Voyages Online

The Pacific health sector is growing in confidence and numbers as it responds to the health needs of Pacific peoples. Voyages spoke with the Minister of Health, the Hon Pete Hodgson, about the challenges facing the sector and the gains made so far.

Pete Hodgson

How much progress has been made so far in improving those health outcomes?
There has been a huge amount of progress but there’s still a long way to go. Pacific people show up so strongly with initiatives such as the MeNZB and Get Checked campaigns but there’s a long way to go because there are health disparities that are yet to be addressed. So we can’t say that the Pacific health community or we as a nation are doing enough. There’s been a wonderful development of Pacific health providers but it is not enough.

What do you think have been the most significant developments?
Well, MeNZB will do, or Get Checked for Diabetes will do or HEHA (Healthy Eating Healthy Action) will do. If you look at the health issues that are important to Pacific people, you can see they have risen to the challenges that continue to face them and they do so with a lot of vitality.

I’d like to make another point. The Pacific church structure is a wonderful gift to the New Zealand health system, even though it is going through change and no doubt will continue to do so. The Pacific church structure, for example, was vitally important for us to understand and utilise with the MeNZB campaign. If you look at the range of things that are going on in the Pacific community with the Let’s Beat Diabetes campaign or with various parts of the HEHA Strategy or Mission On, you’ll find the churches in the midst of it.

Does this reflect the fact that a Pacific approach to health is community-based rather than an individualistic one?
That’s where my word ‘vitality’ comes from. It’s the vitality of the community acting together. Pacific people do things together naturally and normally. This is very much in line with the move towards a more population-based approach to primary healthcare where health providers are charged with looking after the health and wellbeing of their local populations. Pacific people think that’s normal, they just think that way, they think about their community.

Do you think the Pacific Provider Development Fund is working well and achieving its objectives?
It strikes me as an important and vital fund. I think it’s a fund which is important to maintain, given the considerable success it has had up to now. I’m sure it has caused disappointment for some and pleasure for others – all funds do that – but overall I think it’s a really important part of taxpayer spending.

The Pacific health workforce is growing but it is not growing fast enough. We will never have a future when a Pacific person will automatically go to see a Pacific health professional – it’s not that direct. But when there is a Pacific provider, there will be no cultural barriers, which is particularly important for older people who may need to communicate in their own language.

What plans are in place to boost the Pacific workforce?
There’s a Pacific Workforce Development Plan which is ongoing and somewhat successful. But as with many things in health, progress doesn’t mean sufficiency. We don’t have sufficient involvement of Pasifika in our health workforce.
A really interesting development in Counties Manukau – the most intense Pacific population in the country – is the decision by the Board to grow its own workforce. The Counties Manukau District Health Board (CMDHB) looks at the future, they look at what sort of workers they will need in 10 or 20 years’ time and they haven’t a clue where they are going to get them.

So they say ‘we will have to get them from our place.’ That has led the Board to run a series of seminars on workforce development, to get involved with schools and start marketing a career in health locally. They are sending a message to Pacific parents – if your child enters the health profession, think around the economic benefits for your family. So they are approaching the issue from a number of angles and that strikes me as a good thing.

What do you see as the most pressing health challenge for the Pacific community?
The biggest public health challenge facing New Zealand – in the absence of bird flu I should add – is the fact that our population is growing bigger. More and more New Zealanders are overweight and more and more are overweight earlier in their lives, including children.

If you then look at Pasifika as a sub-group of that population, these trends are even more pronounced and that’s why Let’s Beat Diabetes in South Auckland and Mission On is probably the best value-for-dollar health expenditure there is. No country in the world has got on top of this obesity issue but let me say that New Zealand is seen as trying a whole lot harder than most countries to address the issue and we are seen as having a community that is genuinely concerned about it.

Within New Zealand Pacific leaders and Pacific youth are particularly concerned about it. We have some very strong Pacific youth leaders who are hugely helpful and were at the heart of our launch of Mission On. They are a great influence on their school peers, their families, their communities and their churches.

So the most pressing health challenge facing Pasifika is being tackled by Pasifika with vitality. We don’t have success but we are off to a beaut start and Pasifika is at the heart of that effort.

But we are trying a number of things. That’s why Lancet magazine said a year ago to watch New Zealand because we are so active that some of the things we are doing might work. We don’t know what those things are yet. It’s a matter of learning by doing.

What is your view of New Zealand’s role in supporting health in the Pacific Islands?
That role continues to mature. I think we do have a role but it is always at the invitation and with the permission of the host country. I think this collaboration occurs in a number of ways. For example, soon a Pacific Island network is being established in Samoa around mental health; thought is being given to whether or not there needs to be a Pacific-wide response to the issue of HIV; the launch of Mission On last September was attended by every Pacific Health Minister. The Health Minister from Samoa said then and there ‘that’ll do me, I’m taking it home.’

Then there’s the relationship between the Counties Manukau DHB and some Pacific countries on the issue of workforce development. This is beneficial to both parties because health workers from the islands are exposed to the New Zealand health system and the advantages that accrue from that and we in New Zealand benefit because we have more Pacific health workers in our system, even if they are in training.

Finally, any reflections on the involvement of Pacific peoples in the Meningococcal B vaccination campaign?
First of all let’s recognise and say again what an astonishing and stunning success it was. Given that the disease had its way with the Pacific population to a disproportionate extent, let’s celebrate the fact that fewer children are now going to be struck down by meningitis.

Secondly, I think we have probably changed the views of a generation towards vaccination in general so that’s an additional advantage. Thirdly, I think Pacific pride in that remarkable health achievement might be a boost which will encourage a faster development of Pacific health services than might have otherwise occurred.

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