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How to achieve 'the perfect health system'.

POLITICS AND policy was the focus of a plenary session by Kai Tiaki Nursing New Zealand (KTNNZ) co-editor Teresa O'Connor and NZNO's senior policy analyst Marilyn Head. A condensed version of O'Connor's address was published in last month's KTNNZ, titled "Wanted: politically aware and involved nurses" (p24-25).

Head outlined how NZNO had developed its election manifesto and its priorities for health. Without a political mandate, ie buy-in from NZNO members, no policy, good or bad, would see the light of day, she said. This was also true for the development of policies in the broader New Zealand context.

Thanks to the broad spectrum of opinion, taxpayer-funded health services were still provided in New Zealand. And for a very good reason, she said. "Public provision of health care is cheaper, more effective and fairer than the alternative, as recent Treasury papers have stated."

Collective responsibility for population health and sustainability was also part of New Zealand history, for both Maori and Pakeha. "And although we are a long way from achieving health equity, there is no suggestion that equity is not fundamental to New Zealanders in a way that is very different from other, older cultures.

"However, within the broad church of consensus, there are some differences of opinion about what the perfect health system might look like, and very different, sometimes opposing, views on how to get there. At heart is the balance between individual responsibility for the health choices you make, and social or public responsibility for health care and health environments. Generally speaking, those on the right emphasise individual responsibility for health choices, ie less regulation and targeted funding, and those on the left focus on structural levers for health improvement, ie more regulation, universal coverage etc."

Vote Health currently made up 20 per cent of core Crown expenditure, Head said, with health and social services comprising the second largest area of employment. NZNO's manifesto reflected mainstream thinking, with most parties agreeing in general with the priorities identified, eg the importance of primary health care, the focus on children, investing in public health, and developing a skilled and flexible workforce.

Head stated the choice as to how our taxpayer money was spent rested with the public. "There is little doubt health is the best investment. You can spend money well or you can spend it poorly. We need good choices and good policy."

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Title Annotation:nzno conference
Publication:Kai Tiaki: Nursing New Zealand
Geographic Code:8NEWZ
Date:Oct 1, 2014
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