Commitment to community input into health care

Press, 25 September 1987, Page 4

Commitment to community input into health care

A commitment to community input into health care was given by the new Minister of Health, Mr Caygill, in his first address to a main health group yesterday. Mr Caygill, in an address to the annual conference of the New Zealand Nurses’ Association, said that the right of the ordinary citizen to have a say in public policies was a vital safeguard in an increasingly complex system of Government.

“People do hold strong views on health — for example, about the standard or cost of the health care that they expect — but it seems to me that these views are not always wrong,” he said. “I certainly do not believe, any more than many others may seem to, that Wellington always knows best”

Mr Caygill said tbat it was for this reason that he was a strong supporter of area health

boards. “I support them on two counts: first, they seem to allow an input, through the domestic process, of regional or community views.

“Second, they broaden the focus of health care away from any narrow concern with hospital care.”

The long-awaited moves to area health boards did not cut across the recommendations of either the Royal Commission on Social Policy or the task force on hospital and related services.

“I cannot imagine either body seeking to diminish the elected or regional input into the health services.”

Apart from the specific instance of area health boards, Mr Caygill said he hoped to adopt a broad approach to health care. “The increased emphasis that many people seem to have called for on health promotion and

disease prevention seems to me entirely appropriate. “I am not sure how it can be achieved but if all New Zealanders were able to adopt a better diet, a higher standard of fitness, and to stop smoking if they are still doing that, then I am sure that they and all of us will be better off.” Such primary health care initiatives fitted his notion of democracy. "Which is not that the Government should take charge of everything, but rather that we should seek to empower people to take greater charge for themselves.”

Since his appointment, Mr Caygill said he had asked himself many questions about the future of

New Zealand’s health service.

“What does a betterquality health service actually mean? How do we measure or identify the quality of a health ser-

vice? How will we know that it’s doing any better?”

He confessed that on reflection even the Labour Party’s health objective of "Health Care fi —11, 'he r nd whe it

/or aii, when and where h is needed” did not seem as self-explanatory as he once thought it was.

Although now was a time of significant change

in the area of health, the Government was committed to doing more than achieving an improvement in the nation’s overall standard of health. “We wish to ensure that access to health services and improved health outcomes are shared widely

across the community and are not concentrated on those who are already materially better off.”

Mr Caygill acknowledged that with 26,000

members, the Nurses’ Association was the biggest single occupational group in the health services.