The research also discovered the wealthiest 10 percent of New Zealanders can expect to live a decade longer than the poorest 10 percent.

Widening social and economic gaps are driving health inequities that successive governments have failed to address, the Association of Salaried Medical Specialists (ASMS) reports.

"The most expensive way to treat people is to wait until they are in hospital, and they need a hospital admission," says ASMS executive director Sarah Dalton.

Life expectancy at birth for Maori males was 73.4 years and for Maori females it was 77.1 years. In comparison, non-Maori males are expected to live to 80.9 years, while non-Maori females are expected to live to 84.4 years. Current trends show the gap won't be closed for a century, according to the report.

The report - presented to Health Minister Andrew Little on Tuesday - makes several recommendations to cut the 100 year wait and reach health equity by 2040. Ideas include making general practice free, extending free childhood education to 1 to 2-year-olds and better planning to address chronic workforce shortages. More than 200 health professionals contributed to the report.

"Eighty percent of the solutions to ongoing health issues sit outside the health system," Dalton says.

She lists factors like warm, dry affordable housing, making the living wage the minimum wage, lifting people out of poverty, providing benefits that lift people up, access to primary health care including dentists, GPs and physios.

"If people can get that level of care when they need it, at little or no cost, that would bring a massive return to our economy," she says.

Little says the research should "worry us all".

In his opinion the Government's major restructure of the health system, which will be replaced with a single health organisation and a Maori health authority will help address inequality.

While the report will contribute to Government decisions, Little says making GPs free wasn't something it is looking at doing.

"It's a big problem and a big challenge. I don't have any specific solutions at the moment, but it is a big problem I want to address."

He said solutions were needed from outside the health system, but the Government was focussed on adequately funding it first.

"That is the challenge of the Government overall... free school lunches for kids is an overall part of that, making childhood education available at an earlier age remains an aspiration.

"We are very much focussed on, that the additional funding we need for other parts of health are there before we look at significantly extending mandates at the moment."

Dr Tanya Wilton, an emergency department specialist says people are struggling to get care at every step in the over-stretched health system, while people from deprived backgrounds were getting sicker at a younger age.

She cites an inaccessible health system, overbooked primary health care, long waits at emergency departments and for specialist appointments in the hospital system as contributing to poor health outcomes.

Source

• Stuff
• Image: Stuff

Ministry of Health officials have highlighted "complex and sensitive elements" to the End of Life Choice Act and incoming assisted dying regime in a briefing paper to Health Minister Andrew Little.

The paper had been given to Director-General of Health Dr Ashley Bloomfield in January, highlighting numerous unresolved questions and risks surrounding assisted dying services.

Among the "elements" include "uncertainty" over how many people will seek assisted death, terminally ill patients having to travel for services when the law comes into effect, competing pressures in the health system, and a possible need to rewrite parts of the law to resolve "legislative issues".

A statutory body, Support and Consultation for End of Life in New Zealand (SCENZ), will include up of 11 medical experts who will manage the incoming assisted dying regime.

SCENZ will develop and oversee the standards for terminally ill patients should receive when they seek an assisted death.

Although the ministry says work to implement the new Act is "well underway", legal action over assisted dying services is considered "almost certain", due to the "strong views from sections of the public in favour and against assisted dying".

Dr John Kleinsman, the director of The Nathaniel Centre for Bioethics sees "a tragic irony in the fact that the Ministry of Health is able to put so many resources into enabling assisted death, and fully funding it in our country, when palliative care is not equitably available and also not fully funded.

"Advocates of the law change campaigned for change on the basis of choice, but for too many people they won't have the choice to access quality end of life care.

"I am not surprised by the prospect of further legal action. On the one hand, the Act is a terribly weak piece of legislation and I and many others, including lawyers and health practitioners, pointed out its many problems when the Bill was being considered.

"Too many MP's chose not to listen."

"Many proponents of the new law made it abundantly clear at the time it was passed that they thought it too restrictive! So they will be pushing hard for the law to be expanded. It is what has happened in every other jurisdiction and it will happen here."

Although Little has been approached by media about the Act in recent weeks. he has not been available.

The three "key risk factors" health officials identified in the briefing paper given to Little and Bloomfield are that: parts of the health sector are refusing to be involved in assisted dying; competing resources and pressures in the health system; and inadequate or insufficient engagement with "stakeholders" within the short timeframe to enact the law.

A "key question" is whether assisted dying should be fully government funded, or a "mixed-model". How a mixed-model could work was not detailed.

The legislation, which was a members' bill, may need to be rewritten "to ensure that the Act functions as intended", the paper said.

Source

• Stuff
• Supplied: The Nathanial Centre for Bioethics
• Image: Stuff