In a recent article, political journalist Colin James made this observation:

“An Otago University Wellington medical school symposium last week detailed the huge individual, social and economic loss from children not getting a healthy start. Those inequalities and inequities persist because most voters think of ‘health’ as ‘fixing sickness’ and demand a large, expensive ‘sickness industry’ to fix it. Hospitals are revered; healthy eating is a nanny-state bore.

Some health inequalities — physical and mental deformities and disabilities, genetically determined conditions, damage from accidents — can’t be fixed, though intelligent policy can render them less disabling. But inequalities which stem from unhealthy houses, poor diet and poor or damaging parenting, all made more likely by poverty which makes good life choices harder, can be reduced. These inequalities are inequities.

The sickness industry is much more focused on costly end-of-life interventions — cutting people up and filling them with dangerous drugs — than start-of-life enabling of children to be healthier. The economic return on investment in the first two years of life is huge and in the last two years tiny.

The idea that ‘spending’ on enabling a better life is ‘investment’ is still not mainstream, though for more than a decade some officials and the odd politician have argued it. Social activists, as was evident at the symposium, are uncomfortable with the hard-edged thinking economics demands.

But is change coming? A sickness industry lobby, the Medical Association, co-sponsored the symposium.”

This ‘return on investment’ proposition seems especially relevant for Hawke’s Bay, where we face sharply growing populations at both ends of the spectrum — children and senior citizens.

It would be interesting to know the per capita spend our regional health system — both DHB and primary providers — makes on each of these two groups! And whether this allocation might or should change.

I’ll venture a guess — guess who votes?

But perhaps someone at DHB can enlighten us.

Tom Belford

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1 Comment

  1. A disappointing end to an interesting and important topic. My impression is that the DHB at least is wrestling proactively with this very issue.

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