National Prevention Service Cuts - A Body-Blow To Health

A proposal to cut 55 positions and 300 currently vacant roles from a health service responsible for preventing disease and keeping people out of our over-stressed, under-resourced healthcare system is a body blow to the health of New Zealanders.

The proposal to cut $32 million from the National Public Health Service (NPHS) and one quarter of staff comes after two major restructures in two years.

"It’s just one body blow after another for the dedicated professionals who have worked tirelessly to keep our population safe and healthy," Health Coalition Aotearoa (HCA) co-chair Professor Boyd Swinburn said.

"This just flies in the face of all evidence and common sense to give up on building fences at the top of the cliff when the ambulances at the bottom are already grossly overworked."

ASMS, the union for senior doctors, strongly opposed the cuts.

"We can’t understand why the NPHS is facing $30M of ‘cost savings’, given the Commissioner’s undertaking that frontline services would not be cut," ASMS executive director Sarah Dalton said.

"Evidence shows that public health spending delivers a 14:1 return on investment, so stripping out capacity makes no sense."

Public health services, including infectious disease surveillance and control, water and air quality monitoring, promotion of healthy eating and physical activity, tobacco and alcohol enforcement, have a vital role in protecting New Zealanders from communicable and non-communicable diseases.

We are concerned about the future effectiveness of public health interventions designed to meet our obligations under Te Tiriti o Waitangi with the restructure of Māori public health services and the proposed large reduction in the Pacific Public Health team, when there are such enormous inequities of health outcomes in these population groups.

The proposal to reduce the size of the Alcohol and Addictions unit is astounding, considering the scale of alcohol harm in Aotearoa.

"Given the scale of harm from alcohol - $9.1 billion per year - and the Government’s stated objective to reduce hazardous drinking, prevention is a vital and strategic investment. Cutting the team and multiplying its workload makes no sense," Swinburn said.

We also note the cuts include smoking cessation roles, which makes a mockery of the Government's Smokefree 2025 plan announced today - including a "renewed focus for smoking cessation services, health promotion, and community mobilization, while enhancing compliance and enforcement measures".

HCA calls on the Minister to explain how the Government will "prevent and reduce the impact of 5 non-communicable diseases: cancer, diabetes, respiratory disease, cardiovascular disease and mental health" - a stated goal of its Policy Statement on Health, while slashing a third of the service responsible.

"When you cut $32m from a service, and take 355 roles away, the ability to promote and protect the health and well-being of New Zealanders will be severely impacted," HCA board member Dr David Galler said.

HCA supports improving efficiencies and reducing unnecessary and genuine duplication, but only if any cost savings are used to expand provision of effective prevention services, HCA co-director Professor Lisa Te Morenga said.

"It is clear this proposal is driven by a Government directive to cut spending on the health budget, and this makes any claims about achieving efficiency and improving outcomes hard to believe."

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