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Green Party: Health Policy

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1. Public Health and Illness Prevention

Programmes aimed at health promotion and preventing illness and injury are an investment in the future health of Aotearoa/New Zealand. Their success will have a major bearing on the level of treatment services that are needed in later years.

At present, most of the over $9 billion health budget is being spent treating people once they have become ill, rather than trying to prevent people from becoming ill in the first place. Money allocated for health promotion has often ended up being used elsewhere, due to the demand for acute health services. To keep people healthy and improve New Zealanders' health status, the Green Party will:

1. Progressively increase funding to prevent illness and injury and promote health, to 10% of the total healthcare budget, commencing with the introduction of a free annual wellness check by a health professional for all New Zealanders.
2. Support the implementation of the New Zealand Health Strategy (Ministry of Health) and related strategies and programmes; and ensure that they addresses the underlying environmental, economic and social factors of ill health, such as unemployment, poor housing, poor nutrition, and air pollution.
3. Ensure the health of the population is a key goal across all government activities and ensure a health impact assessment is completed on all government policies and projects.
4. Establish an independent Environmental and Public Health Agency to:
1. Monitor the effectiveness and implementation of the New Zealand Health Strategy, and advise the Minister of Health on further initiatives required to prevent illness and promote health, thereby reducing the need for hospital and health services in the medium to long term.
2. Research and provide independent advice on the economic, environmental, and social issues that impact on health.
3. Advocate for policies that reduce the underlying environmental and social causes of ill health.
4. Identify and promote culturally appropriate programmes to address the public health needs of Maori, Pacific Islanders and people of other cultures, children, young people and older people.

2. Health Services

Aotearoa/New Zealand was the first country in the world to publicly administer and fund health care services, a model which was copied around the world. This commitment has been severely eroded over the past 20 years, resulting in a two tier health care system where the rich can afford quality private services, and the poor face long waits for specialist services.

The Green Party wants a strong public health system that functions effectively, delivers a high standard of patient care, and has sufficient funding for service delivery, administration, and ongoing research and development.

We support local decision making in setting priorities and managing our health services, with a role for the Ministry of Health in ensuring that District Health Boards are meeting national health policy objectives and goals. The Green Party supports the development of a process of full public input into both the financing and funding priorities of the New Zealand Health Service, with the goal of eliminating the two tier system.

The Green Party will:

1. Continue to improve health care resources, to ensure that the public health system is effective and accessible to all New Zealanders.
2. Support 3 year, inflation-adjusted rolling funding to allow District Health Boards to plan health and disability services with certainty.
3. Ensure the costing and pricing models used by the Ministry of Health reflect the real cost of services.
4. Ensure District Health Boards are adequately resourced to work with district, city and regional councils and government agencies, in order to fulfil their statutory obligation to promote the health of people and communities.
5. Ensure District Health Boards and the Ministry of Health facilitate and encourage cooperation and coordination between health service deliverers at a local, regional, and national level.
6. Work to implement a system in which all DHB members:
1. Are democratically elected by their district in wards, and are accountable to their local communities.
2. Reflect the composition of their communities.
3. Are able to comment publicly on health board matters.
4. Fulfil their obligation to foster community participation in health care decision making.
7. Require each DHB to develop a process of community meetings and other forms of strategic dialogue in which the public can have input into the level of funding they wish health care services to receive in Aotearoa/New Zealand, the priorities they support for this funding regarding the illnesses and conditions treated, and the range of treatments offered.
8. Simplify and widely publicise the patient complaint system and ensure it is user friendly.
9. Support coordinated delivery of healthcare services between primary, secondary and disability services.
10. Continue to develop the health information system to improve the quality of information available to health care providers, facilitate integrated health care, improve resource allocation decisions, and reduce compliance and administration costs for DHBs, PHOs, and community health care providers.
11. Prohibit the funding of health services by food companies, which sell or promote unhealthy high fat, high sugar food.
12. Require publicly funded hospitals and healthcare organizations to set an example of healthy eating by only selling and promoting healthy food and drink that meets nutritional guidelines and is not high in sugar or fat.

3. Health Workforce

There are critical shortages of health professionals in our health system, owing to the loss of up to a third of our health professions' graduates to overseas posts. Also, there is a shortage of posts in Aotearoa/New Zealand because of the under-funding of health services. The shortage of qualified health care professionals is a factor in long waiting lists for specialist services and causes scarce resources to be diverted to costly overseas and locum recruitment. It is important that the pay and working conditions of New Zealand health professionals be improved.

The Green Party will:

1. Support improvements in the pay and working conditions of health professionals, including mandatory staff to patient ratios in order to ease nationwide recruitment and retention problems.
2. Increase the number of positions for nurses in the health sector and work with nurses to identify other models to enhance the role of nurses, for example, giving prescribing rights to nurse practitioners.
3. Introduce lower tertiary fees and a student allowance for all students including those training for health professions. (see our Student Support policy for full details).
4. Accelerate the work of the Health Workforce Advisory Committee in carrying out its terms of reference and in particular, address the health workforce needs of an ageing population.
5. Work with medical practitioner training providers to develop a curriculum that increases the awareness of:
1. Economic, social and environmental factors influencing health.
2. The role of nutrition in health.
3. Complementary health therapies.
6. Support midwives to train in complementary therapies that support mothers through pregnancy.
7. Ensure full accountability of non-treating health professionals who provide assessments for the purpose of government agencies, employers, or the insurance industry.
8. Increase government funding, beyond the 6% announced by government in December 2004, for the aged and disability care sector with a view to providing:
1. A well-trained and well-paid workforce in both residential and home care.
2. Improved staffing levels in residential care facilities.
3. A requirement for District Health Boards and other funders to reimburse home care workers' travel costs.
4. A move from the current reimbursement regime for Carer Support respite care to payment of an adequate hourly wage to respite caregivers.

4. Waiting Lists

Waiting lists have been used throughout the health system as a means of rationing limited health care service and, actually, denies people treatment at an early stage of their condition. Patients are spending more time waiting for treatment under the current assessment and review system, which is likely to make their health worse, increase the eventual cost of treatment, and cause their quality of life to deteriorate. Also, the referral of patients to 'Active Review' is making ill people invisible and artificially controlling waiting lists.

The Green Party will:

1. Do a cost-benefit analysis of waiting lists and the 'Active Review' system in order to work towards providing a health care system that best serves patients' needs.
2. Support initiatives that will ensure people get treatment at an early stage of need.
3. Increase funding for straightforward surgical services, including mobile services, to reduce the number of people waiting for surgery.
4. Ensure all patients waiting for treatment are treated within timeframes set out by internationally established standards for the specific specialty and condition.
5. Commence radiation treatment for cancer patients within the internationally recognised time frames (e.g. 12 weeks for breast cancer).

5. Primary Health Care

Primary health services are central to improving the health of New Zealanders and tackling inequalities in health. Primary Health Organisations (PHOs) are a good starting point for primary health services, but are limited by the cost of treatment and their focus on general practitioner provided health care.

We want to ensure primary healthcare services are accessible and affordable for everyone, to facilitate early diagnosis and treatment. The work of PHOs needs to be expanded from general practitioner care to include multi-disciplinary primary health care teams of health professionals — doctors, nurses, community health workers, social workers, physiotherapists, psychotherapists, other mental health workers, and complementary health practitioners — working together to deliver a range of health services.

The Green Party will:

1. Increase funding to progressively make primary health care affordable for everyone.
2. Explore the cost and benefits of extending the categories of New Zealanders who can receive free primary health care.
3. Ensure all Public Health Organisations (PHOs) take an active role in improving health through measures such 'green prescriptions', nutrition education, and encouraging healthy transport choices.
4. Provide DHBs with resources to support the integration of quality not-for-profit primary healthcare providers, who involve their communities in their governing structures and in particular, target low income, high health needs areas and areas of deprivation.
5. Promote team-managed, home-based primary care for at-risk disabled and older people.
6. Work with DHBs, PHOs, and the New Zealand Medical Association to reduce over-prescription of antibiotics and other drugs.

6. Complementary Health Care

At least one in four New Zealanders uses complementary therapies, and Aotearoa/New Zealand has an extensive network of complementary healthcare practitioners. The Green Party wants to see better integration of complementary health providers in primary and secondary care, to improve safety and meet the health needs of New Zealanders.

The Green Party will:

1. Establish a Complementary Health Care Unit within the Ministry of Health to facilitate the integration of selected complementary health practices and therapies into the public health system.
2. Provide District Health Boards with resources to integrate complementary health therapies and practitioners into PHO and hospital care, to provide multidisciplinary health services.
3. Encourage complementary health practitioners to form strong self regulation to standardise peer review and training, and encourage statutory regulation of complementary health practitioners through the Health Professionals Competence Assurance Act where relevant.
4. Implement the recommendations of the Ministerial Advisory Committee on Complementary and Alternative Health (MACCAH).
5. Expand funding for the Complementary and Alternative Medicine (CAM) database to further develop researcher and practitioner understanding of the role and safety of complementary therapies in the treatment of illness.
6. Facilitate access to a wide range of safe and effective dietary supplements.
7. Ensure Aotearoa/New Zealand retains regulatory control of the dietary supplements industry and does not proceed with government plans for restrictive trans-Tasman regulation of dietary supplements.

7. Rural Health

Stable and secure primary care services and access to emergency, surgical and diagnostic services are central to the health of people in rural areas.

To support general practitioners and other rural health professionals the Green Party will:

1. Ensure that District Health Boards make free access to centres for accident and emergency services readily available for all New Zealanders.
2. Provide additional funding to rural health services, to improve pay and working conditions, to attract qualified staff and to recognise the greater diversity of skills required by rural health professionals.
3. Support the establishment of multi-disciplinary primary healthcare teams in rural areas.
4. Encourage the utilisation of publicly funded mobile services to improve the delivery of primary healthcare, children's dental care, mental healthcare, marae clinics, surgical services, and palliative care.
5. Provide extra assistance to rural general practitioners, nurses, and community health services to improve emergency and palliative care.
6. Work with rural health services and medical and complementary health schools to encourage trainees to undertake graduate work in rural areas.
7. Maintain and support the rural general practitioners' locum scheme.
8. Promote rural post-graduate or registered competency training and education to ensure rural health workers are not professionally isolated and can keep up to date.
9. Retain hospital services serving rural communities. Where possible secure their viability through measures such as increasing elective surgery performed locally, and supporting the employment of the additional staffing needed to provide a full-time emergency care service.
10. Fund the health-line telephone and internet services for rural areas.
11. Support the integration of complementary health practitioners into all rural health schemes.

8. Mental Health

Good mental health is an essential part of our overall well-being. The Green approach is a holistic understanding of mental health and illness.

There is a wide range of psychological, social, environmental, and physiological factors that can affect mental health. The degree of social support, financial security, reasonable working conditions, housing, supportive schools and access to life skills training can all affect our mental health and how we cope if we become mentally ill.

The Green Party supports the recovery approach to mental health. The term 'recovery' refers to the ability to live well in the presence or absence of mental illness. Recovery can happen when service users are meaningfully involved in decisions about their health and treatment options, and when services are coordinated.

The Green Party's policies on Income Support, Work and Employment, Housing and others help to provide an environment that is conducive to mental well-being and recovery. Our commitment to localisation and building strong people-friendly communities will help create an environment that is both less threatening to those whose state of mind is fragile and more welcoming of a diversity of people.

The Green Party will:

1. Review the Mental Health Commission (MHC) with the option of establishing it as a permanent semi-autonomous body overseeing the sector and providing advice to the Minister.
2. Support the ongoing implementation of the 1998 Blueprint for Mental Health Services in Aotearoa/New Zealand and support continued funding increases to allow the service provision targets in the Blueprint to be met and where necessary exceeded. Specifically, the Green Party will:
1. Give urgent attention to services for child and adolescent mental health needs as they are well below Blueprint targets.
2. Ensure that early psychosis intervention services for adolescents and young people are available throughout the country.
3. Provide adequate numbers of sub-acute beds throughout the country.
4. Ensure that at all times all acute and sub-acute units operate with safe staff-to-patient ratios.

Healthcare for Less Severe Mental Health Problems

3. Assist the PHOs to improve access to appropriate treatment, including counselling, for those with less severe, moderate, and minor mental illnesses, who may not necessarily need treatment from specialist mental health services.

District Health Boards

4. Ensure every District Health Board (DHB) has a standing committee on mental health, including having mental health expertise on the board (consumer groups would also like family advisors). If there is no elected person with this expertise, then the DHB can appoint an ex-officio member to ensure this occurs.
5. Ensure mental health funding sourced in all relevant government departments is ring-fenced so it cannot be diverted into other services.

Cultural Appropriateness

6. Support tangata whenua initiatives to supply high quality and culturally appropriate mental health care.
7. Ensure mental health services continue to adapt to meet the needs of a diverse population, including those needs specific to Pacific Island people, refugees, migrants, and minority cultures.
8. Significantly strengthen controls around the use of Electro Convulsive Therapy (ECT). Except where a patient is adjudged incompetent to give informed consent, ECT will only be permitted with the explicit consent of a patient, and based on full explanation of the risks. In determining competence to consent to ECT, the same standard will be applied as with other invasive medical procedures. In all cases, interested parties will be informed about the option for judicial review.

Respect for Tangata Whai Ora and their families

The Green Party will:

9. Encourage and resource tangata whai ora to have ongoing input into the mental health sector at all levels.
10. Require all service providers to document that families/whanau and other significant people in the lives of tangata whai ora have provided input into treatment planning.
11. Increase training for family carers, home help, and personal carers.
12. Encourage ongoing public dialogue and education about mental health issues and the ways in which social and environmental factors can affect people's state of mind.

Not-for-profit providers

The Green Party will:

13. Increase support for not-for-profit suppliers of mental health services.
14. Support consumer networks and peer-run services.

Workforce

The Green Party will:

15. Ensure that all mental health professionals develop an understanding of the recovery approach to mental illness.
16. Support mental health consumer workforce development.

Diversity of Approaches

The Green Party will ensure our approach to mental well-being by providing for:

17. Adequate funding for mental well-being incorporated into the mental health system and that environmental and social factors affecting mental and physical health are addressed.
18. Improved access and affordability to psychotherapy and counselling services in the public health system.
19. Greater emphasis on the 'recovery' model and other effective alternatives to the 'illness treatment' model of mental health care.
20. A mandate that any hospital-based, long-stay tangata whai ora are not moved into community settings without clear protocols and robust processes to ensure the continuation of good care and support.
21. Improved funding and support for vocational rehabilitation and placement services for patients recovering from mental illness and for groups providing paid and voluntary employment opportunities for the people with impairments.
22. Greater funding for a variety of options for accommodation and related services for people living with, and recovering from, mental illness.

Substance Misuse Services

The Green Party acknowledges that those living with addictions face a unique range of mental health issues. Preventing addictions and promoting healthy lifestyles is essential. Addiction health services can be effectively provided at the community level, and training and funding of these health providers needs to be improved. The Green Party will:

23. Support strong integration of and better resourcing for mental health and substance misuse services

Justice

The Green Party will:

24. Provide more support for the many prison inmates suffering from mental illness, alongside a far greater focus (as per the rest of our policy) on providing adequate health care and social support systems for tangata whai ora before they commit the crimes that land them in prison.
25. Change the current legislative framework to make detention of special patients the responsibility of health professionals, rather than a political decision by the Minister of Health.
26. Provide appropriate education and rehabilitation to prison inmates who have a mental illness and a learning disability.

Psycho-geriatric Care

The Green Party will:

27. Provide those elderly in residential care with a pharmaceutical review of all medications to ensure that adverse effects and interactions are avoided.
28. Ensure all those who are in residential care or receiving home support have access to appropriate mental health care.
29. Increase aged care sector funding, particularly the funding for residential care and home support.

9. Maori Health as Taonga

The Green Party will work with Maori to:

1. Facilitate and support the development of research partnerships between Maori and non-Maori researchers to meet the urgent need for research that benefits Maori health.
2. Increase accessibility of health services to Maori through increased provision of community and marae-based services.
3. Ensure Maori representation and consultation at all levels of the health service.
4. Support additional funding for health research resources to be directed at Maori health issues in order to address the continuing disparities in the standards of health between Maori and non-Maori.
5. Further build the capacity of Maori to manage their own health needs and provide Maori specific services.
6. Support rongoa Maori (traditional Maori healing) practitioners and practices.
7. Facilitate the development of linkages between rongoa Maori and other health services.
8. Accelerate the training and development for Maori healthcare workers.
9. Continue the work of the Maori Health Strategy (He Korowai Oranga).

10. Reproductive and Sexual Health

The Green Party will:

1. Improve access to family planning and sexual health services.
2. Support targeted education and screening programmes to reduce the incidence of sexually transmitted infections.
3. Develop a National Infertility Prevention strategy that focuses on ways of protecting fertility and reducing infertility.
4. Support natural fertility treatments that are proven to be effective, as well as equitable access to IVF therapies.
5. Research environmental causes of infertility in women and declining sperm counts in men and in particular chemicals that mimic or disrupt hormones.
6. Legislate to ensure that all pesticides and chemicals to be reviewed for their endocrine-disrupting potential and phase out any chemical that is found to cause reproductive hazards.
7. Provide research funding into the epidemiology of endometriosis and other hormonally induced illnesses that affect fertility and health.
8. Prohibit the use of genetically engineered embryos in all fertility procedures.

11. Maternal and Child Health

The Green Party believes that the quality and range of maternal and child health services need to be improved. The Green Party will:

1. Increase choice for women about the length of hospital stay following childbirth.
2. Improve postnatal care, including care for postnatal depression.
3. Improve access to appropriate birth facilities, particularly for rural women.
4. Ensure women have the choice of a lead maternity carer, e.g. midwives, GPs, particularly in rural areas.
5. Improve information and support for home birth.
6. Investigate why the number of caesarean births has increased.
7. Provide education and support programmes for new mothers to encourage breastfeeding.
8. Improve resources and educational services for organisations that provide support for mothers who are breastfeeding to ensure children have the best possible start to life.
9. Initiate an awareness campaign and provide legal protection to eliminate discrimination against women who breastfeed.
10. Support programmes and initiatives which encourage both mothers and fathers to become better informed about parenting, together with the more effective education of children and young people about the responsibilities of parenting.
11. Support research into operative and intervention deliveries, with an objective to keep birth as safe and natural as possible.
12. Ensure all women have access to an adequately funded and staffed information helpline such as Plunketline.

Children currently face ill health as a result of poverty, poor diet, air pollution, poor housing, lack of exercise, poor or late diagnosis and treatment, and exposure to pesticides, toxins and other toxic chemicals.

The Green Party will:

13. Continue free primary health care for children under 6 years of age.
14. Review the explosive growth of prescription of some drugs to children, e.g. Ritalin.
15. Support research to further identify and assess the social and environmental factors affecting children's physical and mental health, and the ways in which communities, business and government can promote wellness in children.
16. Reduce respiratory diseases in children by reducing car pollution through mandatory vehicle emission testing and cleaner diesel and petrol.
17. Help improve both exercise levels and children's mental health by creating more child-friendly public spaces and reducing risks to children from traffic (through measures such as reduced speed limits and traffic calming) so that parents are more likely to allow children to walk and cycle.
18. Improve children's diets by:
1. Developing a national strategy and action plan to encourage healthy eating amongst our children. This will include:
1. A high profile, multi-media nutrition education campaign aimed at parents and children; this will include promoting healthy foods such as fresh fruit and vegetables, and positive nutritional messages on television (For full details see our Safe Food and Healthy Eating Policy).
2. Ensuring all food produced in Aotearoa/New Zealand is GE free and any imported GE food is comprehensively labelled.
2. Researching the increase in, and impact of, sponsorship, advertising and promotion in schools by companies promoting food that does not meet nutritional guidelines on children's eating habits.
3. Extending nutrition and ingredient information labelling to fast food, take-away and delicatessen food.
4. Reviewing all maximum residue limits for pesticides and additives and setting them on the basis of children's tolerances, not adult ones.
5. Developing criteria to identify whether food or drink is detrimental to, or promotes, children's health.
6. Providing free fruit to all primary schools, and ensuring that nutrition, cooking and gardening skills are taught in primary schools.
7. Requiring all food sold on school premises or at school sporting functions to meet the criteria for food and drink that promotes children's health.
8. Requiring all advertising of food to children to meet the criteria for food that promotes children's health.
19. Improve access to free dental care for all children under 18, and review dental care services to examine why children are not accessing free care
20. Ensure parents are informed of the benefits of non-amalgam fillings and of their rights to request these as part of their child's free dental care service.
21. Provide public funding of non-cosmetic orthodontic treatments when the deformity damages a child's health.
22. Promote alternatives to fluoridation and mass medication in community water supplies, to lower dental caries. Options can include:
1. Promoting comprehensive oral health and education in preschools and schools, including brush-ins.
2. Ensuring schools provide nutritious, healthy foods and lunches in schools, school tuck shops, and vending machines.
3. Providing screening, risk assessment, and referrals for publicly funded dental sealants and fluoride varnishes for those at high risk of developing dental caries.

12. Cancer

Cancer is the leading cause of death in New Zealand, unlike other developed countries, where cardiovascular disease is the most common cause. Among men and women New Zealand has the third highest age standardised rate of cancer among developed countries. New Zealand women have the highest age standardised rate of cancer in the world. While our cancer epidemic can be blamed in part on exposure to ionizing radiation from Pacific island nuclear testing, there is increasing evidence that decades of exposure to toxic chemicals in industry and agriculture also play a major role.

In breast cancer, where environmental and lifestyle factors have been most studied, 80% of cases are thought to be preventable. However, according to the New Zealand Cancer Society, there is increasing evidence that diet and lifestyle factors also play a major role in the development of lung, bowel, prostate, uterine, esophagus, skin and other less common cancers. Existing cancer policy still focuses on early detection, ignoring prevention. As with other areas of health policy the Green Party approach is holistic with emphasis on prevention.

Prevention

The Green Party will:

1. Develop a public awareness campaign about how all New Zealanders can reduce lifestyle risk factors such as alcohol, cigarettes, obesity and lack of physical exercise that contribute to the development of common cancers.
2. Amend the Cancer Control Strategy to include a strategy to reduce our exposure to environmental risks such as toxic chemicals including pesticides, radiation, etc.
3. Require the phasing out of all chemicals that may contribute to cancer or that mimic oestrogen from products such as pesticides, household products, cosmetics, and building materials.
4. Require full content labelling for products such as personal care, cosmetics and household products that contain ingredients linked to an increased risk of cancer.
5. Develop a detailed regional registry for cancer incidence so that possible environmental causes can be identified.
6. Continue to implement the Gisborne Cervical Screening Inquiry report recommendations.

Breast Cancer

Breast cancer affects one in every nine New Zealand women and it is increasing.

The Green Party will:

7. Work for a National Breast Cancer Prevention Strategy.
8. Promote a National Breast Cancer Prevention Week.
9. Develop a public awareness campaign about how women can avoid the chemicals implicated in breast cancer, how to reduce lifestyle risk factors such as alcohol, cigarettes, obesity and lack of physical exercise, and how to improve nutrition to reduce breast cancer risk.
10. Identify the occupations at high risk of breast cancer and reduce the risk factors in these working environments.
11. Restrict hormone replacement therapy to cases of significant medical need, and then to be used only in accordance with Medical Adverse Reactions Committee guidelines.

Screening and Cancer Treatment

The Green Party will:

12. Continue to provide cervical screening to all women. Evaluate alternatives to routine mammography such as thermography and sonography.

Prostate Cancer

Prostate cancer is the most commonly diagnosed cancer in New Zealand men and the third most common cause of male cancer deaths. The Green Party will:

14. Increase funding for research into the prevention and early detection of prostate cancer.
15. Increase the early detection of prostate cancer through a public awareness campaign to make men aware of the early symptoms.
16. Work to identify and address factors that prevent men from seeking health checks at the earliest possible stage of the disease.

13. Community Care

The Green Party will:

1. Significantly increase funding for the aged and disability care sector to address the:
1. Low pay of all aged and disability care service providers.
2. Staff recruitment and retention crisis in the sector.
3. Need to improve staffing levels and staff training in residential care facilities.
2. Support a return to some role for the public sector in aged care service provision.
3. Ensure that District Health Boards reimburse homecare workers' travel costs.
4. Continue to support the Health of Older People Strategy.
5. Promote team-managed, home-based primary care for at-risk older patients.
6. Abolish asset testing for residential care.
7. Improve funding of residential care for older people to recognise increased costs and develop a sustainable funding path.
8. Work to develop services that enable older people, and those receiving palliative care, to stay in their homes for as long as possible and for as long as they choose.
9. Work to ensure that older people, disabled people, and those receiving palliative care have access to appropriate home-help, day care centres, and home health care as an alternative to residential health care.
10. Work with community based agencies to detect and prevent elder abuse and abuse of people with impairments.
11. Ensure older people throughout Aotearoa/New Zealand have access to specialist psycho-geriatric services.
12. Encourage national discussion and debate stimulated by a Commission of Inquiry into issues of improved palliative care and end of life services
13. Increase and co-ordinate national educational and training programmes to deal with attitudes and behaviours that result in violence.
14. Support anger management and other educational programmes that teach non-violent conflict resolution skills.

14. Minimising Harm of Alcohol, Drugs and Smoking

The Green Party will:

1. Continue support for smoking cessation programmes.
2. Ban broadcast alcohol advertising.
3. Require compulsory health warnings on all alcohol products.
4. Support continued use of pricing mechanisms, including taxes, duties and levies, to discourage the use of tobacco and alcohol.
5. Ensure that a comprehensive and effective drug education programme is available to schools and communities, which promotes the drug-free lifestyle as the healthiest and informs young people of the risks of using drugs such as cannabis, alcohol and tobacco.
6. Continue funding for the Green initiative that established a Ministerial Advisory Group on Drug Education, to develop and implement measures for evaluating drug education programmes and to improve delivery of drug education messages, particularly to young people.

15. Pharmaceuticals

The Green Party supports equity of access to pharmaceuticals.

The Green Party will:

1. Support the independence of Pharmac.
2. Ensure cost/benefit analyses take into account the full economic cost of ill health, such as unemployment and inability to do unpaid work, when assessing the costs and benefits of a drug.

16. Reducing Unwanted Effects of Pharmaceutical Use

A significant amount of illness and even death results from the inappropriate prescribing of pharmaceutical drugs, from adverse reactions to pharmaceuticals, or as a result of interactions between different classes of drugs that should not be used together.

The Green Party seeks to reduce drug-induced illness and adverse reactions to pharmaceuticals, and will:

1. Ban the 'direct to consumer' advertising of pharmaceuticals, because this practice drives up the demand for pharmaceuticals and plays down adverse reactions to drugs.
2. Require every pharmaceutical sold in Aotearoa/New Zealand to contain a consumer information panel, which explains the risks and potential adverse reactions to that product clearly and comprehensively.
3. Require Medsafe to take a lead role in working with DHBs, PHOs and the New Zealand Medical Association to reduce, though both public and provider-focused education, inappropriate prescribing of drugs such as antibiotics and antidepressants.
4. Encourage pharmacists to work with doctors and registered nurses to develop pharmaceutical plans for older patients and high users of pharmaceuticals.
5. Place tighter controls on the routine prescription of highly addictive drugs, and educate doctors, patients, and the public about the risks of dependence and use of safe alternatives.

17. Ensuring Nationwide Quality Healthcare Standards

The Green Party will:

1. Support the establishment of an independent, impartial monitoring and audit unit for all health services, and competency/peer review for all registered health practitioners.
2. Review drug-induced diseases and deaths in hospitals and residential facilities with a view to improving quality assurance systems surrounding multi-drug use.
3. Ensure all hospitals and health services meet nationally consistent clinical safety standards including national infection control standards, to minimise the risks to patient safety.
4. Work to reduce by 50% the number of people adversely affected by healthcare treatment.
5. Ensure the national qualification standard for ambulance officers is mandatory rather than voluntary.

18. Responding to the Threat of Superbugs and Antibiotic Resistant Pathogenic Bacteria, Pandemics, and Electromagnetic Radiation

Diseases caused by patients being exposed to antibiotic resistant bugs such as Methicillin Resistant Staphylococcus Aureus (MRSA) and multiply-resistant E coli are escalating in Aotearoa/New Zealand. The Green Party will work towards reducing the incidence of superbugs and antibiotic-resistant bacteria by:

1. Developing a proactive and nation-wide strategy to reduce the incidence of antibiotic-resistant infections in Aotearoa/New Zealand. As part of this, the Green Party will:
1. Require all diseases caused by antibiotic-resistant bacteria such as MRSA to be notifiable, so that authorities can develop a clear idea as to the spread of these diseases and the extent to which they are increasing.
2. Ensure all hospitals and rest homes have implemented nationally developed infection control standards and ensure ongoing national monitoring of these standards.
3. Appoint a panel of experts in the control of antibiotic resistance to advise the government on the most effective strategies to reduce its spread in Aotearoa/New Zealand.
4. Undertake annual prevalence studies to estimate how widespread antibiotic resistant bacteria have become within the human and animal populations.
5. Take steps to reduce the use of antibiotics by:
1. Requiring doctors, wherever possible and practical, to identify the strain of bacteria before prescribing an antibiotic, in order to ensure the appropriate one is prescribed.
2. Continuing high profile education campaigns to reduce the inappropriate prescribing of antibiotics to humans.
3. Introducing random testing of chicken meat to ensure it is not contaminated with antibiotic-resistant bacteria.
4. Banning the routine feeding of antibiotics to animals who are not sick or suffering from acute infections.
5. Investigating the extent to which antibiotic markers in GE organisms contribute to antibiotic resistance.

Pandemics

The World Health Organisation has warned of the need to be prepared for a global pandemic. The Green Party will:

2. Ensure Aotearoa/New Zealand's preparedness for a pandemic, including stockpiling sufficient doses of antiviral drugs, surgical masks, ventilators, syringes, and other medical equipment and resources.
3. Update the Pandemic Action Plan to take into account lessons being learned in the Asian Avian Influenza outbreak.

Electromagnetic Radiation

The Green Party will:

4. Take a precautionary approach to electromagnetic radiation regarding its possible effects on human health, and set up an independent committee to review the limits set by the National Radiation Laboratory for EMF, in particular for dwellings and schools located near high voltage transmission lines.
5. Minimise exposure to electromagnetic radiation especially for children and pregnant women.
6. No new unshielded high voltage power lines or towers to be built within 300 metres of any residential homes and schools.
7. Investigate how to deal with existing high voltage transmission lines located within 300 metres of any residential homes and schools.

19. Privacy of Information

Currently the National Health Index (NHI), a unique personal identifier for people who have received treatment with the public health system at any stage of their lives, is not controlled by any legislation. The Green Party believes there is a need to review the use of the NHI and other health information and ensure proper safeguards are in place.

The Green Party will:

1. Review the current range of health information collected by government agencies and the uses to which it is put.
2. Develop an appropriate statutory framework for the use of the NHI to ensure principles of privacy, informed consent and government accountability are respected.
3. Review the National Testing Centre in Auckland (which stores blood/DNA samples of New Zealanders born after 1969) to examine issues of informed consent, regulatory oversight and accountability measures.

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