Wednesday, 24 February 2016

25 February 2016

Two reports caught my eye this week. First was the Amnesty International Report on Human Rights in New Zealand, and the second was the report of the Family Violence Review Committee on the state of domestic violence in New Zealand.

Amnesty International was critical of a number of aspects of human rights in New Zealand, particularly around the numbers and treatment of refugees, and also relating to aspects of our surveillance policies, in particular the “full take” approach we apparently adopt with regard to Pacific states.

The Family Violence Review Committee report highlighted the unacceptably high level of domestic violence in New Zealand, and called for all relevant government and non-government agencies to work more effectively and collaboratively towards its resolution.

While at first glance these reports may appear to have little in common there is a link between them. It relates to the vexed question of information-sharing. On the one hand, according to Amnesty International, we are insufficiently discriminating when it comes to gathering (and presumably sharing) intelligence information on our Pacific neighbours. Debate about the scope and implications of "“full take” information gathering policies has led the United States to modify its approach in the last couple of years, with Congress placing new restrictions on such practices, even if the FBI is now trying to subvert those in its current bullying of Apple over access to encrypted mobile phone data.

On the other hand, the Family Violence Review Committee report calls for greater co-operation between agencies, including more information-sharing. And this is the point of connection between the two reports.

There is a strong case for better information-sharing between agencies, when it is in the individual citizen’s interests. There is an arguable case for information-sharing when it might assist the identification of at-risk families, or aid the investigation and prevention of crime. (The jury is still out on where the boundary-line is to be drawn in these cases, between the mechanisms to be adopted, and the rights of the individual protected.) But there is no case at all on human rights and individual privacy grounds for any continuation of “full take” data-collection and information-sharing, especially when that involves data collected about other countries.

People expect governments to share information between agencies when it is in their individual interests, but they also expect governments to treat such information with due care, and to never forget that they are but the custodians of an individual’s information. It is never the government’s information, but is always that of the individual citizen, and must be respected as such. It goes without saying that it should only be used for the purposes for which it was gathered.

One way of resolving this inherent conflict might be to do what happens in Estonia. There, citizens have the right to see at any time who has been accessing their personal data. If that access is deemed inappropriate, strict criminal penalties apply. As a consequence, there have been extremely few privacy breaches. Maybe, we should be looking to implement such a protection here?     




Wednesday, 17 February 2016

18 February 2016

One of the more pointless but recurring debates, no matter which government is in office, relates to the level of spending on the public health system.

Currently, Labour says there have been $1.7 billion of health cutbacks over the last five years, which National counters by pointing out that health spending has gone up by $4 billion over the same time. Ah yes, says Labour, but it should have gone up by at least $5.7 billion, so the difference represents the effective cutback that has taken place.

It is all quite pointless. The focus should be on the performance and productivity of the health sector, and the overall impact that is having on the health status of New Zealanders.

On that basis, performance against the Ministry of Health’s targets tells a good story, according to the latest results. Overall, although the performance does vary from DHB to DHB, stays in emergency departments are shorter; there is generally improved access to elective surgery, and faster access to cancer treatment; immunisation rates are rising; more smokers are quitting; more people are having regular heart and diabetes checks; and, children’s oral health is improving.

In international terms, we rate ahead of France, Canada and the United States, but behind Britain, Australia, and Germany, according to a 2013 study on healthcare outcomes by the Commonwealth Fund. So, while we have a good healthcare system, there is obviously room for ongoing improvement, which brings us back to the issue of funding. The same study showed we have the lowest level of per capita spending on health of the eleven countries surveyed, even though our overall performance rates much higher. The productivity of our health professionals is clearly better than most.

This year, the government will spend just under $16 billion on the public health system, around 10% of GDP, compared to just over 7% in 2000, and around 8.5% when it took office.

Now, one thing anyone who studies health spending and services knows only too well is that the demand for services is insatiable, and that any government, no matter how prosperous the times, will be engaged in some form or other of rationing to meet the budget.

Which is where service improvements, efficiency gains, better use of technology, and new forms of clinical practice come in. A recent telecommunications and technology study has estimated that more video-conferencing between doctors, patients and specialists will not only reduce the need for emergency room visits, hospital admissions and the long-term prescription of often costly medicines, thus providing better, faster and more convenient care for patients, but also has the potential to save about $6 billion in current health costs, releasing funds which could then be ploughed back into currently expensive areas of health care, like, for example, the cost of new medicines (like Keytruda?).

That is where the real debate about the future funding of our health services should be focused, rather than continuing the tired old games of “National says, Labour says”.  








Wednesday, 10 February 2016

11 February 2016

I agree with the Labour Party on the TPP.

Well, some of what it is saying anyway. Actually, to be more accurate, some of what Andrew Little is saying, because everyone else in his Caucus seems to be trying to cover all sides of the argument, all of the time.

No, I agree with Andrew Little when he says it would be crazy for New Zealand to pull out of the TPP once it takes effect. He is absolutely right.

Over the summer period, I took the opportunity to listen quietly to what real New Zealanders, not the vocal protestors, were saying. Their message is mixed. They hear the government’s story about the trade opportunities arising from the TPP, and while, on balance, they are a little sceptical, they tend to see that as positive. They do worry about sovereignty issues, but note that every agreement we have signed up to, including membership of the United Nations under Peter Fraser and the World Health Organisation, has involved sovereignty issues, and there has never been a problem. In any case, they tend to accept the view that New Zealand will make its own mind up if any clashes arise.

Some have seen it as ironic that when it came to issues like sending troops to Iraq, New Zealand did not do so, because there was no United Nations mandate in place, and we believed in collective action, and the Labour government of the time was insisting – correctly in my view – on there being such a mandate as a condition of its participation. Others have wanted to know how come it was acceptable for New Zealand to take Australia to the World Trade Organisation over its restrictions on our apple exports, but not acceptable for similar provisions to apply here.

A lot of scorn has been heaped upon academics like Jane Kelsey for their role in the debate. Part of that seems to me to be the narrow anti-intellectual bias of some New Zealanders, which is a pity, but I did hear one comment to the effect that never has someone said so much, for so little impact! (It is fun what one hears when sitting quietly in a café.)

People quite like Andrew Little’s line that we are a country built on free trade. They snigger a bit though at the verbal gymnastics that have seen him go through saying that on the one hand, while saying he opposes TPP on the other, but would not stop it if he won office.

But the common point all the discussions I have heard seemed to end up on was what happens if the TPP proceeds, and New Zealand is not part of it. How does that help our exporters, and what will it do to the cost of imports? The xeonophobes – who certainly do not like the TPP – splutter that not being part of it might make even us more reliant on China.

To me, it all sounds a little like the 1980s restructuring. No-one at the time particularly liked it, but most people knew in their heart of hearts that it had to happen. The then Labour government got grudging support for staying the course. Only when it flip-flopped, did it lose public goodwill. That is the lesson for the current government on the TPP. Stay the course, capitalise on the hard yards already made, and lock in the benefits. After all, as Andrew Little has made very clear, the TPP is here to stay.