United Future will:

1. IMPROVE ACCESS TO PRIMARY HEALTH CARE
2. CUT SURGERY WAITING TIMES
3. ENSURE A VIABLE HEALTH WORKFORCE
4. REVIEW PHARMAC
5. IMPROVE THE HEALTH SYSTEM, RATHER THAN RESTRUCTURING IT
6. IMPROVE CHILD AND YOUTH HEALTH
7. TARGET THE HEALTH EFFECTS OF DRUG USE
8. PROMOTE PUBLIC HEALTH
9. IMPROVE CARE FOR THE DISABLED AND THE ELDERLY
10. FOCUS ON MENTAL HEALTH

1. IMPROVE ACCESS TO PRIMARY HEALTH CARE

United Future will:

• Extend low GP fees to all families, so that parents pay no more than $20, schoolchildren no more than $10, and under 6s are free.
• Give every New Zealander the chance to get a free standard "Warrant of Fitness" health check-up once a year.
• Implement outcome measures for PHOs as an immediate priority, to ensure that the financial investment in this strategy produces measurable improvements in the nation's health.
• Broaden community services card coverage to include subsidies for basic dental check-ups and basic procedures.
• Encourage the establishment of after-hours medical centres close to hospitals, and ensure that the establishment of PHOs does not result in the closure of these services.

2. CUT SURGERY WAITING TIMES

United Future will:

• Establish a contestable fund so that both public and private health providers can tender to provide elective surgery services in order to clear the backlogs of people waiting for surgery.
• Extend Mobile Surgical Services.
• Establish a national study of the physical, social, economic and family costs of long waiting times, so the points system can be reviewed to accurately reflect the impact on patients.

3. ENSURE A VIABLE HEALTH WORKFORCE

United Future will:

• Cut tuition fees for those studying medicine and nursing.
• Provide scholarships and student loan write-offs to bond graduates in fields facing shortages (e.g. mental health nurses, child psychologists, pathologists, radiographers, general practitioners, psychiatrists) into a period of service in New Zealand following graduation.
• Ensure that the Ministry of Health takes effective responsibility for leading workforce development and coordination activities. They will establish comprehensive data collection and analysis on workforce development issues, and design and implement a national workforce development strategy and action plan in order to address the growing health workforce shortages.
• Focus on providing first class working conditions for health professionals as the key to recruitment and development, through the accreditation of workplaces such as the American "magnet" hospital status.
• Develop apprenticeship-style training for caregivers, allowing them to acquire qualifications while working in residential or home care environments, to ensure that they can develop a career path in this field.
• Support Rural GP services by encouraging medical students to consider rural general practice, increasing financial incentives for rural GPs, introducing Rural Nurse Practitioners as a new field of practice for senior nurses, and by establishing appropriate practitioner to patient ratios that will ensure quality of care and reduce the risk of burnout.
• Establish a nursing staffing ratio and ensure that it is realised by improving pay and conditions for nurses.
• Introduce a sabbatical scheme that would allow health professionals to take a year out of work every five years.
• Improve the system by which overseas medical qualifications are approved, to ensure that migrant medical professionals can participate in New Zealand's health system as soon as practicable.
• Embark on a pro-active overseas recruitment campaign, and develop the concept of bonded "working holidays" for health professionals.
• Ensure that funding for the aged care sector covers staffing costs in both residential services and in-home care in the form of better pay and conditions.
• Support pay parity between nursing staff at DHBs and those in the primary care sector.
• Ensure that in-home carers receive allowances for travel.

4. REVIEW PHARMAC

United Future will:

• Review the role and operations of Pharmac to ensure that not only are pharmaceuticals made available at the most competitive price, but also that the interests of individual patients are taken into account when funding decisions are made.
• Develop a national medicines strategy to ensure quality use of pharmaceuticals, and to ensure that New Zealanders have access to the most up to date drugs.

5. IMPROVE THE HEALTH SYSTEM, RATHER THAN RESTRUCTURING IT

United Future will

• Retain the current basic structure of the health system, to provide stability for health professionals and consumers and to give it an opportunity to deliver.
• Commit to the public health model so that it continues to assume the key role in the provision of vital health services.
• Ensure that the health system is characterised by a climate of certainty by clearly defining core services, so that New Zealanders know what the public health system covers them for and what they are not covered for.
• Review the administrative burden facing hospitals and GPs to free up resources currently dedicated to management, which should be directed towards actually making people better.
• Require greater co-operation between DHBs to reduce management and operational costs, with the view to amalgamating some boards in the future.
• Ensure that Ministerial appointments to District Health Boards include representatives of families and those with an understanding of the many subgroups within a community and/or a health or medical background.
• Improve the financial accountability of DHBs by requiring them to demonstrate that additional spending has resulted in clear improvements in services, and by requiring those running deficits to demonstrate how they intend to get out of debt.
• Ensure that DHBs make the best decisions about which providers they should be purchasing services from, and about the emphasis given to primary care and public health strategies.
• Promote public-private partnerships in health care, contracting out health services such as surgery to private providers, or others services such as primary care to non-profit agencies, where they can provide care more efficiently or cover shortages in the public sector.
• Introduce tax concessions to recognise the savings created by those who choose to take out private health insurance, or pay for private treatment, prioritising those aged over 65.
• Establish an independent commission of inquiry to investigate the issue of access to rural health services, as the starting point in the development of a rural health strategy built around families and local communities
• Ensure that ambulance and air rescue services are maintained at a level that does not compromise public safety.
• Increase funding for health research to bring New Zealand's funding up to at least the OECD average as a proportion of GDP.
• Ensure that tax revenues collected from products as tobacco and alcohol are directly channelled into the health budget to recover the costs associated with their use.
• Establish a CAM (Complementary & Alternative Medicines) Unit within the Ministry of Health to monitor the regulation and development of CAM products and practitioners, and facilitate integration of CAM and conventional medicines and practice where appropriate, as recommended by the Ministerial Advisory Committee on Complementary & Alternative Medicines.
• Encourage the development of electronic medical records and prescribing systems to reduce medical errors, remind patients and physicians about preventative and follow-up care, and facilitate the sharing of integrated records and information across sites of care.
• Commit to a full inquiry into the impact of demographic and other pressures on the cost of health care now and in the future, with a particular focus on the impact on aged care services, and incorporating the views of both the public and private sector health providers.

6. IMPROVE CHILD AND YOUTH HEALTH

United Future will:

• Target young children's healthcare by concentrating on the health of mothers before and after birth and ensuring high quality care and support, including home visits, by lead maternity carers and Plunket.
• Ensure that Plunket is sufficiently resourced to make sure that every child receives the recommended eight well child health checks in the first five years.
• Establish new health clinics within family service centres, to provide comprehensive health screening programmes.
• Establish itinerant health clinics in schools where medical and counselling professionals (incorporating Social Workers in Schools) can support young people in need.
• Encourage general practitioners to remain responsive and accessible to teenage patients.
• Ensure that information about immunisation is widely promoted, including the latest international developments, to promote informed decisions by parents.
• Reassess the efficacy of the national vision and hearing screening programme in schools, and expand the frequency of testing to include years 1, 3, 5 and 7.
• Target dental health care education to families and teenagers.
• Ensure that children and adolescents access free dental check-ups, and make more use of mobile dental clinics for this purpose.
• Establish a secondary school subject called 'Life Skills', which has a curriculum that includes segments on career planning, health, sexuality and relationships, drugs, budgeting advice, civics education, parenting skills, and driver education.
• Require health education programmes dealing with risk-taking behaviour in adolescence (e.g. drugs, alcohol and sex) to present abstinence as a genuine option, rather than the current focus on 'harm minimisation' that does not respect the ability of our children to make sensible decisions, and is often in conflict with the law.
• Increase funding for early identification of children with special needs and disabilities with targeted systematic, intensive and high quality interventions that address the needs of the family as well as the child.
• Make additional funding available for youth-focused counselling services as the first line of defence rather than over- prescribing pharmaceuticals for mental health concerns.
• Ensure that information and advice from Plunket continues to remain accessible through the new Healthline phone service.
• Ensure that DHBs make a greater investment in children's health services

7. TARGET THE HEALTH EFFECTS OF DRUG USE

United Future will:

• Oppose the decriminalisation of cannabis and any liberalisation of other drug laws.
• Place greater emphasis on increased funding and co-ordination between alcohol and drug services and mental health services to ensure appropriate, accurate assessment with correctly directed treatment.
• Require the Ministry of Health to undertake research to establish the relative cost effectiveness of existing treatments, including day treatment, residential treatment programmes and other options, with the clear objective of achieving recovery for drug dependency rather than just maintaining it.
• Boost funding for drug treatment programmes, and ensure that residential treatment centres are available and properly funded in each region.
• Review the use and availability of methadone with the intention of reducing methadone reliance.
• Research and establish the annual cost to our health system of drug use.
• Fund research into the physical and social consequences of the use of party pills and other 'legal highs'.
• Investigate the role of alcohol and other drugs in youth suicide and other forms of self-harm.
• Ensure that tax revenues from the sale of legal drugs - alcohol and tobacco - are directly channelled into programmes to address drug abuse and cover the terrible cost to both our health system and to our families.
• Regularly review the classification of drugs to ensure that they accurately reflect their health, behavioural and social effects, and only allow them to move upwards into more serious classes of drugs.
• Allow police to drug test all offenders, including young offenders, and make it mandatory for all young people testing positive to be referred to treatment programmes.
• Ensure that all who are apprehended for possession or use of drugs for the first time are required to undergo treatment, whether they receive a custodial sentence or not.
• Introduce specialist drug courts to allow treatment options to be incorporated into sentencing, combined with the use of further sanctions for continued abuse of drugs and other re-offending.
• Increase the age at which liquor may be purchased from off-licensed premises to twenty.
• Establish legal guidelines for drug-testing in workplaces, schools and other environments, and encourage comprehensive employee assistance programmes in return for reduced ACC levies, to ensure there are no barriers to implementing testing.
• Ban advertising promoting illicit drug use or accessories.
• Introduce a Restricted Substances Act that would regulate the sale and use of party pills and other substances such as nitrous oxide and solvents that also have legitimate uses.
• Work with schools to ensure that they remain drug-free by promoting treatment options in conjunction with punishment for drug offences.

8. PROMOTE PUBLIC HEALTH

United Future will:

• Support effectively targeted cervical, breast, and skin cancer screening programmes, and establish a new prostate cancer screening programme for men.
• Support public education campaigns that emphasise the importance of nutrition and exercise in combating obesity and its consequences such as diabetes and heart disease.
• Increase funding for sexual health/contraceptive programmes targeted towards women aged 20-24, Asian and Pacific Islanders, in light of higher abortion rates for these populations.
• Support public education campaigns that highlight the negative health effects of smoking, alcohol and substance abuse.
• Take a pro-active stance towards the prevention and treatment of HIV/AIDs to meet the threat of an epidemic in the Pacific region, moving beyond targeted initiatives at identified risk groups to improve awareness amongst the general public.
• Support the use of "green prescriptions" through the development of safe and convenient venues for physical activity, such as walking paths and bicycle lanes.

9. IMPROVE CARE FOR THE DISABLED AND THE ELDERLY

United Future will:

• Ensure that there are sufficient community nurses and other welfare agencies so that people can be treated at home where possible.
• Provide better incentives for the nursing, rehabilitation and treatment of the elderly in non-medical institutions, such as rest homes, at home and in retirement villages.
• Ensure that hospices are properly funded so that high quality compassionate palliative care is available.
• Allocate funds to provide all intellectually disabled people who are seeking to make the transition from education or training into the workplace, with an employment advocate/support person for the duration of the transition period.
• Ensure that resources focused on the acute health needs of the elderly are balanced by attention to those ailments that impact on their quality of life.
• Ensure that older people are fully consulted about their health care and are empowered to make informed choices.
• Re-assess the way in which the government funds aged care services, as part of a broader inquiry into future health care costs.
• Ensure that pay rates of providers of care are increased, and that opportunities to gain qualifications are enhanced.
• Initiate an inquiry into the extent of elder abuse in institutional and non-institutional settings, and adopt an aggressive approach to combating elder suicides, particularly at the time of retirement, by improving opportunities for continuing community involvement.
• Extend access to the High Use Health Card to all over 65s.
• Investigate the introduction of a carer's allowance for those who stay at home to look after elderly relatives, from the starting point of providing a limited period of paid leave for those who take time off work to care for their parents in the final stages of their life.

10. FOCUS ON MENTAL HEALTH

United Future will:

• Introduce a more holistic approach to mental heath and addiction. Encourage government agencies to work together on early intervention, prevention, treatment and rehabilitation of mental health patients.
• Ensure that the right balance is struck between inpatient and community care to prevent people becoming a danger to themselves and society, but with recovery in the community remaining the goal.
• Ensure that the Mental Health Commission continues beyond its completion date of 2007 to monitor the needs and performance of the mental health sector.
• Increase resources for mental health professionals to ensure that those who may pose a risk to others or themselves are adequately assessed and treated.
• Introduce minimum ratios for nurses working with psychiatric patients and increase the number of community-based mental health workers to ease high caseloads.
• Amend the Privacy Act so that family members of those who may pose a risk to themselves or society and are under treatment orders may be fully informed of their care and release, with consequential rights of appeal in decisions that place the offender in community or home care.
• Fund child and youth mental health inpatient beds at a level sufficient to achieve the Blueprint for Mental Health Services in New Zealand target level.
• Prioritise child and adolescent mental health to help avoid life-long difficulties.
• Tackle the issue of the lack of accommodation and employment support options for people recovering from mental health problems in the community.

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