Pharmacist prescribers Linda Bryant and Leanne Te Karu discuss positive polypharmacy for heart failure. Current evidence shows the intensive implementation of four medications offers the greatest benefit to most patients with heart failure, with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality
Decision delay on disability services seen as opportunity by the disability sector
Decision delay on disability services seen as opportunity by the disability sector
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Time out has been called on reforming the disability part of the health and disability sector. Advocates hope the opportunity remains for significant improvements, as Alan Perrott reports
THE QUESTION, where disability support services best fit, has been delayed until September.
The final report of the Health and Disability System Review had placed such services within the Ministry of Health, with responsibility for conducting needs assessments and coordinating service provision going to primary and community networks via DHBs.
Advocates for the disabled community are strongly against that recommendation, saying that, despite the review’s expansive title, they did not have any meaningful engagement with the review panel. They said handing oversight to DHBs would not give disabled people greater choice and control over their lives.
Health minister Andrew Little responded by excluding disability services from his wider health reform package. Mr Little called on ministry officials to come up with a new range of options in conjunction with organisations such as the New Zealand Disability Support Network. The options are to be announced in September, with further sector feedback then sought.
The minister acknowledged the review’s failure to look fully at the needs of disabled people, the ongoing poor health outcomes of disabled people, and the lack of accurate data on the wider community.
DISABLED PERSONS Assembly chief executive Prudence Walker says the assembly has been in communication with health officials ahead of workshops, where possible options for disability services are to be discussed.
The assembly and CCS Disability Action are calling for the creation of a new authority, so that disability services would be removed from under the “health” umbrella.
CCS chief executive David Matthews says what is needed is a separate governmental entity responsible for funding and supporting new disability initiatives and providing resources.
Disability sector advocates and whānau say disability is not a health issue, and services should focus on ensuring people with disabilities can lead good lives.
Mr Matthews wants better data collection on how disabled people engage with healthcare.
The most recent New Zealand Health Survey shows those with disabilities are the most likely to put off medical treatment because of cost.
He says there are also significant barriers to care for Māori, Pacific peoples and those living rurally.
Jane Cartwright is chair of Brackenbridge, a Canterbury-based charitable organisation assisting people with intellectual disabilities and autism.
Ms Cartwright would like future disability support to follow a social model, rather than a health-based one, with funding following the individual.
But she says such a system requires infrastructure and high levels of trust in the system.
Ms Cartwright says optimism rose during the round of health reforms two years ago, when services for disabled people were reclassified to become part of Tier 2 (hospital and specialist). However, she says the arrival of COVID-19 prevented any benefit from this.
Ms Walker says she hopes the proposed national health IT system will allow medical records to be shared across regions, which would help people with disabilities who require medical attention while travelling.
There are serious delays with the current system, as practitioners are unaware of the patient’s medical history.
But she says the options under development must note the diversity within the disabled community, which includes people from every ethnicity, gender, orientation and locality.
We hold the documents so you don’t have to! Our coverage of the Little reforms references a number of documents which we have gathered together on our website