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Getting out of an unhealthy relationship

Newtown TPPA mtg 19 1 16 IMG_4111Tomorrow, the 4th of February, the Government is signing the Trans Pacific Partnership Agreement (TPPA) in Auckland, along with eleven other countries.

I’ve been travelling around for the last few weeks and talking about why it’s important we walk away, for our health and our human rights.

This ‘partnership’ agreement they are signing is not an equal or healthy one and I’m really worried.

I’m worried that Pharmac is going to have to pay more for essential medicine. If just one company holds a patent for a longer time, they can charge whatever they like – for example, up to $300,000 per patient for a cancer drug like Keytruda. This could cost us hundreds of millions of dollars in the long run and people we love could miss out on care they need.

I’m worried that foreign tobacco companies can demand they ‘help’ us write the laws on tobacco control. Even if they can’t sue us directly, they can ask their own Governments to do it for them. We need to have the right to make our own laws. I’m worried other companies, like Coca-Cola, or casinos, or oil companies, will use this agreement to go after a small country like us if we do things against their interests. Even law changes like removing the GST on fresh fruit and vegetables could be at risk. Protecting our own health should be our decision, not theirs.

I’m worried for our hospitals. If DHB services are contracted out to private companies, it could be really hard to get these services back in the future. Under the TPPA, we couldn’t do anything that ‘favours’ services owned and supplied by the people, versus for-profit companies. The American health system has been taken over by huge multi-national insurers, and we don’t want to end up in the mess they are in!

Thankfully, it’s far from over. Although the Government is signing the agreement tomorrow, they have to change a lot of law in parliament for it to begin. Every time they do this, we have the opportunity to tell them it’s not ok. We need them to know it’s a really unpopular move for any Government to sign away our rights.

Keeping our independence to decide what’s healthy for our country is keeping our strength. Nurses and health workers in America, Australia and around the Pacific Rim are sending their governments the same message.

Tomorrow I’m standing with them, against the TPPA and for partnerships which protect health and human rights, and I’m asking you to join me.

Details of the rallies against the signing can be found here.

If you want to read up on the TPPA text in more detail, check out my speech notes from the speaking tour on my blog.


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Working in partnership for health

IMG_0103Yesterday NZNO president Grant Brookes, CTU economist Bill Rosenberg and others made submissions to the Greater Wellington Regional Council on a motion brought by Cr Paul Bruce.

Cr Bruce realised that, if ratified, the Trans Pacific Partnership Agreement (TPPA) would constrain the Council from reaching its goals, in many ways. The Council has recorded its opposition to the TPPA.

Grant made the links between people and health, and the environments they live in. Achieving health requires wrap-around thinking and intersecting actions. We all need to be on the same page if we are to realise a healthy Aotearoa New Zealand.

Here’s Grant’s submission:

Kia ora koutou. Good morning. My name is Grant Brookes. I am a registered nurse, and the president of the New Zealand Nurses Organisation.

NZNO is the leading professional association and union for nurses in Aotearoa New Zealand, representing 46,000 nurses, midwives, students, kaimahi hauora and health workers – including four and a half thousand in the Greater Wellington Region.

NZNO embraces Te Tiriti o Waitangi and works to improve the health status of all peoples of Aotearoa New Zealand through participation in health and social policy development.

At present, a major policy focus for the sector is the update of the New Zealand Health Strategy, being led by the Ministry of Health. The relevance of this to Councillor Paul Bruce’s motion will soon become clear.

The previous New Zealand Health Strategy, introduced in 2000, has occasionally been referenced in this Council’s planning.

The updated Strategy, which proposes a clear view of the future for the health system over the next 10 years, is likely to have greater bearing on your decision-making.

This is because an eighth guiding principle for the health system has been added to the existing seven, in recognition of the way the wider environment contributes to people’s health. It is: Thinking beyond narrow definitions of health and collaborating with others to achieve wellbeing.

Particular examples of collaboration between health services and other agencies are mentioned in the Strategy. They include Healthy Auckland Together and Healthy Christchurch.

Healthy Auckland Together revolves around a Regional Action Plan, developed by 21 organisations, including District Health Boards, Primary Health Organisations and the Auckland Council. It views local government domains like transport and regional parks (and indeed local government employment conditions) as part of the health infrastructure.

Healthy Christchurch is a similar, DHB-led collaboration involving local government, based on the World Health Organisation’s Healthy Cities model.

Meanwhile, World Health Organisation Director-General Dr Margaret Chan has spoken of the TPPA as part of a “particularly disturbing trend [involving]… the use of foreign investment agreements to handcuff governments and restrict their policy space.”

And as we’ve just heard from New Zealand Council of Trade Unions economist Bill Rosenberg, the TPPA’s restrictions apply to local government as well – even as your role in creating healthy environments is receiving greater recognition.

As a nurse, I am very concerned that the TPPA will restrict your ability to fully contribute under the updated New Zealand Health Strategy.

So I applaud you for being one of the councils, covering 60 percent of New Zealanders, who have previously voted to express opposition to the TPPA, as it stood.

I now ask you to support the recommendations in Cr Paul Bruce’s notice of motion, especially these parts:

“That the Chief Executive… deliver a report… on the impact that the TPP will have on Greater Wellington Regional Council’s ability to make decisions in the interests of our region, the people and their environment”, and

“That the Council asks that central government carry out… health impact assessments of the potential effects of the TPP.”

Thank you for the opportunity to address you today.



A fat lot of good?

3nN3nDmNfO-4Yesterday the Minister of Health, Jonathan Coleman released his much awaited plan to combat obesity in New Zealand.

His plan focuses on childhood obesity – a good place to intervene we thought. And at first glance it all looks good, but dig a little deeper and you’ll find only half a plan. The half that involves individual responsibility; not the half that would regulate, control and fix the very things that cause obesity – the aggressive marketing of and too-easy access to high sugar, high fat foods and drinks.

That said, the plan is broad (no pun intended), with three focus areas and 22 linked initiatives. Most are not new, but they do now add up to a more coherent approach than we’ve had before.

We were hoping for a bold and effective plan. This plan does not live up to the hype. Trying to deal with a systemic and societal issue by blaming fat kids and their mothers is mean, sexist, unfair and ineffective.

Two of the main recommendations of a 2015 World Health Organisation report on childhood obesity are to impose taxes on sugary drinks and to reduce children’s exposure to the marketing of unhealthy food and drink. The report gives clear guidelines about how to go about achieving these two recommendations.

Our Government has had discussions “on the role industry can play in helping to address childhood obesity. These discussions have included the possibility of voluntary industry pledges, and changes to food labelling, marketing and advertising to children.”

Hmmm. Not exactly earth-shattering. In fact, you might go so far as to wonder if the Government was trying to keep the big sugary drink and fatty food companies on-side. Big sugary drink companies and multi-national fast food companies sure don’t like having their profits threatened by countries legislating and regulating for the good of their citizens.

In fact, if the New Zealand Government did go ahead and legislate for public health it would be at great risk of being sued by those companies, under the Trans Pacific Partnership agreement.

So, a voluntary standard it will be – if anything happens at all. And nowhere near what the World health Organisation is recommending.

The Government’s childhood obesity plan also includes a Health Star Rating, a voluntary front-of-pack nutrition labeling system developed for use in New Zealand and Australia.

Voluntary again, you will note, and with the onus on individual shoppers to make “good” food decisions.

Schools will be encouraged to offer and promote more sport and activity, but won’t be required to provide healthy food and beverage choices. Sure, no one would argue that sport and activity isn’t a great idea – but when it’s not backed up with a wraparound healthy environment there’s only so much we will achieve.

There has already been a lot of comment on the plan, with many saying it doesn’t go far enough and others (teachers and GPs in low-income areas) saying anything is better than nothing.

I think we’d have to agree – the Minister’s plan is better than nothing and it doesn’t go far enough.

To quote NZNO principal researcher Dr Léonie Walker, “There is a need for more prominent and pressing action relating to the impacts of poverty, nutritional poverty and an industry fuelled obesogenic environment.”



An open letter to John Key

It’s been kept pretty hush-hush but it looks like the New Zealand Government wants to sign us up to the Trans Pacific Partnership Agreement in the next couple of days. The views of an overwhelming majority of New Zealanders are being completely ignored. If you want to put your hand up and say, “Walk away from the TPPA!”, here’s your opportunity.

If you would like to become a signatory to the open letter below, please add your name in the comments, or print the file, sign it and send it to:

Rt Hon John Key
Prime Minister
Parliament Buildings

An open letter to the Government from nurses, midwives and healthcare assistants
September 2015

Tēnā koe Prime Minister

We are disturbed to read reports that you intend to seek a hasty conclusion to negotiations on the Trans Pacific Partnership Agreement.

“It’s the best we could do” is not a good enough reason to sign a bad deal.

As health professionals we believe the best we can do to ensure our communities stay healthy is to ask you to reject the deal, and walk away.
Access to the best medicines at the earliest opportunity and at an affordable price is vitally important.

Signing New Zealand up to a deal that puts our health, our sovereignty, and our quality of life at risk is foolhardy.

It is not too late to walk away from Trans Pacific Partnership talks. Please do the right thing for New Zealand.

Nāku iti noa, nā
The New Zealand Nurses Organisation
and the undersigned


NZ must walk away from the TPPA

FB coverThe leaks are coming thick and fast as Trans Pacific Partnership talks are reaching their conclusion. From what we know, it seems there are many downsides and not many benefits for our nation.

In the words of Kenny Rogers, “You’ve got to know when to hold ’em. Know when to fold ’em.”

Well, we think it’s time to fold ‘em.

We’re worried that Trade Minister Tim Groser is afraid he would lose face if New Zealand was to walk away from the deal at this late stage, but it’s what we need to do.

A trade deal that privileges big business over nations, that reduces our ability to purchase affordable medicines, that will impact on our health and well-being in many ways is not a deal we need.

Sometimes the bravest thing to do is walk away.


You might be interested in some of our other writings about the TPPA

Don’t sign our future away

Who’s in charge here?

Why the TPPA is a health issue

Nurses support the call for TPPA transparency and health check

NZNO sends open letter about TPPA to Prime Minister

It’s our future – we want a say

TPPA not democratic and not right nurses say

Pharmac under attack



Who’s in charge here?

2007-08-02-UncleSam-thumbNZNO senior policy analyst Marilyn Head asks why we would want to let the United States dictate New Zealand’s laws.

I’ve been following the progress of the Trans Pacific Partnership (TPP) negotiations right from the beginning. It’s a scary process, being negotiated in secret. The leaked documents I have seen show that if signed, New Zealand would lose out in all sorts of ways – from a loss of sovereignty to adversely affected public health outcomes.

What I didn’t fully appreciate until now was that, if we go ahead with the agreement, the United States’ (US) heavy handed approach to enforcement could extend as far as directing New Zealand’s laws. Judging by information released on a new website which  identifies the legislative changes the US might expect of  TPP partners, it appears I was overly optimistic.

The US has a ‘certification’ process which involves consultation with and monitoring of trading partners to ensure that their regulatory environment in consistent with treaty/partnership obligations. While that sounds fair – we all want to be sure that we are operating from a level playing field – in practice it is more ominous, amounting  to direct interference in the democratic processes of sovereign nations.

The certification process would come after the TPP agreement is signed! It is another opportunity for the US to tell us what laws and regulations we must change before they implement the agreement. It is like having another bite at the cherry. It enables the US to exert huge pressure on countries which may not want to risk the ‘good deal’ they’ve signed up to with 11 other countries if the US pulls out.

The website exposé shows the areas they will be looking for ‘compliance’ with US regulations and the sort of pressure they’ve exerted on countries such as Peru where, as part of the certification process for the Peru-US free trade agreement, the Office of the United States Trade Representative actually drafted Peru’s legislation and demanded that it be accepted without change, with quite disastrous consequences for Peruvians.

The ‘barriers’ the US wants removed according to the website,  will require changes to our domestic copyright and patent laws and Pharmac’s operating processes –  changes that NZNO and many in the health sector have repeatedly pointed out present a risk of  increasing the cost of medicines and limiting  government’s ability to regulate for public good. The New Zealand Climate and Health Council OraTaiao says (pdf) that losing our sovereign right to create and strengthen the laws that form the building blocks for fair and healthy lives – access to medicines, clean water, food and air – will make it extremely difficult for New Zealand to maintain and improve our quality of life.

I agree. New Zealand laws must be made by New Zealanders.

Ahakoa, he iti he pounamu.




Don’t sign our future away!

TPPA311Last weekend Trade Minister, Tim Groser accused NZNO and others of being less than truthful when we say New Zealanders are not being consulted about the Trans Pacific Partnership agreement (TPPA), which is currently being negotiated in secret.

He said, in a RadioNZ interview, “There’ve been more discussions with stakeholders on this agreement by a country mile than any trade agreement I’ve been associated with negotiating in New Zealand in the past 30 years, it’s just that these are people taking a very, very politicised view of the matter.”

He then went on to assure New Zealanders that they would hear the facts when the deal was put before Parliament.

Sadly, he neglected to say that when the deal does finally “get to Parliament’ it will be waaaay too late to do anything about it. In fact, Parliament itself is not even able to do anything about it.

Professor Jane Kelsey explains, “Parliament’s role in treaty making is largely symbolic. It has no power to decide whether or not the TPPA should be signed or ratified and no ability to change its terms TPPA or require it to be renegotiated. The select committee process is a farcical exercise because its members know they cannot change the treaty.”

And as for those purported consultations… a few private briefings of selected health representatives does not qualify as transparent, informed public debate.

Why is the content of the TPPA a secret to New Zealand stakeholders? We expect transparency and the protection of public health as a key pillar of our social democracy. ‘Commercial sensitivity’ does not justify blanket secrecy where publicly funded health is at stake; especially when, unlike New Zealand citizens, US trade lobbyists have access to the ‘secret’ text.

We do know some things about what is being negotiated – I blogged about it here and it’s not good news.

Most governments, and it seems that ours is likely to be one, will be deterred from public health regulation because they’re scared of being sued by big business, though a few have refused to be intimidated. Australia went ahead with its plain packaging of tobacco products and is staunchly defending its right to do so against three investor challenges, at a cost of many millions of dollars. Disappointingly, New Zealand reacted by delaying its plain packaging legislation, leaving Australia to defend this important public health decision alone.

This agreement was initiated before the global financial crisis in 2008 and both the economic climate and the public’s willingness to accept deregulated markets allowing unbridled corporate growth have changed a lot since then. People are aware that while there have been tremendous gains as a result of new health technologies and medicines, the benefits have not been shared equally. Inequility is increasing globally, regionally and within New Zealand. The TPPA has the potential to exacerbate that inequity if the growth and innovation it promises increases the costs of health care as has been suggested.

Come on Minister Groser – release the text, release publicly commissioned information and analysis, and give New Zealanders a say in what you’re signing us up to.



Why the Trans-Pacific Partnership Agreement is a health issue

ImageWe’re hearing more and more people, from all over the world, talking about the Trans-Pacific Partnership Agreement  (TPPA), and they are all saying the same thing: trade deals that are negotiated in secret, that do not give citizens any say over the content, that have the potential to have huge effect on the lives of ordinary people should stop right now. We at NZNO agree; we have a right to know what’s going on.

The TPPA is a free trade agreement that is being negotiated between the United States and ten other Asian and Pacific Rim countries. The negotiations are being held in secret, so what we do know comes from leaked documents.

The things we are finding out are extremely worrying. Big business seems to be in control.

And when big businesses have more rights than States and Governments, you know that it is the citizens of those countries who will bear the brunt.

The group set up to demand transparency and fairness in the TPPA, says,

“From what we know so far, if the negotiations are completed it will become much harder for the New Zealand government to look after our environment, promote health, protect workers and consumers, and promote the public interest.”

NZNO is particularly concerned about that public health will be a major loser under the TPPA and this is why

Pharmac is New Zealand’s purchasing agency for medicines. It buys all the drugs for the country, in bulk and generic versions where possible, to give tax payers the best value for money. It’s a very clever system and as a result we end up paying much less for medicines and medical equipment than other countries like Australia and the US.

The agreement will give big pharmaceutical companies the ability to patent their products for longer, meaning that cheap “off-patent” generic drugs will not be available for years, and possibly decades. They will also be able to make tiny tweaks to existing drugs and then patent them again.

The agreement will also put into place “transparency” provisions which will interfere with the successful commercial strategies that PHARMAC uses to get medicines at an affordable price.

New Zealanders need access to affordable medicines. We are a small country; Pharmac uses our bargaining power very effectively and must be protected from provisions in the TPPA which reduce its effectiveness.

Unfortunately, this isn’t the only provision in the TPPA that will affect the health of New Zealanders and their safety. There’s more on the It’s our future  website and NZNO will blog about this important issue again.