Future Prosperity of the Hawke’s Bay Region – the infamous August 2012 ‘Winder Report’ – has become the mirror we are currently holding up to the face of our community to see where opportunities exist and challenges lie. In the document we are graded by the authors, as if we were a child still growing, full of untapped potential but shaky on our feet, and a little wide-eyed to the ways of the grown-up world.

Translating the region’s performance over the last decade into a report card, the overall message would probably be “has significant natural talent, but does not yet use it all effectively” and “could do better”.

It is not a huge leap to propose that much of our natural talent, our ability to use it effectively and the necessity to do better in the future really does lie with our children.

Local control

In Hawke’s Bay, the very group we will all rely on so heavily in the future is the one currently getting the rawest deal.

Children’s Commissioner Russell Wills is a Hawke’s Bay-based paediatrician, and in his dual role sees the hard-nose of the situation, as well as the governance umbrella of policy and political debate. He says: “A newborn baby in Hawke’s Bay today is the workforce in 20 years. When we retire, this generation, being born now, will be the ones caring for us. It’s in the best interests of all of us to make sure they’re healthy and well-educated. If this current generation of newborns has the same outcomes as kids leaving school now we’ll be in real trouble.”

The fact is Hawke’s Bay has one of the poorest populations of children of any DHB in the country. Nearly 60% are living in the poorest deciles.

“Poverty is a real issue for Hawke’s Bay and we have high rates of poverty-related illnesses such as acute chest and skin infections, rheumatic fever and pneumonia,” says Wills.

Mãori children in Hawke’s Bay are statistically poorer than the national average and have poorer health outcomes. Mãori and Pacific, and the very young, are over-represented in statistics: 75% of those in the children’s ward at any one time are Mãori and Pacific and 75% of those are under five.

Russell Wills believes very strongly that our priority, at a community and a decision-making level, needs to be our under-fives, because that is when brain development is at its most crucial and long-term damage can be done. At the moment support and policies are focused in the wrong direction.

“For example,” says Wills, “look at current income support. It’s geared to small families and older kids and that’s not the best way to help our most vulnerable children. That’s $2 billion not targeted at the poorest or the youngest which is where it’d get the biggest outcome.”

In his role as Children’s Commissioner, Wills has led the preparation of an Expert Advisory Group Issues and Options paper tasked with finding solutions to child poverty. Solutions posited are required to be “realistic, pragmatic, effective and take into consideration current and likely future fiscal constraints.”

The paper takes a child-centric view of tax and income, health and education, and housing, and focuses specifically on Mãori and Pacific needs. It proposes new ways to spend old budgets – reshuffling existing funds being a key approach to ensuring any potential fix falls within “future fiscal constraints”.

Russell Wills: “We have to choose to prioritise needs and we have to make some big decisions. But there are many things we can do right now that will require no new money at all. However, they will require some hard choices.”

Hastings District Mayor Lawrence Yule agrees money is often failing to get where it is most needed and solutions will take bold moves.

“We have hugely fragmented resources, but the issue of child poverty won’t go away until we start having some very grown-up conversations,” says Yule. “There are people in Hawke’s Bay who are willing to change the status quo and do something about it, and I am one of them.”

Yule’s bold proposal is to take local control of central government spend coming into the region.

“This region getting hold of government resources would make change, and that includes taking control of health, education, welfare, policing and council spend, then maximising the value of that money at a really local level,” says Yule. “We’re in difficult times, there is no more money so we’ve got to make sure what money there is is maximised.”

Pots of money

Back to the current mirror we are using to assess opportunity and need. The Winder Report summarises the spend currently entering Hawke’s Bay from central government:

• The Hawke’s Bay District Health Board received $392.9 million from the government in 2010/11.
• NZTA’s strategy for the region for 2009 to 2012 planned total expenditure of $214.1m (around $70 million per annum).
• The Eastern Institute of Technology received $36 million of government funding in 2010-11.
• Estimated expenditure on primary and secondary school education within Hawke’s Bay is in the order of $178 million per annum.
• In addition to these the government funds substantial welfare payments and a wide range of other services.

The report clearly states that Hawke’s Bay’s success lies within Hawke’s Bay itself: “One of the critical success factors for the future will be the region’s ability to work with government to secure decisions that work in the best interests of Hawke’s Bay.”

A project currently bubbling in Hastings is ‘Henare’s Houses’. Councillor Henare O’Keefe is leading an initiative to take local control of state housing in Flaxmere. Lawrence Yule calls the idea a microcosm of the larger need.
“If Hawke’s Bay wants to be successful then it’s got to start looking after itself. We’ve got to change the way we think. We’ve got to be upfront about the issues.”

Russell Wills agrees that housing is key to bettering the lives of children. His paper says: “One of the major issues facing children living in poverty is poor quality and unaffordable housing. Too many children live in damp, cold, over-crowded houses.”

He goes further, explaining that in housing he finds an example of an issue that plagues much of our social commitment to vulnerable communities: policies and procedures that fail to address the needs of children. “Housing is New Zealand’s biggest asset, but it’s not in the national infrastructure plan, which does include things like roads and airports. Housing New Zealand used to provide ‘a home for life’ but that has now been reworded to say ‘for the duration of their need’. I think that has the potential to increase transience and children moving from school to school.”

But Housing New Zealand acts as landlord for only a fraction of our poorest children. Seventy percent of children living in poverty are in rented accommodation – extrapolate that out: 20% are in ‘state houses’ and 50% are in private rentals.

“I am told that the real poverty is not found in state houses, it’s in privately-owned properties and there it’s harder to monitor,” says Yule.

In the current climate, decisions on social wellbeing are predominantly coming from Wellington, whereas local government is being told to stick to their ‘core functions’ of dogs, roads and rubbish. Funds and resourcing priorities are also being set centrally.

“There is a lot of central government money coming in to our region for various initiatives including air quality, health initiatives, insulating homes, employment. But none of it is joined up. Everyone worries about their own patch,” says Yule.

“The further away you go from the community itself, the harder it is to get a solution.”

Yule does warn that making such a sea-change will take education and understanding.

“At the moment it’s the seed of an idea, an acorn, but everybody knows there is a problem and it’ll take some blue-sky thinking to address it.”

Vibrant contributors

Lawrence Yule is careful to point out that although negative statistics favour Mãori and Pacific, the issues those statistics signal will affect our entire community.

“We are looking at children now who will either be an active workforce or an added burden, so this issue will affect white, educated, moneyed, and their children,” he says. “The ‘Haves’ are getting more and the ‘Have Nots’ are getting less – the divide is getting bigger.”

Mãori and Pacific population growth is greater than that of other groups, due mainly to higher birth rates. Looking into the future: Pacific and Mãori populations will average annual growth of 2.4% and 1.4%, respectively. In comparison, Statistics New Zealand’s ‘European or Other’ category will increase by an average of 0.3% a year. (Statistics New Zealand: National Ethnic Population Projections 2006-2026)

“Inferior social, health and welfare status in Mãori and Pasifika communities is over-represented,” says Yule. But he also feels positive about the future. “If we can fix this there’s a great opportunity for those communities to become healthy vibrant contributors.”

Russell Wills is also optimistic about the opportunities that exist if we can begin to improve the lives of children living in poverty. He prefaces his Expert Advisory Group’s Issues and Options paper by saying:

“New Zealand has a distinct advantage over other OECD countries; we have one of the highest proportions of the population who are children. Like other OECD countries, our population is ageing and the number of people of earning age per retiree is falling. If we look after our children well, particularly while they are very young, we will be in a much stronger economic position than countries with fewer children. We are also a small country by OECD standards; and we know who the children who need extra assistance are. It should be straightforward to ensure they have the resources they need to thrive, belong and achieve.”

Plunket Babies

Russell Wills, Children’s Commissioner and Hawke’s Bay paediatrician cites Hawke’s Bay’s new Plunket Hub in Onekawa as a great example of providing improved services to our most vulnerable people, at a very local level.

Although Plunket is not mandatory, of the 2,000 babies born in Hawke’s Bay every year, 80-90% of those are ‘Plunket babies’. A Plunket nurse will visit a family in the first three months of a baby’s life, and if necessary will go door-knocking to make sure families aren’t falling through the gap.

“Hawke’s Bay is a good place to be a baby. We have a great environment and a stable well-child workforce,” says Sarah Mulcahy, Plunket Hawke’s Bay’s area manager. “But we do have poverty and there are some very vulnerable children here.”

Building skills and confidence are two vital ways Plunket can support even the most at risk families to feel positive and empowered.

“When we talk about low socioeconomic we can’t necessarily say those children are vulnerable. The nature of poverty is much more complex and multifaceted than that,” says Mulcahy. “Changes in family dynamics can occur and sometimes when they do, in poorer families, that can be much more catastrophic.”

Alison Prins, Plunket HB area board chair, agrees: “If stress kicks in and there’s other things happening in the house, then that can be a real issue.”

Environment and policy

In terms of vulnerability there are two major things at work outside the family unit that influence the situation: the environment and the policies that have enabled that environment.

“There’s the situation a child is born into, that may be a cold, damp house for example,” explains Mulcahy. “And there’s the central government policies that have made that situation possible.”

Where changes to environment and policy are currently left at a government level, Plunket is a key agency left to pick up the pieces. They do, however, take an active role in lobbying and informing government decision-making where policy directly affects the lives of children.

Plunket Hub’s focus on co-location of resources and services means new parents have everything they need in one place. Children’s Commissioner Russell Wills is so positive about the place he wants to see another 20 such centres around the country.

The Hub combines antenatal, midwifery, postnatal, support and wellbeing initiatives focusing on babies, their parents, carers and wider families. There’s a baby-clothes op-shop, and car-seat and toy hire. Future plans include a community cafe.

Volunteer driven

The work carried out by Plunket has not changed dramatically since 1907 when it was established by Sir Frederic Truby King. Plunket is still often the first point of contact for mothers with newborns.

“Outwardly we have changed considerably from the Plunket rooms of the 1950s, but Plunket at its heart has always been a social innovator, staying relevant to the needs of the community,” says Alison Prins.

Sarah Mulcahy suggests that today, in some ways, Plunket is filling a need created by modern life. “People are more transient, life is complex, parents and grandparents work a lot more.”

“Plunket can provide mother-to-mother, peer support, those people with kids already have a whole lot of knowledge to share,” says Mulcahy. “Some families are doing that already but other people just aren’t connected in those ways.”
Much of the work carried out by Plunket is done by volunteers.

“Volunteers are what makes Plunket unique,” explains Prins. “Plunket links the clinical component of early childhood with a volunteer workforce.”

Volunteers take on many varied roles including toy library and play group facilitation. Although the volunteer workforce is active and growing, Plunket is always looking for new additions.

Prins: “We could do a huge amount of stuff with more volunteers. Plunket needs people – all kinds of people, for projects, staffing, and at a governance and lobbying level.”

Bequests are another important part of ensuring the sustainability of Plunket services.

“That is something you can practically do for children in the future. Particularly if you were a Plunket baby … that is a great way of continuing the Plunket story,” says Prins.

Future families

Imagining a future Hawke’s Bay populated by the Plunket babies of today, Mulcahy and Prins are relatively upbeat.

“If we talk about families with good support: those families will have babies who grow up connected to community, empowered to make decisions and choices about their own lives,” says Mulcahy. “They’re more likely to have engaged with early childhood education, to have finished school, to have better more stable relationships. And they are more likely to become excellent parents themselves.”

Prins extends the thought to say the wellbeing of us all depends on engaged, connected, well-supported individuals: “In Hawke’s Bay everyone has the same vision of what a great place our community can be, and our children are vital to that vision.”

Plunket line 0800 933 922