabinet (DPMC) says posts on a Government website saying a KFC worker did nothing wrong were made in “on the understanding it was accurate” as the information came from the Health Ministry. 

If it wasn’t accurate, what was it doing on the website?

Multiple posts were made on the Unite Against COVID-19 website, which is run by the DPMC, on February 26. The posts were responding to questions from the public and stated that the KFC worker, known as Case L, didn’t need to isolate and her and her family “complied with advice they were given at the time”. 

The Prime Minister said on the same day she was “frustrated” with Case L for not isolating and being at work. . . 

COVID-response Minister Chris Hipkins said today the information was “out of context.” 

But National’s COVID-19 spokesperson Chris Bishop said the situation showed even Government departments are confused. 

“This is just baffling and bewildering. The Unite Against COVID-19 Facebook page is posting the Ministry’s own advice while Ministers dissemble and play the blame game. It is deeply unedifying.”

A spokesperson for the DPMC said the posts were “made in good faith” on the understanding that the information was correct, but “recognises the use of the word complied in the reply made it more definitive than it should have been.” . . .

On the understanding that the information was correct? More definitive that it should have been? Surely all communication on an official website should be correct and definitive.

It should also be clear, easily understood and not open to varying interpretations.

Who’s responsible for ensuring that it is? It’s not the members of the public that the politicians are criticising.

It’s the same people who are responsible for all the other mistakes and shortcomings in the Covid-19 response – the government and the Ministry of Health.

It is less than edifying to have different government agencies bickering publicly about who was right. It wouldn’t be happening if there was a single Covid recovery agency responsible for all policy and communication.


Keep Covid-19 behind other borders

12/01/2021

I thought the government was being unnecessarily cautious when it wouldn’t open the border with Australia when there was no community transmission there.

Subsequent outbreaks show the caution was justified and now there is even more reason to be far more cautious.

The government has been too slow to require testing before people boarded flights to New Zealand, as National suggested in August.

Those tests are now mandatory but National’s Covid-19 spokesman Chris Bishop says the government isn’t going far enough:

. . .“Now that pre-departure testing is recognised as adding to our border protection it needs to be extended to all returnees not just those from the UK and the US. The Government needs to explain why this protection will not be compulsory for all returnees.

“The confirmation that returnees from the UK and the US will be required to have their first test on day 0 in New Zealand makes a mockery of the Government’s arguments as far back as August that day 3 testing didn’t need to be compulsory because day 12 testing was.

“National has been calling for day 3 testing, as the first test in New Zealand, to be compulsory, but the Government refused. Now, suddenly, a day 0 test is required.

“The reasoning for day 0 testing today is the exact same as for compulsory day 3 testing months ago. That is, as soon as possible compulsory testing should be undertaken when people enter New Zealand.

“We support compulsory day 0 testing and call on the Government to make all border testing compulsory. Ensuring day 3 testing is compulsory is important as this is when most people test positive.

“This announcement however runs the risk of creating substantial confusion around who needs pre-departure testing and which testing is compulsory.

“An easy way to simplify this is to pick up National’s Border policy which requires all returnees to be tested prior to departure, and that all border tests in New Zealand should be compulsory.”

How hard would it be to go further still and require managed isolation for 14 days before people board planes?

The only way Covid-19 can spread in any country without community transmission of the disease is through holes in the border.

If everyone flying was required to stay in managed isolation for two weeks and have a negative test before boarding a plane it would keep the disease behind other borders.

It’s not just the destination countries that would benefit from this policy, it would protect everyone whose job potentially puts them at risk of contracting Covid-19.

Allowing people who could be carrying the disease to board endangers airport staff,  airline crew, all passengers, everyone who works on border control; the people who drive passengers to MIQ hotels; and all staff at the hotels.

It wouldn’t be an inexpensive exercise, but it would be a lot less costly in human and financial terms than an outbreak which necessitated any further lockdowns.

Drastic action is even more important now that more virulent strains of the disease are being  spread and questions are being raised about staffing at MIQ hotels:

Nurses working at managed isolation facilities across the country have raised concerns about staff shortages and instability.

These problems were formally recognised in an audit by the Ministry of Health in October.

The ministry said the matters have been addressed – but many health care professionals working at border facilities disagree.

The Infection Prevention and Control Audit of Managed Isolation and Quarantine Facilities was released publicly last month. In it, the ministry revealed more facilities have been facing staffing shortages and roster problems.

In a statement to RNZ, the ministry confirmed all matters identified in the audit had been followed up and addressed.

But that is rejected by two of the country’s largest nursing unions, which have hundreds of members working in MIQ facilities. . . 

Who do we believe – the Ministry, or the people working in MIQ?

This is awfully like a repeat of complaints of insufficient supplies of flu vaccines and PPE from people on the ground that were met with repeated assurances from the ministry, and politicians, to the contrary.

The people who had no vaccines to give and those working with inadequate PPE were later proved to be right.

That experience makes it more likely the nurses’ concerns are valid and makes it even more important to ensure the virus is stopped before it gets to our borders.

The only way to do that is for everyone wanting to come here to isolate for 14 days before they board a plane.


Two reports and an apology

09/12/2020

It is natural to seek to determine who is responsible when an atrocity has occurred and to find someone to blame.

That is not always possible.

The report from the Royal Commission on the Christchurch Mosque murders found several government agencies could have done better but did not point the finger at any individuals.

However, Judith Collins is correct to point out who was responsible:

. . .“The atrocities committed on March 15, 2019 were the actions of an evil terrorist designed to spread fear and silence those who did not share his world view. But the actions of New Zealanders since then in denouncing him and what he stood for is proof that he failed. . . 

“The Opposition stands ready to work constructively with the Government to ensure sure we learn from this event and make New Zealand a safer place for all five million of us.

“Ultimately, the person responsible is the one serving a life sentence without parole. But it appears certain systems within Government could have, and should have, performed better.

Brenton Tarrant admitted committing the crimes. We will never know who the individuals in the government agencies were whose work fell short of what should have been required.

But we need to know that the required changes to fix the shortcomings are made.

“In principle, we support strengthening the role of our security and intelligence agencies but we must tread carefully to safeguard New Zealanders’ rights and liberties.

“We cannot end up sacrificing our liberal democracy, otherwise we will end up with the sort of New Zealand this terrorist was trying to create.

Among those rights and liberties are freedom of speech which must be protected.

“It is clear this terrorist should never have had a gun license and we support moves by the police to improve training and firearms licence vetting.

“But more needs to be done to get guns out of the hands of criminals, and National’s proposed Firearms Prohibition Orders are a crucial tool that we need in this fight.

“We have shown that, as a nation, we are not prepared to give into fear, we are not prepared to tolerate extreme hate, and we are not prepared to let anything like the wickedness that took place on March 15 ever happen in New Zealand again.”

No laws can ever make a country and its population 100% safe.

In addressing the shortcomings that enabled the March 15 attacks to happen the government must make sure it doesn’t over react and mistake excessive restrictions for safety.

The Royal Commission report was released yesterday. Another report has yet to be made public:

Covid-19 Response Minister Chris Hipkins must immediately release the Roche/Simpson review report into our border testing systems, National’s Covid-19 Recovery spokesperson Chris Bishop says.

The Government commissioned this report under urgency in late August after its border testing systems failed spectacularly, and Chris Hipkins told Parliament today a copy of the report was sent to him on 30 September.

“The report should have been released before the election – but as we learned today in Parliament, the Government has simply sat on the report since then. The Minister would not even commit today in Parliament to releasing the report before Christmas,” Mr Bishop says.

“This is simply unacceptable. As the Minister himself said when announcing the report, ‘the Group’s formation represents another key step in our ongoing battle against Covid-19. As has been our approach from the start, we are continuously reviewing our systems and finding ways to improve. That approach will continue’.

“Getting our border response right is critical for the future of this country. With businesses closing down and Kiwis losing their jobs, we can’t afford to waste time not considering this report.”

It was also revealed in Parliament today that the Ministry of Health disagrees with elements of the report.

“The suspicion must be that the Ministry has spent the time since 30 September fighting to stop the report being released and trying to change the findings of the independent panel.

“There is now even more reason for the report to be released without any changes that may be insisted on by the Ministry of Health. The Government appointed these independent reviewers and the public deserves to see their findings.”

The mosque murders were atrocious but another terror attack is a remote possibility. Community transmission of Covid-19 owing to holes in the border is much more likely.

Whether or not the MoH agrees with the report, the review was done by independent people and not only do we have a right to know what their findings are, we need to know so we can be be sure that any issues it highlights are addressed.

While we await the release of the report, we have had an apology:

Parliament’s Speaker Trevor Mallard has apologised for comments he made last year claiming a rapist was working on the premises.

He made the remarks on RNZ shortly after the release of a report which revealed frequent bullying and harassment at Parliament.

Mallard later told reporters a staffer had been stood down and a “threat to the safety of women” removed.

In a statement released today, Mallard said it was “incorrect” of him to give the impression the man had been accused of rape “as that term is defined in the Crimes Act 1961”.

Mallard had provided a personal apology to the man for the “distress and humiliation” caused to the worker and his family, the statement said.

“Both parties consider this matter is now closed and no further comment will be made.” . . 

There is no mention of compensation for the worker who lost his job and we’re very unlikely to find out how much he received.

It will have been made by Parliamentary Services which is not subject to Official Information Act requirements.

One report has been released, another has not and we’ll almost certainly never know how much Mallard’s loose lips have cost us. And quelle surprise, his apology was announced when all attention was on the Royal Commission’s report. Given this is an open and transparent government, that would just be an unfortunate coincidence, wouldn’t it?


Still holes in border protection

11/11/2020

Another day, another report on holes in our border protection:

Health workers in New Zealand quarantine hotels are some of the worst protected in the developed world, according to a man in managed isolation who’s helped kit out medical staff all over the world.

Tim Jones says he predicted the current outbreak when he arrived at his isolation hotel two weeks ago, shocked by the low level of personal protective equipment worn by nurses, defence force personnel and border workers.

He was returning home from Britain after working for four years for a New Zealand-owned, US-based company RPB which provided protective equipment for frontline workers in hospitals in 50 countries, mostly the United States, Britain and Europe.

“In short, New Zealand has been the worst protected for frontline health workers that we have seen,” Jones said.

“I guess probably the biggest red flags were when we landed at the border. We only saw surgical masks, including on army people who were on the bus with us so obviously in close proximity, travelling to our managed isolation facility.”

He was “completely blown away” to find out from a New Zealand Defence Force contact that even staff who worked in Auckland’s Jet Park, where most people have Covid-19, were wearing the most basic surgical masks. . . 

Where’s WorkSafe when we need them?

Failing to provide border staff who are dealing with potentially infected people with the best PPE is a serious breach of employer responsibility. It is even worse for staff in facilities where people with the disease are quarantined.

If farms didn’t provide staff with good protective equipment when they’re dealing with dangerous chemicals they’d be liable for prosecution for health and safety breaches. Not providing MIQ staff with adequate protection from a potentially fatal illness looks like a similarly serious breach.

The Ministry of Health is urgently looking into whether to use N95 masks at the highest risk facilities, like Jet Park.

Dr Bloomfield said there was growing evidence workers who had contracted the virus at managed isolation hotels may have caught it from transmission through the air.

This is a case where precaution should come before the evidence. It’s much better to provide more protection than necessary than to wait until the need for it is proved or disproved.

The Nurses Organisation has been calling for the better level protection, saying it did not know why it was not there already.

It also wants an investigation into how all managed isolation facilities are being run.

This follows David Farrar’s revelation of this mismanagement of a man who flew with someone who tested positive for Covid-19:

I’ve been contacted by the family of someone who was in the same row as the positive Covid-19 contact on Air NZ flight 457 on Thursday.

They have been given different isolation instructions from every agency they have interacted with. They are so alarmed as the lack of coherent and consistent advice, that they want people to be aware that we still have systematic failures in our Covid-19 response, as we saw with the lack of front line worker testing. . . 

Theses are systems failures and each one adds credence to the belief that eliminating Covid-19 in the community and keeping it at the border owes at least as much to good luck as good management.


Rural round-up

21/09/2020

Minus 12.2.% – Mike Chapman:

Our GDP has hit rock bottom at minus 12.2% in the June quarter, and on top of that, the Government has already spent the $50 billion recovery package.  The financial cupboard is literally bare.  Everyone is talking about the rebound and they seem very confident about it.  If there is one thing that Covid has taught us, it is that predicting what is going to happen is not easy.  In fact, I would say it is near to impossible.  The result is we have all had to be very flexible- what we planned to happen has more often than not had to be changed.  I can’t see any reason why the current uncertainty and the ever-present unpredictable future will suddenly become certain and predictable.

The problem with spending the $50 billion is that it has not by in large been spent on enabling New Zealand’s economic recovery.  It has been spent propping up the status quo with wage subsidies and the like.  With that money spent, how are these workers going to get paid?  Where are they going to work?  Accommodation and food services took a 47.4% hit in the June quarter with hits also in mining, clothing and footwear, furniture manufacturing and transport.  Just walk down any main street and see empty shops.  Agriculture went down 2.2%, but that drop was saved from going further down with fruit exports up 10% and wine up 15%.

New Zealand is in recession.  Tourism, international education and hospitality will not be the drivers for economic recovery in the immediate future.  The main driver for economic recovery will be the primary sector and within the primary sector horticulture and wine. . .

Helping grow farming’s future – David Anderson:

John Jackson’s ability for future and critical thinking saw him deeply involved in the development of an agribusiness programme that has now been rolled out in secondary schools throughout NZ.

The North Waikato sheep and beef farmer has had an interesting and eclectic journey on the way to his eventual farming career and farm ownership. With a long history of community service, Jackson was invited to join the Waikato Anglican Trust Board in 2012 that governs the running of St Paul’s Collegiate in Hamilton, where his children went to school.

“John Oliver – a notable King Country farmer and philanthropist – encouraged the school to consider teaching agriculture and develop a curriculum accordingly,” he explains. . . 

NZ’s largest ever medical marijuana crop gets the go-ahead :

A Marlborough medicinal cannabis company has secured a licence to grow New Zealand’s largest ever crop.

Puro received the license allowing it to commercially cultivate 90,000 plants for medical use from the Ministry of Health on Thursday.

The crop will be germinated in tunnel houses before being transplanted into the company’s site at Kekerengu.

But it will hold no recreational appeal with it being used for CBD and cannabinoids to be exported overseas. . . 

Move over, mānuka honey, bee pollen is creating a buzz – Esther Taunton:

Move over mānuka honey, there’s a new bee product creating a global buzz.

Demand for New Zealand bee pollen has skyrocketed since the outbreak of coronavirus, with one company saying sales have soared and there are no signs of a slow-down.

NatureBee says sales of its potentiated bee pollen capsules have increased five-fold over the last year as the Covid-19 pandemic drives a shift in consumer behaviour. . . 

Cows big change from animals in Laos – Mary-Jo Tohill:

She has swapped monkeys and tigers for dairy cows and is loving the change of animal.

Sonya Prosser was one of 13 students who took part in the first SIT-Telford GoDairy course at the South Otago campus near Balclutha, which began on August 24.

Before the pandemic, she had been working in Laos for three years, where her partner, Maddie, had got a job with the world’s largest sun bear sanctuary, Free the Bears, in Laos and where Ms Prosser was doing freelance wildlife work.

This included Project Anoulak, in Nakai-Nam Theun National Protected Area in central-eastern Laos, which is home to nine species of primates. . . 

Where would we be without bees? – John Harvey:

It’s fair to say that most of us have some understanding that bees play an important role.

But do we understand why?

Because bees are more than important, in fact they’re critical to our food security.

Through the process of pollination we depend on bees for one in every three mouthfuls of the food we eat. . . 

 


From bad to worse

18/06/2020

National health spokesman Michael Woodhouse was right: the two latest confirmed cases of Covid-19 in New Zealand did have contact with someone after getting lost on their drive from Auckland to Wellington.

After leaving quarantine in a car provided by friends, the two women got lost on the Auckland motorway system.

The friends who lent them the car met with them and guided them to the right motorway, and were in physical contact for about five minutes.

The National Party’s health spokesperson, Michael Woodhouse, told Parliament this afternoon that the pair had hugged and kissed someone on their travels.

That was after Dr Ashley Bloomfield said they had no contact with anyone.

The ministry didn’t confirm if they hugged or kissed their friend, and said it received the update this afternoon.

Woodhouse told Parliament a “reliable but confidential source” had informed him that story was “not all as it seems”.

“They did become disorientated and lost their way coming out of Auckland and needed help to get on the right road,” Woodhouse said.

“They called on acquaintances who they were in close contact with and that was rewarded with even more close contact – a kiss and a cuddle.” . . 

The announcement that the women had Covid-19 and hadn’t been tested before being granted compassionate leave from isolation was bad, the new information makes it worse and  this shows things can get even more worse:

Former police commissioner Mike Bush has admitted one person who should have returned to managed isolation after a funeral, is still at large.

The 18-year-old was part of a family allowed a compassionate exemption to attend a funeral. The five other family members are now in quarantine after avoiding their return to managed isolation “for some time”.

Initially all six were evading managed isolation. Then four family members returned and just two – an eight-year-old and 18-year-old were missing. 

The child has since been brought back to managed isolation and the teenager remains at a family property in Hamilton in self-isolation. . . 

Does the fact that it was a gang funeral give confidence that the teenager will self-isolating as required?

But wait, there’s more:

Newshub can reveal another serious blunder by health officials who have failed to follow their own rules.

A group of around 10 people, who were in quarantine in Christchurch, were allowed out early to attend a burial with more than 150 people on Tuesday. 

That’s despite the Ministry of Health announcing nine days ago that such exemptions were no longer permitted – leaving a funeral director and his team thoroughly perplexed. . . 

And more:

Chief Ombudsman Peter Boshier is furious that his staff were forced to mix at a hotel with people who were being put into quarantine.

Boshier told the governance and administration committee this morning that his staff had arranged to stay at a hotel in Auckland before inspecting a prison the next day a few weeks ago.

“Suddenly in the evening, all these people arrived from overseas to be put into quarantine and we weren’t told. So we were all mixed up with everyone else and I was livid.

“I had to cancel the prison visit the next day.” . . 

And in spite of the sacrifices we’ve all made and the dangers of importing new cases,  Covid-19 tests for people in managed isolation are voluntary:

As two new confirmed Covid-19 cases broke an almost month-long streak of no infections, people in mandatory quarantine have been told that swab testing is voluntary.

It goes against what many people believed was a compulsory test for those entering New Zealand – particularly those coming in from countries where Covid-19 has run rife.

Since April, everyone arriving in the country has had to spend 14 days in managed isolation or a higher level of quarantine if they have symptoms.

The Ministry of Health earlier announced that from June 8, all travellers who arrive in the country would be tested for Covid-19 at their respective facilities. . . 

But some guests under mandatory quarantine in Auckland hotels have revealed that they have been told the Covid-19 swab tests are voluntary – not mandatory.

A woman staying at the Grand Millennium, in downtown Auckland, said a pamphlet guests had received said the choice was ultimately theirs.

“I’m worried that they’re not testing everyone,” she said.

“Isolation is so difficult, but this one thing is not compulsory. This country is doing such an incredible job, we can’t mess this up.” . . 

The country has been doing an incredible job but the government and the ministry are letting us down and innocent and grieving families who are paying the price:

The Government has refused to apologise for the strict quarantine protocols, despite leaving would-be compassionate exemption recipients heartbroken.

On Tuesday, Jacinda Ardern announced that compassionate exemptions from quarantine have been suspended after two women were allowed to leave isolation without being tested for COVID-19, and later tested positive. . . 

“The important thing is to fix this problem,” David Clark said. “The director-general [Ashley Bloonmfield] has owned this failing… I have every sympathy for those people, my expectation is it will be fixed.”

Ardern said the case is an  unacceptable failure of the system” that should never have happened and “cannot be repeated”.

“My job is to keep New Zealanders safe, I know the decision to suspend compassionate leave will not be a popular one, but it is the right one,” she said.  . . 

What does it say about the competence of the people running all this when  the military has been brought in to oversee the border?

As more than 300 close contacts linked to New Zealand’s two Covid-19 cases are “encouraged” to get tested, Prime Minister Jacinda Ardern is bringing in a military leader to oversee the country’s isolation and quarantine facilities.

Ardern addressed media on Wednesday, as the fallout from Tuesday’s revelations two women were able to leave mandatory isolation six days into their stay on compassionate grounds continues to intensify.

Assistant chief of defence, Air Commodore Digby Webb, has now been called in to oversee border facilities, including how travellers depart from them. . . 

Most of us did as we were told in adhering to lockdown rules, at considerable personal and financial cost. Why hasn’t the government been doing what it should have been to ensure that the hard-won Covid-free status wasn’t squandered by slack systems and protocols with people coming in from other countries?

It took the detection of two new cases of Covid-19 for the government to take border security and isolation seriously yet the media has been reporting people complaining about lax standards at isolation facilities for at least a week.

As Todd Muller said:

“The sacrifice of the ‘team of five million’ cannot be put at risk by a clumsy and incompetent Government that allows bureaucrats to run the show by deciding which of the rules they are going to apply on any given day. . . 

Alex Braae echoes this in writing of an avalanche of incompetence:

It is staggering to see so many stories come out all at once, and many people will feel an uncomfortable sense of deja vu. I realise a lot has happened between then and now, but all of these stories feel deeply reminiscent of the incompetence shown at the border before lockdown started. Systems were theoretically in place, but weren’t being enforced with any sort of rigour or discipline, and it took media reports for those who were meant to be in charge to take notice. Readers might also remember that those blunders were arguably what necessitated lockdown in the first place. It’s not bloody good enough at all.

The government lost its social licence for keeping us at level 2 when nothing was said to deter protest marches.

It needs to get quarantine and managed isolation sorted because this week has shown how soon things can go from bad to worse and it won’t have the social licence to lock us up again.


And still we wait

02/06/2020

The last case of Covid-19 which was thought to result from community transmission was on April 2. That’s more than eight weeks ago.

And still we wait to drop from Level 2.

There have been no new cases Covid-19 for 10 days.

And still we wait to drop from Level 2.

There is one active case of Covid-19 in New Zealand.

And still we wait to drop from Level 2 lockdown.

Many Covid-19 testing stations are closing down.

And still we wait to drop from Level 2.

People are losing 1000 jobs a day.

And still we wait to drop from Level 2.

New Zealand is facing the largest decline in GDP in 160 years.

And still we wait to drop from Level 2.

Thousands of people assembled to protest  the murder of Minneapolis man George Floyd. That murder was atrocious but no excuse for flouting the rules when still only 100 people can attend weddings and funerals and we’re all supposed to be social distancing, festivals and events from the National Fieldays to church fairs can’t be held and many businesses cannot operate at full capacity?

And still we wait to drop from Level 2.

The Government needs to explain to New Zealanders why it won’t consider a move to Alert Level 1 for another week, Leader of the Opposition Todd Muller says.

“Kiwis have made enormous sacrifices to flatten the curve, but if their efforts still aren’t enough to move to Level 1 then the Government must explain why.

“It has been more than a week since the last confirmed case of Covid-19. There are fewer cases now than there was before any restrictions were put in place.

“The Government has a duty to speak with one voice on such a critical issue, but all Kiwis are hearing now is mixed messages from the Prime Minister and her deputy.

“Businesses on the brink of closure have been left in limbo too long. It’s time for the Government to be clear about what conditions need to be met for the move to Level 1.

“Level 1 should mean businesses can return to full capacity, transport networks can resume without constraints, marriages can be properly celebrated and loved ones can be appropriately mourned.

“The sooner small businesses know what Level 1 will look like, the easier it will be for the backbone of our economy to start repairing itself.”

Most of us co-operated with the Level 4 lockdown requirements.

Most of us co-operated with the Level 3 lockdown requirements.

Many of us are confused about exactly what we can and can’t do at Level 2 – protests are unlimited but work, church, funerals, weddings festivals and social gatherings are restricted?

And still we wait to drop down from Level 2.

But why?

The Ministry of Health’s criteria for  Alert Level 2 is:

The disease is contained, but the risk of community transmission remains.

Risk assessment

    • Household transmission could be occurring.
    • Single or isolated cluster outbreaks

The criteria for Alert Level 1 is:

The disease is contained in New Zealand.

Risk assessment

    • COVID-19 is uncontrolled overseas.
    • Isolated household transmission could be occurring in New Zealand.

By those measures it should be safe to go to Level 1.

And still we wait to drop from Level 2.

But we’re sick of waiting.

The social licence that is needed for us to keep the rules was torn up and stamped on yesterday.

If protesters don’t have to wait for a drop down from Level 2, why should the rest of us?


Where’s kindness and empathy when it’s needed?

06/05/2020

Heather du Plessis-Allan writes of a woman stuck in quarantine as her mother dies :

. . . She thought they were about to say yes today because she heard the PM yesterday say 18 people had been given permission. She thought that meant she was probably going to get a yes too.

Our producer had to tell her the PM was wrong, no one’s been given permission. She started crying on the phone.

Let’s be honest: she might not ever see her mum alive again.

The Ministry of Health is reviewing all 24 requests that they’ve declined, but that review will take most of the week. By then, this woman’s quarantine will probably be finished as she’s allowed out this weekend. But her mum might not make it to the weekend.

And the review doesn’t bode well for anyone else in quarantine hoping to say goodbye to loved ones.  The review’s being by the ministry’s legal team. Does that feel like the very people you’d send in to try to find a way to avoid having to change the decisions?

I don’t know how we’ve ended up with a health ministry so heartless and a Director-General of Health who isn’t sorry that this is happening.

He says his team are empathetic, but they’re not.  They’ve declined all the requests for exemptions. 

I read the judgement last night in the case of Oliver Christiansen and it’s obvious the Ministry of Health doesn’t want to say yes. Either that or we’ve found a collection of the stupidest public servants in the country.

Every time Oliver asked for an exemption on the grounds of ‘exceptional circumstances’, they told him that he didn’t qualify for a medical transfer.

Of course he didn’t qualify for a medical transfer. He wasn’t sick. He wasn’t even asking for that, but they made it sound like that was the only grounds for an exemption, and it wasn’t.

So they’re either stupid or deliberately frustrating people who want to say goodbye to their parents. . .

How heartbreaking it must be to be so near yet so far away from a dying family member; to be stuck in limbo between home and the loved one’s death bed; to be prevented from spending those precious last days or even hours together.

The government has gone from being too slow to close the border and quarantine new arrivals to overseeing a Ministry which is being pig-headed in its refusal to let a few people through on compassionate grounds.

Covid-19 came from overseas and we can’t afford to have the good done by the lockdown undone by slackness at the border again.

But it must be possible to follow protocols to reduce the risk, such as those the court ordered Oliver Christiansen to follow in overturning the MOH’s refusal to allow him to visit his dying father:

. . .The judge said, in her assessment, overall justice “demands an effective and swift response”.

“I have in mind here particularly the imminence of Mr Christiansen’s father’s passing and the very material factor that visitation is only at a private home and not in a public space.”

She ordered the ministry to permit Christiansen to leave managed isolation to visit his father.

But he could only do so if he traveled unaccompanied by car to his dad’s home and remained there until his father died.

Christiansen was also told to maintain physical separation from other family members at the home and to return on his own within 24-hours of his father’s passing in the same car to the isolation facility for the remainder of the 14-day period. . .

If necessary family members could be required to self-isolate for 14 days from the time they had any contact with the traveller as a precaution to further reduce the risk of spreading Covid-19.

The border with Australia will be closed for weeks to months and visitors from other countries will be required to stay in quarantine for a fortnight for much longer. There will be many more people coming to New Zealand to be with dying family members in that time. Protocols must be worked out to allow them to do so safely.

And it’s not just the people in quarantine. Back to Heather:

This has been happening for seven weeks. For the entire duration of Level 4 Lockdown, people were forced to die alone in their hospital beds without any family or friends with them.

The Ministry of Health has lost perspective. In the battle against a disease, it has condemned families to a sorrow that will sit with them for the rest of their lives.

I am not proud of them. I want them to show compassion. I want them to take a dose of their own medicine.

Remember what their boss Ashley Bloomfield and the PM keep telling us? Be kind. They should try a bit of kindness themselves.

Keeping people apart at the end of life is inhumane.

The way the dying and their families have been, and are continuing to be, treated shows a complete lack of  the kindness and empathy we are all being enjoined to demonstrate.

Both must be applied in designing a way to allow families to be together when one of them is dying without risking the spread of Covid-19.


Thanks IHC

30/10/2019

People with intellectual disabilities and their parents owe gratitude to IHC which has just turned  70:

On 25 October 1949, 22 parents met in Wellington. A notice had been placed in the Evening Post the previous day calling for ‘parents and guardians of backward children in the Wellington district… to attend a meeting … to consider the formation of a parents’ association’. 

The meeting elected Hal Anyon as interim president and his wife Margaret Anyon as secretary/treasurer, plus two committee members. At the following meeting, on 23 November, 50 people formed the Intellectually Handicapped Children’s Parents’ Association. Within three years there were a thousand members in several branches around New Zealand. In 1994, following several name changes, the large nationwide organisation became the IHC.

Those founding parents were brave and stroppy. They had to be. In 1949 there was widespread discrimination against people with what was then called intellectual or mental handicap. This situation was a legacy of decades of eugenic assumptions in which disabled people, particularly those with intellectual or learning disability, were considered defective and likely also deviant. Widespread assumptions of ‘tainted heredity’ and shame meant parents were strongly advised to hide their disabled children away from families and communities in institutions and forget about them. Many mothers were powerless to fight the removal of their child in the face of state authorities. . .

Both our sons had brain disorders which left them with multiple disabilities.

Tom was only 20 weeks when he died. Dan survived five years without passing any developmental milestones.

Looking after him got harder as he grew physically without developing intellectually and IHC’s support was invaluable.

Just how good the organisation was, was summed up by the manager of the local branch when we were trying to work out what was best for Dan.

He said, “Let us know what you need and we’ll work out how to provide it.”

I served on the branch IHC committee for several years which increased my admiration for the work the organisation does in supporting and advocating for the intellectually disabled and its members.

They continue to face challenges, one of which has resulted in a mother taking the government to court to prove her disabled son isn’t her employer:

An independent disability advocate has filed papers asking the Employment Court to decide if people with intellectual disabilities have the mental capacity to be employers.

The government is promising to change this, but advocate Jane Carrigan doesn’t want to wait and is going to court. . .

In order to get funding, Ms Fleming has to be an employee of her disabled son, a relationship the Ministry of Health has already admitted is a mere fiction.

Independent disability advocate Jane Carrigan said for too long the ministers and their ministries have indulged in what she calls tricky and technical conduct, by creating sham employment relationships.

And in doing so, the ministers had removed themselves from their responsibilities under the New Zealand Public Health and Disability Act, she said.

“This allows the ministry to step back in the very cynical name of choice and control and say to people with disabilities – the majority of whom I might add have an intellectual disability – ‘well there you go, you’re the employer, you have the choice to employ who you want, the control to manage how your employment relationship works’.”

Ms Carrigan said that was ludicrous.

“The so-called employer is usually lying in bed with nappies on and has no capacity to manage the employment relationship intellectually. And even those people who are only physically disabled, many of them, because they are high/very high needs, will rely on a family member to do all the employment relationship stuff,” Ms Carrigan said.

Ms Carrigan said if there was an employment relationship it was between the carer and the Ministry of Health and she wanted the court to say so. . .

Thanks to those brave and stroppy parents who formed it, IHC’s advocacy has resulted in a lot of improvements to care and support for intellectually disabled people and their families in the last 70 years.

I am very grateful for the help it gave us and also aware of the help others still need and the battles still to fight.


When politics of birth comes before its purpose

25/02/2019

Why would government officials try to discredit a critical piece of research that raised concerns about maternity care and why wasn’t it followed up?

In the months leading up to the release of a study which asked how safe it is to give birth in New Zealand, health officials were busy.

As a courtesy, researchers from Otago University had advised the Ministry of Health well in advance the study looking into maternity care outcomes would be coming out. Closer to the date, they provided an advance copy to the department.

The study found evidence to suggest all babies were not being born equal. Those in midwife-led care were at risk of poorer outcomes than babies in doctor-led care. The authors, Diana Sarfati and Ellie Wernham, were careful to point out their support for a midwifery-led system.

However, their conclusions were clear: the current way maternity care is provided in New Zealand is not as good as it could be.

“It may well be that midwife-led care is optimal within the context of well-organized systems,” the authors wrote.

At the very least this should have led to more research, but what did the Ministry do?

In the months they knew about the study – and the nine weeks they had a copy of it – ministry officials did little to suggest they would take its findings seriously.

Instead, an investigation by Stuff has found the ministry actively worked to try and obscure the results. Communications in the months before the study’s release show staffers worked on how to avoid “fallout,” and in one case shared plans to discredit the study ahead of its release with industry body the College of Midwives.

The ministry this week rejected suggestions it underplayed the findings of the study.

But documents obtained under the Official Information Act show attempts to spin the results of the study and avoid the spotlight on the safety of the system, into which 60,000-odd babies are born each year. These were met with stiff resistance from Otago University. 

But documents obtained under the Official Information Act show attempts to spin the results of the study and avoid the spotlight on the safety of the system, into which 60,000-odd babies are born each year. These were met with stiff resistance from Otago University.

Ministry officials took the unusual step of meeting with Professor Peter Crampton, then the head of Otago University’s Medical School and the pro-vice chancellor of health sciences. In an interview with Stuff,Crampton said it was clear the ministry felt the study was flawed. He disagreed, backing the university’s research. . . 

The Ministry felt? Ministries shouldn’t act on feelings, they should act on fact based thoughts and research but:

No further research was commissioned.

The study fell from the headlines; Sarfati went back to cancer research, and former midwife Wernham is in her last year of training to be a doctor.

But Crampton, who has had oversight of hundreds of studies in more than four decades in academia, can’t forget.

“I’ve never seen anything quite like it. The extent to which [the researchers] felt beaten up and traumatised by the experience was way outside of the normal,” he says.

“There should have been more high quality research set up to explore the issues that were raised, and we should have been doing this from day one. The chilling effect of the response to the results basically means this hasn’t happened.

“In my view, this was more about the management of a contentious issue than a policy engagement with important findings.

“If this area is too hard to research, then this is a big problem.”

While all research was vulnerable to critique, the authors had been clear about the limitations of the research and to ignore the results was a mistake, he says.

“The [ministry’s] response implied a problematising of the research in a way I found very unusual and disquieting. They viewed the results as highly problematic, and my general sense was that there was a considerable effort to explain them away.” . . 

Why?

Birth is a highly politicised business.

Practices have quite rightly moved away from the old system where mothers-to-be lay back with their legs in stirrups, everyone did what doctors said and midwives were undervalued.

But the pendulum has swung too far to the opposite extreme where too often birth politics gets in the way of the safety of both mother and baby and those involved lose sight of the point of pregnancy – the safe delivery of a healthy baby.

Problems have been exacerbated by the exit of doctors from obstetrics and a shortage of midwives.

Problems with midwife shortages – particularly in rural and low-income areas – and an unsustainable working model for midwives which means long working hours, burnout, and insufficient pay have been long identified as issues.

Wernham and Sarfati’s study was the first ever to take an overarching look at the safety of babies within the current system. The differences she and Sarfati found were not small; across the five-year study of more than 244,000 babies, they found those in doctor-led care had lower chances of poor birth outcomes.

This included 55 per cent less chance of oxygen deprivation during delivery, 39 per cent lower odds of neonatal encephalopathy, and 48 per cent less chance of a low Apgar score, a measure of a baby’s wellbeing after delivery.

There was also a lower rate of stillbirth and newborn babies dying under medical-led care. This link was statistically weak due to the small number of baby deaths in the five years covered – 1.84 per 1000 births for midwife-led care (410 total deaths, from 20 weeks gestation to the first 27 days of life) and 1.31 per 1000 births for doctor-led care (27 total deaths) – but it was there.

Of course, comparing women with midwives as their lead maternity carer to those who have doctors is not necessarily fair.

After all, doctors – counting GPs and obstetricians – look after less than ten per cent of mums. It is very possible the types of mothers they see are different – mums who smoke might be more likely to see a midwife, while healthier mums might pay for a private obstetrician, for example.

The researchers knew these things could effect the results. So they used a mathematical model to account for factors like smoking, age, ethnicity, deprivation, and weight. “Women are not comparable, but the design adjusted for that,” says Otago University epidemiologist and emeritus professor Charlotte Paul, who has reviewed the research. “The authors restricted their population to women who were having single births and term births to make them more alike. Then they collected information on characteristics that differed between the groups and statistically adjusted for them. The results remained.” . . 

But the results didn’t fit the prevailing ideology and raising questions as this research did led to defensiveness rather than answers.

Independent policy analyst and researcher Dr Jess Berentson-Shaw co-directs think-tank The Workshop and is the author of A Matter of Fact: Talking truth in a post-truth world.

She says the midwifery-led maternity model was a major policy change which, like many in New Zealand, was never evaluated.

“We should always be exploring what models of care are working best for the people they are supposed to serve – mothers, babies, families – and that includes midwives themselves. We can’t shy away from it, shut it down, or pretend it doesn’t exist,” Berentson-Shaw says.

In maternity, with its historic power dynamics of a women-led profession fighting for autonomy, questions about the system were often not considered objectively. “There’s this feeling that you can’t critique maternity care without critiquing midwives. How has it got so unconstructive? How has this happened to the point that we cannot have a conversation about standards of care?

That the Ministry and College of Midwives appear unready to even have the conversation is a big part of the problem. The only bias either body should have is towards the health of both mothers and babies.

Sarfati doesn’t know what she could have done differently. “It was so draining and exhausting and seemed to have so little effect, and it was so stressful personally. It had a big impact on Ellie and me for quite a long time, and despite all our efforts it had no impact at all.

“All we were trying to do was evaluate this major policy change that had happened. We have a really unique system in New Zealand, and the research they use to support it is based on systems completely different to ours. It was an attempt to look at that.

“It suggested there were problems, which isn’t to say the entire system should be thrown away, but you need to address them like any professional group should.”

David Farrar calls this disgraceful behaviour by the MoH.

Stephen Franks gives due credit to the journalist in Great Michelle Duff journalism on MOH surrender to witchcraft

The latter isn’t a criticism of all midwives but it is a criticism of the system which has put the politics of birth before its purpose.


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