Kevin Hague
Rational Tony Ryall

I am continuing to push the Minister of Health on the issue of planning for diabetes because it is his job to plan for future health services that we need; and he is not doing that. This is a problem for all of us who will inherit, within our lifetimes, an obesity and diabetes crisis that will totally monopolise our limited health resources. The plain translation of that is that our hospitals will increasingly be filled with people in dialysis machines leaving less room, money, and staff to deal with other health problems.

We should be planning now for this crisis.

Instead of putting his head in the sand, Tony Ryall should be gathering information to give us some sense of just how much diabetes will cost us in the future and what funds we need to devote now to preventing that.

Previously, when I asked him in the House about diabetes prevention, Tony Ryall said:

“Look, I think it would have been rational to have the investment that this Government is making in the area of diabetes and helping people manage their weight. The Government is spending $60 million a year on prevention initiatives, which include Fruit in Schools, the funding for which was going to be stopped under Labour[1]; a range of nutrition and breastfeeding programmes; and a very significant investment in Kiwisport. So it is across the range and across the life course.”

So I asked him more questions about this figure yesterday.

The Minister has never sought nor received any advice on the potential cost of diabetes to New Zealand, so this $60 million figure is just a stab in the dark at some sort or prevention; not based on any analysis of the actual amount of money we should be spending today to address the tidal wave of costs that diabetes is going to hit New Zealand with in the future.

The Ministry of Health has provided the breakdown of that $60 million. It is, in reality, a decrease in budget since 2008 and includes things like increasing spend on bariatric surgery. While that surgery can save lives of people with obesity, it is a treatment, not a prevention measure. It is disingenuous of the Minister to say that he is spending $60 million on prevention measures when actually that is the amount of ‘obesity related expenditure’.

If you take the first 7 lines of that table, which are the actual prevention measures, then we are looking at a 29% reduction in obesity prevention spend all while obesity rates continue to climb.

Table 1: information provided in response to Q176 (Examination of Estimates Budget 2013)

$(million)

2008/09 2009/10 2010/11 2011/12 2012/13 2013/14
Actual Actual Actual Actual Budget Budget
Nutrition & Physical Activity 18.339 15.378 15.364 15.395 15.529 15.529
Fruit in Schools 10.719 9.827 7.428 6.902 6.902 6.902
HEHA Implementation 28.720 18.642 16.127 12.983 1.313 3.123
Green Prescriptions - 3.772 3.981 4.321 3.784 5.224
CVD Diabetes- DHBs 8.355
CVD Diabetes- Ministry 0.430 1.282 0.553 0.183 -
Kiwi Sport – SPARC 7.462 7.462 7.462 7.462 7.462 7.462
HRC – Research into Interventions 5.000
Bariatric Surgery 2.000 2.000 2.000
Bariatric Surgery – DHBs (estimate) 4.940 4.940 4.940 4.940 7.700 7.700
  70.610 61.303 55.856 54.187 44.691 61.296
Notes: This excludes Ministry of Health funding for a range of related programmes and services, such as maternity; maternal and child health services (Well Child, B4SC-Before School Check programmes), PlunketLine; and HealthLine. These services are not specifically designated as nutrition and physical activity programmes or promotion, but they do include advice on improving nutrition and breastfeeding promotion which make a contribution to reducing obesity.This excludes Government funding to district health boards (DHBs) used to employ dietitians. These dietitians provide primarily ‘one-on-one’ nutrition services, and DHBs may use their funding to provide additional nutrition and physical activity programmes and promotion.This excludes funding to general practice for its enrolled population. Advice on nutrition and on reducing obesity is also provided at a community level through general practice.

The Government funds Kiwi Sport $20.5 million of which the Vote Health contribution of $7.462 million Per Annum is identified in the table above.

 

 


[1] As a side note, Tony Ryall is not normally a fan of free fruit in schools and made the call not to extend it to other decile schools.

5 thoughts on “Rational Tony Ryall

  1. Kevin says “If you take the first 7 lines of that table, which are the actual prevention measures, then we are looking at a 29% reduction in obesity prevention spend all while obesity rates continue to climb.”

    That’s totally misleading.

    If you look at line 3, you’ll see that $25m of the reduction is because HEHA (healthy eating healthy action plan ) has now been implemented right across the education, health and sports sectors.

    So what has actually happened, is the opposite of what you claim.

    With HEHA nearly fully implemented (after nearly a decade) there now more action against obesity through education, health and sports sectors than there has ever been before.

    Like or Dislike: Thumb up 4 Thumb down 0 (+4)

  2. Can we get serious about limiting the number of fast food outlets that increasingly smother the place these days?
    Some streets are little more than eatery strips and many of them not offering healthy options. Why do we keep giving the green light to yet more overseas businesses peddling greasies?

    Like or Dislike: Thumb up 1 Thumb down 0 (+1)

  3. Photonz – no. HEHA was a programme of activities, that were supposed be ongoing, rather than a one-off. Tony Ryall didn’t like the programme, so essentially stopped it, at the same time that he scrapped the ‘food in schools’ regulations.

    Like or Dislike: Thumb up 3 Thumb down 1 (+2)

  4. jc2 ‘CVD diabetes’ refers to cardio-vascular disease and diabetes (type 2), both of which are strongly linked to obesity. The expenditure in the most recent year ($8.355M) I think relates to some new Government funding for DHB-funded services to prevent people identified with pre-diabetes or CVD risk going on to get diabetes or heart disease (in fact a very limited, though, worthwhile, part of prevention).

    I have been repeatedly asking for, but don’t yet have, the fine detail of what was previously being funded and what is being funded now, so can’t tell you more about what was in each of these categories, or why there was a gap.

    Like or Dislike: Thumb up 2 Thumb down 0 (+2)

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