Respiratory physician Lutz Beckert considers chronic obstructive pulmonary disease management, including the prevention of COPD, the importance of smoking cessation and pulmonary rehabilitation, and the lifesaving potential of addressing treatable traits. He also discusses the logic of inhaler therapy, moving from single therapy to dual and triple therapy when indicated, as well as other aspects of management
Cutting frontline services will result in worsening mental health outcomes
Cutting frontline services will result in worsening mental health outcomes

Family violence is likely to increase, more young people will switch off at school and there will be a worsening of mental health outcomes thanks to the Government’s latest cost-cutting exercise.
So says the NZ Association of Counsellors which decries the $30 million a year drop in the Oranga Tamariki budget for contracting services as appallingly short-sighted, particularly for South Canterbury frontline services.
It comes after the Public Service Association revealed its briefing with Oranga Tamariki would see funding cuts to Family Start reduced by 25 per cent.
A raft of Presbyterian Support South Canterbury’s service would also no longer be funded, the organisation’s chief executive says, affecting people in the community who needed it most.
Unfortunately, frontline services in South Canterbury aren’t the only ones on the chopping block.
Almost 40 per cent of Family Start staff in the Nelson area will be lost after cuts, leaving vulnerable tamariki and their whānau across the top of the South Island on their own.
In Tāmaki Makaurau, funding for the Auckland Women’s Centre is under threat and so too at the Mangere East Family Services and E Tipu E Rea Whānau.
For the Government to stress its cost-cutting exercise is only affecting backroom functions is, at best, highly misleading or, at worst, deliberately deceptive, NZAC President Sarah Maindonald says.
She adds the cuts are hugely devastating for communities and will also make the Government’s job harder to achieve its five mental health targets.
“But the worst of it all is how this affects the region’s most vulnerable. Many families in Timaru rely heavily on Family Works’ services because there are few other services to meet the needs of the community.
“I think there will be a worsening of mental health across the board; there is likely to be an increase in family violence and potentially greater disengagement from young people at schools.
“Switching off the, often, life-saving support that counselling services have provided for people will be devastating not just for those that desperately need them but the system as a whole. Where will these people go for help now?”
While these decisions “were made in line with [Oranga Tamariki’s] priorities”, it is hard to reconcile with the Mental Health Minister’s belief in July that he was “determined to deliver results that make a difference”.
“These are only a handful of services that are affected, that were doing a very good job, but they are terribly underfunded and under-resourced and have been for years,” Maindonald says.
“With appropriate funding and resourcing, services like Family Works could do the job they were set up to do in the first place and we wouldn’t need to reinvent the wheels.
“Social services aren’t profit-producing businesses so can’t be judged nor treated as such, neither should they have a cost reduction model applied to them. Helping people save lives is the only model that applies.”
NZAC Te Ahi Kaa Eugene Davis adds that “hard to reach clientele” and whānau, who are currently receiving counselling, could potentially retreat back into the cracks of the system should these services cease to exist.
“These counselling services were important because they became good at going above and beyond reaching the people who would otherwise fall through the cracks.”