social determinants of heath

Hi, my name is Hamish Hutchinson. I’m a registered nurse, an NZNO delegate and I work at Waitakere Hospital in Auckland.

We’re coming up to the Budget, which is when the Government prioritises its spending for the next year. Will they prioritise health? I’m not holding my breath.

The Council of Trade Unions calculated we are well over a billion dollars short for the health system just to stand still. I can’t really comprehend what a billion dollars looks like, but I can tell you what underfunding looks like to me, every day.

I’ve been working as a nurse for 5 years. I chose nursing because it’s the sort of profession where you can use your own humanity to help others. This is still why I want to be a nurse.

I work in an Emergency Department (ED), so we are used to it being busy. We have a great team that responds well in a crisis. But it’s not always trauma and lights and sirens – another part of the ED is about doing screening for family violence and asking about how things are for people in the home. When it’s busy – and it’s getting more and more busy all the time – this stuff – the social stuff, the time spent listening to people gets pushed aside. That worries me.

We always say that the Emergency Department is for emergencies only. I’ve lost count of the times I have heard people saying that they couldn’t get into their GP for 3-4 days or couldn’t pay for after-hours clinics or couldn’t get into a GP because they work two jobs and have kids. Inevitably they come to ED – where else will they go?

Just as an example, I saw one man who had an infected wound. He had put off seeing the GP because of cost and because he couldn’t take a sick day from work. When he finally arrived in the ED his wound had gotten really bad. Something that probably could have been managed by a GP a few days ago ended up needing surgery and a hospital stay. It was worse for the patient and it cost so much more than it needed to as well, in equipment, bed space, and staff time. This doesn’t need to happen.

Some days the Emergency Department feels like a game of musical beds. When the hospital is full it’s just one big balancing act. I’m amazed it works and I think that’s down to the tireless work of nurses and other hospital staff. But the reality is this is not a game, this is people’s lives.

Good health is vital for a good society and if I got to make the big decisions, I would make health and wellbeing a bigger priority than it is now. Everyone needs to be able to get health care in their own communities. We need more hospital staff for sure – but keeping people out of hospital is cheaper in the long run.

What this would look like for me? It would mean having enough time to talk to people to find out what brought them to ED and how we can stop it happening again. You can’t do that when it’s too busy, when there’s people in corridors, and it’s the really important stuff like this that falls away with underfunding and understaffing.

Other things that would make a big difference, in my opinion are:

Free GP visits for everyone and clinic hours extended to suit working families. People should be able to see a GP on the same day and have flexibility if they are workers.

Improving the ‘social determinants of health’- the things that should keep people well in the first place, like housing, welfare, education and employment. We would have more time available for the unavoidably sick if preventable causes of disease were reduced or removed.

In particular, outside of the hospital, there has to be more emergency housing, and this is an issue that’s needs to have been resolved yesterday! There’s nowhere in West Auckland to go if you are homeless, only sleeping rough or paying for a motel which might not be an option for lots of people. Addressing the human right to safe shelter is an absolute must and would ultimately improve the health of people in hardship. If nothing is done on this issue, I will be worried for the future, because it’s bad enough now. On Thursday, I hope the Government prioritises health and the people in our communities. And that means housing, welfare, education and employment as well. They could do it if they had the will. They could fix this all if they wanted. That’s something we are all holding our breath for.

Kerri Nuku is NZNO kaiwhakahaere. Eseta Finau is the chair of the Pacific Nurses Section. Today they got together to discuss the unfair treatment of our most vulnerable children.

When we heard yesterday that the Coroner has said that a cold damp house contributed to the death of a beloved two year old girl in Auckland, we couldn’t stay quiet.

It’s only a couple of months since a similar finding was made in the case of a Porirua baby whose housing conditions contributed to his death.

Our hearts go out to their whānau.

Our children, our precious taonga are getting sick and dying because of poor housing conditions. It’s not acceptable!

We both know, from first-hand experience how many of our mokopuna end up in hospital with preventable respiratory illnesses. In some communities it’s considered normal. In other communities it’s less likely to happen.

40,000 children are hospitalised each year with poverty related illnesses. That’s 40,000 too many! It’s a heart-breaking number.

As nurses, we understand how health is affected by many factors; housing, income, education, the environment, to name a few.

We strive for a healthy New Zealand and that means we must advocate for change across many sectors.

That little girl in Auckland, that little boy in Porirua – we have failed them and their families. New Zealand has failed them.

Cold, damp, mouldy, unhealthy houses that families can’t afford to heat are a shame on all of us.

It’s time the Government got serious about preventing all this illness and death.

We want to see a rental warrant of fitness scheme.

We want to see power and heating solution that every family can afford.

We want to see our communities having equal opportunities to participate in our society.

Those 40,000 kids deserve to be warm and healthy! So do their mums, their dads, their brothers, their sisters…

We’re speaking out. We want change. And we’re not going to stop until we achieve it.

Join us.

Together, we can create a healthy New Zealand.