The Failure of Primary Care

In an ageing and growing population, the failure of primary health care in New Zealand is a dire problem. Many general practices are shadows of their former selves. There are too few doctors and too many patients. Many people can't even get enrolled. Those who are enrolled report wait times to see a GP of up to a month. The hours that GPs work have reduced and virtual appointments now seem to be their preference.

A high profile case occurred in Lower Hutt where the High Street Health Hub - now managed by Green Cross - has closed its doors to in-person appointments. They have 9,000 patients on their books. Sick people are going to either the After Hours clinic which is open from 5.00pm to 10pm, or to the Emergency Department at the Hutt Hospital. Queues at the After Hours reportedly stretch down the road prior to opening time. "It's a circus" was a firsthand report I heard from a patient waiting in the Hutt Hospital Emergency Department.

I didn't expect to find myself alongside her. 'People shouldn't be turning up at ED unnecessarily' was my former take on the situation.

But I had developed a blistering rash around my left eye. Three days in (Wednesday) I tried for a doctor's appointment via the phone but was told a GP was only available on Tuesday or Thursday in the morning and I would have to ring back the next day. Next port of call was the pharmacist, who refused to sell me any cream or ointment as she suspected I may have shingles. She advised I get medical help. This time I walked into the GP surgery and asked if I could book an appointment for the following morning. No. I could try my luck tomorrow morning but no appointment could be booked in advance. But she could see my eye was a problem as I relayed the pharmacist's advice. She consulted with the nurse who had  said over the counter, "We are only operating a triage system. You will have to go to After Hours or ED. Because it is near your eye you shouldn't leave it." This made no sense to me. I was being told medical attention was urgent but that it would not be provided there, my local surgery of 30 years. You can only stand your ground so long.

I duly drove myself to ED and arrived at 2pm. The place was packed. I was picking up snippets of conversation to the effect that wait times to see a GP were a month or more. That the After Hours was even worse than ED. That course of action had already been tried and abandoned.

Age-wise there was a cross section of people waiting for help: a fair number of distressed parents and babies, and a fair fewer older people in wheel chairs. But everyone was exceedingly patient and well-behaved.

The reception staff were efficient and warm. Two or three times they asked that anyone who wasn't a patient stood or waited outside due to seating shortages. Nobody grumbled. Patients were checked for BP, temperature and pulse rate not long after arrival but warned that the wait times were around 6 to 8 hours. As shifts changed, announcements were updated. Everyone was kept in the picture. After 8 hours a nurse sorted through the files of those who had been there throughout (a number had given up and left) and vital signs were re-checked. I was also offered sandwiches and pain relief.

About midnight a medical staff member came out and said they were at capacity and thanked everyone for their patience and courtesy to staff. PA announcements were also made staff-to-staff that intensive care could not accept any further admissions. There were also incoming trauma cases for resuscitation.

For a few hours it seemed nobody was processed though obviously unseen ambulances would also be ferrying people in. Surrounded by people whose need was greater than mine I accepted my wait would be longer. People were generally in reasonably good spirits and looking out for each other. As I drifted in and out of sleep, I Iistened to a mother telling her adult sick daughter about what is was like was she was "growing up." "You could ring for a doctor's appointment and get one on the same day - or next day at worst. And you were even offered a range of times!" The trip down memory lane probably wasn't making her daughter feel any better.

But that is the primary health system which most of us were familiar with. It has disappeared. At least it has where I live.

At 3.30am my name was called. The doctor was profusely apologetic about the wait. I was just happy to be seen. The suspected shingles had not progressed to the actual eye and a script for anti-viral medication was written. I was advised to return if the rash or my vision worsened (my heart sinking at the thought of another 13 hour wait).

My own GP could have done the same in ten minutes. That would have saved all of the additional attention and resources required at the hospital.

Workforce shortages appear to be part of the problem, though Green Cross seems to have its own share of management issues. Unfortunately the company also now runs my local healthcare centre which has significantly reduced in doctor numbers and hours of care provided.

It seems the doctors we train no longer want to be GPs. They want to work in hospitals. Or overseas where student loans can be repaid more rapidly.

If the demands on primary healthcare were reducing, the problem might be less serious. But our increasingly top-heavy population will only increase demand.

According to Royal NZ College of General Practitioners in a 2023 briefing to incoming Health Minister Shane Reti:

"We estimate if all the GPs who are at, or over, retirement age all stopped practicing tomorrow, there would be an additional 725,000 New Zealanders without a GP.
When waiting times are at an all-time high and practices are closing their books to new patients, having this many people searching for a new GP is unacceptable and goes against everything that our workforce stands for as we strive to provide complex, comprehensive, timely and equitable care for our communities."

So the Hutt experience isn't unique. In fact it would appear representative.

Depressingly, it is hard to envisage what would dig us out of this hole.  Primary care looks like a row of dominoes. But there is no point or justification in getting angry with those who remain as GPs under the stress and strain. Their staff are understandably trying to gate keep them from more.

But standing at the gate the message received is, "If you get sick - you're on your own."

Welfare - no good news

Right now, benefit statistics are worse than at the time of last year's election. There are 380,169 main beneficiaries - a rise of 5 percent. The number on a Jobseeker benefit is up 7.5 percent.

Yes, the unemployment rate is rising but there is much to do in the infrastructure realm. The Nats talk constantly of growing the economy's engine. That takes manpower. And 4.3% isn't a high number historically. Former WINZ boss Christine Rankin told Mike Hosking last Tuesday that most of the jobs MSD deals with will be entry-level and in that respect, "wherever you go there is a huge need."

She described a benefit as "a privilege, not a right" and added "it's your responsibility to get a job that pays more than a benefit and that is still not a hard thing to do." For a single person without dependents she is right. But if the beneficiary has children, less so. At April 2023 a sole parent on a benefit with two or more children had a net average weekly income of $1,057. I will return to that.

In their six years in government Labour did two crucial things with welfare. They diverted case managers away from work-brokering to ensuring all beneficiaries' entitlements are met. The number of clients under active case management dropped dramatically.

Simultaneously benefit incomes were pumped up to reverse the 1990s cuts and out-pace inflation. According to last year's Benefit Incomes report:

"Total incomes, after housing costs, have increased at a faster rate than inflation since 2017. Total incomes are 48 percent higher than at the end of 2017, after adjusting for inflation."

For single beneficiaries, coming off a low base, 48% was far less significant than for families coming off a high base. So when single parents (which the vast majority of benefit-dependent parents are) start to weigh up the costs of childcare, transport, etc the benefit is the better option.

Yes, a moral obligation to support oneself can be argued but as Rankin put it, the last "confused" government actually believed a benefit is a right and not a privilege. Nobody should have to work if they don't want to.

But it is long-term single parent dependence which drives inter-generational malaise - the most serious social problem the country faces. Inter-generational dependence drives under-achievement, domestic dysfunction, ill-health and crime.

So what is National doing?

The same thing it does every time it returns to power.  It gets a bit tougher about oversight of beneficiaries, although waiting six months before requiring Jobseekers to 'check in' seems counter-intuitive. Six months on a benefit can do a lot of damage to morale and confidence.

They set some soft targets like having "50,000 fewer people on Jobseeker Support benefits by 2030"  but make no mention of sole parents (who are also not required to 'check-in').

The last big National welfare reforms (2013) comprised ... changing benefit names.

The Sickness Benefit was abolished only to be replaced with the Jobseeker Health Condition/Disability. In the last month that it was known as the Sickness benefit there were 59,127 recipients. Now there are 82,482.

The DPB (always a political problem) was replaced with the innocuous-sounding Sole Parent Support. Recipients would be transferred to Jobseeker when their youngest turned 14 but come on. After 14 or more years on a benefit, the chance of joining the workforce is not great.

And the Invalid benefit (83,778 in June 2013) became the Supported Living Payment (now 103,089).

The percentage of working-age people dependent on welfare is higher now than then. 

There is an inertia about the numbers which is going to take some radical actions to disrupt them. But National lacks the necessary reforming zeal.

National will persist with the tinkering that deflects attention and mollifies their voters while the country's historic heavy and unhealthy over-reliance on the welfare system continues.

References

https://www.msd.govt.nz/about-msd-and-our-work/publications-resources/research/benefit-system/total-incomes-annual-report-2023.html

https://www.msd.govt.nz/about-msd-and-our-work/publications-resources/statistics/weekly-reporting/index.html

https://www.beehive.govt.nz/release/job-seekers-report-progress-after-six-months-today

Oranga Tamariki behind the scenes

Another baby known to Oranga Tamariki has died. It is bad enough that a life is lost when it has barely begun. But it is worse when there were opportunities to intervene not taken.

Oranga Tamariki is very preoccupied with process. Perhaps dangerously preoccupied.

They are currently immersed in changing their Practice Approach which involves moving from viewing practice through a western lens to a Māori lens. According to Oranga Tamariki the purpose of the new Practice Approach is to move from "Privileging tauiwi beliefs, values and knowledge (ongoing colonialisation)" to "Preferencing Te Ao Māori beliefs, values and knowledge." 

Social workers also describe the approach as shifting from "a risk-focused approach to a more holistic, whānau centred one."

In plain English, babies are not removed; families are worked with. This may be a successful approach in some cases. In others, it might fail. The risk to the dead 10-month-old was not assessed well enough to save his life.

Oranga Tamariki workers are being schooled in the new Practice Approach with a variety of "tools, models and resources" depicted in the following diagram:

 

(Left click on image to enlarge)

All of this new ‘knowledge’ must be propagated and absorbed against a background of a severely overworked workforce. There aren’t enough social workers and the need for them is escalating. Only two days ago a “leading family violence crisis agency” told the NZ Herald that the violence being reported to them was at an “all-time high.”  Police statistics for assaults on children bear this out. Serious assaults on under 15 year-olds which resulted in injury increased by 46 percent in the five years to 2023. 

Meanwhile Oranga Tamariki have been evaluating their new Practice Approach. While around two thirds of staff were positive there was also resistance including, “Worry that the changes could compromise their management of risk and safety for tamariki and rangatahi.”

Moreover, 59 percent did not respond to the Practice Approach Survey and the following insight indicates a degree of pressure to conform might be operating:

At one site supervisors and practice leads have implemented several practices to support the Practice Approach. For example, they have implemented karakia, waiata, kiwaha, and ko wai au in the morning meetings. They now go around the room and ask social workers what they have done in their work that week to reflect Ngakau whakairo and give examples.

Surely qualified social workers are itching to be out working at the coalface – not sitting around talking about it?

As well as risks to children there are workforce risks - present and future - to consider.

For instance, individuals wanting to work in the field of child protection will be dissuaded by this nebulous, navel-gazing, mumbo-jumbo called Practice Approach. Being best buddies with the whanau may appeal to some character types – and may even achieve the best results with some families – but ultimately, Oranga Tamariki is there to protect the safety, the very lives, of children and young people.

Doubtless many who are employed by the organisation understand and respect that function, but the ideology “framed by Te Tiriti o Waitangi” being gradually imposed upon them will probably undermine their ability and desire to continue.

Yes, the formalised Practice Approach has only been operating since 2022 but the “by Māori, for Māori” ethos has been around for many years now.

How long should it be given to prove it does or doesn’t protect children from abuse or worse? And will we count the answer in time or lives?

  

  

Time for some perspective

A lack of perspective can make something quite large or important seem small or irrelevant.

Against a backdrop of high-profile, negative statistics it is easy to overlook the positive.

For instance, the fact that 64 percent of Maori are employed is rarely reported. For context, the employment rate for all New Zealanders is 68.4%. The difference isn’t vast.

In excess of 400,000 Maori have jobs, provide products and services and pay tax.

Maori are over-represented in the manufacturing, and utilities and construction workforces. They are disproportionately service workers, labourers and machine operators. As such they perform crucial roles.

97 percent of Maori aged 15 or older are not in prison or serving a community sentence or order. Over 99 percent of Maori are not gang members.

Yet as an ethnic group Maori take a lot of heat.

Their pockets of failure (which occur across all ethnicities) overshadow their success because it suits certain political aspirants to promote the negative. The predominant individualist culture wants Maori to get their act together and exercise greater personal responsibility. While the collectivists want the community to take the blame for Maori failure and fix it via redress. The finger-pointing at colonists as the culprits, which has ramped up immeasurably over recent years, has resulted in a great deal of misdirected anger towards Maori, the bulk of whom just want to get on with their lives. (To boot, this simplistic description ignores that since the early 1800s Maori and non-Maori have become indelibly interlinked by blood and it has become impossible to identify which finger is pointing in which direction, such is the absurdity of modern-day racial politics.)

It feels safe to say that most people want to live peaceful, happy and productive lives. We share those basic desires regardless of race. It’s that commonality that makes race irrelevant.

And yet New Zealanders are being increasingly divided, forced to take sides, to figuratively identify with black or white when life is mainly grey. Without some measure of compromise, contradiction and capitulation society couldn’t exist.

The flipside to poor Maori statistics reminds us that as contributing members of New Zealand we have far more in common than ever divides us.

References

EMPLOYMENT

https://www.stats.govt.nz/assets/Uploads/Labour-market-statistics/Labour-market-statistics-March-2024-quarter/Download-data/household-labour-force-survey-march-2024-quarter.xlsx

https://www.mbie.govt.nz/business-and-employment/employment-and-skills/employment-strategy/maori-employment-action-plan/annexes/overview-of-maori-employment-outcomes-in-aotearoa-new-zealand

IMPRISONMENT

https://www.corrections.govt.nz/resources/statistics/quarterly_prison_statistics/prison_facts_and_statistics_-_march_2024

COMMUNITY SENTENCES AND ORDERS

https://www.corrections.govt.nz/resources/statistics/community_sentences_and_orders/community-based_sentence_and_order_facts_and_statistics_-_march_2024

GANGS

https://www.parliament.nz/resource/en-NZ/WQ_15227_2023/8a9747c39eaa9a19cc720513355ac43e285d5b95

https://www.corrections.govt.nz/resources/statistics/corrections-volumes-report/past-census-of-prison-inmates-and-home-detainees/census-of-prison-inmates-and-home-detainees-2003/6-gang-membership/6.1-gang-membership

Meanwhile “… the disturbing trend of increasing violence towards children continues to worsen.”

The Children's Minister, Karen Chhour, intends to repeal Section 7AA from the Oranga Tamariki Act 1989 because it creates conflict between claimed Crown Treaty obligations and the child's best interests. In her words,

 "Oranga Tamariki’s governing principles and its act should be colour blind, utterly child centric and open to whatever solution will ensure a child’s wellbeing. "

There is, however, substantial opposition to this change.

A Waitangi Tribunal preliminary report about the removal of Section 7AA cites testimony from Te Puni Kokiri:

"Te Puni Kōkiri did not support the proposal to repeal 7AA, because it ‘is highly likely to undo the significant progress that has been made to reduce the disproportionate number of tamariki and rangatahi Māori in the care of the state’."

Again, the reduction of Māori children in state care is presented as ‘progress’ (despite evidence of increasing child victimisations.)

But there is another odd aspect to this apparent ‘progress.’

The main pathway through which children come to the attention of Oranga Tamariki is through Reports of Concern which have decreased 28% from 92,351 in 2018 to 66,487 in 2022.

This drop is unusual enough for Oranga Tamariki itself to attempt an analysis which was released on Monday, April 29.

The following presents some of the findings from that report.

After a Report of Concern further action might be required. That outcome is increasing as shown in the graph below, implying that reports are becoming of a more serious nature:

To understand why Reports of Concern have reduced, various barriers have been examined. 

One was the call centre wait time which is up significantly (though the abandoned call rate is reasonably steady since 2014 at around a quarter). Nevertheless, a wait time of almost 8 minutes would be quite excruciating for an emotionally charged, possibly indecisive and apprehensive caller. Many called back but still ended up abandoning their second attempt:

Another was lack of trust.

In respect of trust, social responsibility, leadership, and fairness Oranga Tamariki ranked the lowest of 58 public agencies in 2021 via online surveys and interviews. Oranga Tamariki says:

 “It is clear that three factors found to be key to establishing trust (ability, benevolence and integrity) were questioned by the public, which could have a profound impact on notifiers’ willingness to be vulnerable and engage with Oranga Tamariki.”

While news stories apparently have the single largest effect on that lack of trust, tellingly “those who base their opinion on their experience are the most negative about Oranga Tamariki.”

(Ironically, a regulatory impact statement on the repeal of section 7AA prepared by Oranga Tamariki staff and referenced in the Waitangi Tribunal report concluded, “… we consider that repealing section 7AA in its entirety may worsen long term public confidence in Oranga Tamariki overall.” Can it get much worse?)

Also examined were social worker non-responsiveness and delays. It was found that Intake Social Worker Full-time Equivalents did not increase in line with higher workloads. Additionally, sick days taken in 2022 were 150% up on the average taken during 2018 to 2021.

Three quarters of the reduction in reporting is among professionals in the education and health sectors, Police, Court and other government agencies.

Testimony from a 2023 Listener article is quoted:

“Many child psychotherapists, myself included, have given up working with children. Lobbying the agencies meant to protect them is soul destroying and results in little, if any, change.”

Contrastingly, Oranga Tamariki also admit, “health professionals have said they lose trust in reporting to Oranga Tamariki and instead keep at-risk individuals on their books to ‘keep an eye on them’…” That might be a blessing.

Surprisingly only a brief mention is made of Section 7AA and the strategic partnerships formed with Iwi:

"Further investigation is required to fully understand potential impacts they might have had on rates of reports of concern, but it is feasible that tamariki and whānau receiving support sooner has reduced the need for reports of concern to be made."

It is feasible but at this stage, it remains unknown. 

Using other sources, I therefore come back to what is known.

In the five years to 2023 police data shows the number of children aged under 15 years reported as being victims of a violent crime grew from 6,377 to 8,978 or 41%. As the Salvation Army puts it, 

“… the disturbing trend of increasing violence towards children continues to worsen.”

This against a backdrop of fewer reports to Oranga Tamariki and fewer children being under the care of the state.

Meanwhile Oranga Tamariki bureaucrats, fighting the minister’s proposal to repeal Section 7AA via their regulatory impact statement, continue their obsession with the Treaty and equity:

"Changes introduced in Oranga Tamariki that resulted from the introduction of 7AA have been effective at reducing some of the disparities and inequities experienced by tamariki, rangatahi, and whānau Māori. There has also been considerable progress as a Department towards honouring the principles of the Treaty of Waitangi through the current practice approach and operating model."

Did Oranga Tamariki consider that the fixation with the Treaty of Waitangi throughout the public service is a major reason the public is disengaging? 

If there is no agency that can be trusted by all New Zealanders to effectively protect children, more children will suffer. As we are seeing.

Is Oranga Tamariki guilty of child neglect?

One of reasons Oranga Tamariki exists is to prevent child neglect. But could the organisation itself be guilty of the same?

Oranga Tamariki’s statistics show a decrease in the number and age of children in care.

“There are less children in care now than as at 30 June 2019 when there were 6450 children and young people in care and protection custody and 140 in youth justice custody, a total of 6590 children in care. As at 30 June 2023 there were 4317 children and young people in care and protection custody and 162 in youth justice custody, a total of 4479 children in care.”

That’s a big drop of almost a third. Of particular interest though:

“… recent changes in practice …  have seen a decline of the number of children being brought into care, particularly in the under 5 years age range …”[i]

On the face of it this sounds positive. But not one to take anything at face value, I want to know what it actually means.

Oranga Tamariki and the New Zealand Police both perform the statutory roles of child protection.

It is now possible to interrogate police victimisation data[ii] and look specifically at children aged 0-4 who were victims of crime. In the following graphic, the year June 2018 to June 2019 (as per the Oranga Tamariki data above) is selected:

(left click on image to enlarge)

There were 891 acts intended to cause injury perpetrated against 0-4 year-olds. The ethnic information is limited and inconclusive given 44.5% had ethnicity ‘not stated’.

Next, I moved the time period forward to the year June 2022 to June 2023:

There were 1,296 acts intended to cause injury perpetrated against the same age group. That’s an increase of 45% (with no equivalent rise in the size of the demographic.) The group with ‘no stated ethnicity’ has climbed further to 69 percent, though where ethnicity is recorded the usual disproportionality remains.

So over the 4-year period in question, there were fewer under 5-year-olds taken into care (which can actually mean they come under the care of the state but remain with their caregiver) and more acts against them intended to cause injury.

Which then begs the question, were injuries (or worse) sustained?

Here I am unable to isolate just the 0-4 year-old age group, but for under 15 year-olds serious assaults resulting in injury rose from 1,820 to 2,438 over the exact same period.[iii] A 34% increase.

But back to the pre-schoolers. Almost 1,300 acts intended to cause injury equates to more than three every day against the very young and defenceless. Oranga Tamariki data implies the situation is improving whereas the Police data implies the situation is deteriorating. They can’t both be right.

Is the rate of intentional injury increasing for the very reason that Oranga Tamariki is taking fewer children into state care?

If the answer is ‘yes’ then the whole drive to leave mainly Maori children with their whanau for cultural reasons is flawed.

But how do we know it is Maori children being hurt given police’s growing propensity to omit victim ethnicity?  Data from Health New Zealand confirms ethnic disproportionality[iv]:

It is overwhelmingly Maori children who are hospitalised due to domestic violence.

A recent op-ed[v] published in The Post and elsewhere, written by a regular columnist and past Greens/Maori Party staffer, criticised Karen Chhour’s move to repeal section 7AA of the Oranga Tamariki Act. It claims, “There is no empirical evidence to support this decision.” 

I beg to differ based on Police and Health NZ data.

Then he states, “By Māori, for Māori services such as Whānau Ora have had extraordinary success working alongside Oranga Tamariki to place children in safe, secure, and culturally appropriate care.”

If the last statement is correct, then we can only assume matters could be even worse than they are; that Maori children could be even more disproportionately victims of violence than is currently the case. To accept that scenario a positive trend would need to be evident.

Which is what we get from Oranga Tamariki … but not the Police.

I don’t mind being wrong but it feels like the safety of Maori children is being neglected, perhaps even sacrificed, to prove a political point: that culture matters more than care.

[i]

 https://www.orangatamariki.govt.nz/assets/Uploads/About-us/Performance-and-monitoring/safety-of-children-in-care/2022-23/J000093_SOCIC-Report-2023_v4.pdf

 

[ii] 

https://www.police.govt.nz/about-us/publications-statistics/data-and-statistics/policedatanz/victimisations-demographics

 

[iii] https://www.salvationarmy.org.nz/sites/default/files/uploads/2024/02Feb/SOTN/tsa_sotn_2024_downloadversion.pdf

 

[iv] 

https://www.tewhatuora.govt.nz/assets/Publications/Health-status-reports/HNZ-TWO-Health-Status-Report_FULL.pdf

 

[v] https://www.waikatotimes.co.nz/nz-news/350248565/how-political-culture-wars-impact-peoples-lives

Babies and benefits - no good news

 Ten years ago, I wrote the following in a Listener column:

Every year around one in five new-born babies will be reliant on their caregivers benefit by Christmas. This pattern has persisted from at least 1993. For Maori the number jumps to over one in three.   Add to this Treasury's advice to the Ministerial Committee on Child Poverty,

"...around 1 in 5 children will spend more than half of their first 14 years in household supported by main benefit. This group is at the highest risk of material hardship and poor outcomes across a range of dimensions”.

I am reflecting on this as I receive the latest update in an OIA response from MSD.

Of all the babies born in 2023, 20.2 percent were on a benefit by the end of December. For Maori babies the percentage rises to 34.3%.

My news is not really news. It is confirmation of the ‘same-old, same-old.’ Progress had been made when, by 2017, the portion had fallen to 17.1 percent of all children, but we all know what happened next. The Minister for Child Poverty Reduction – Jacinda Ardern – made it her task to lift welfare incomes for beneficiaries with children.

She said in her 2008 maiden speech:

The majority of children living in poverty now are dependants in families where the main means of support is a Government benefit. But if we believe that our welfare State is a necessary safety net and a support for those unable to support themselves—as I do—then the children living in these circumstances should not be living in poverty. These children are not part of an underclass, as I have heard them called; they are part of our community, and we have a responsibility to continue the momentum of the previous Labour Government and to finally rid ourselves of poverty in Aotearoa New Zealand. This is our collective challenge.

She would have responded to Treasury’s evidence (that these children face material hardship and poor outcomes) by arguing, ‘Of course, that’s because they don’t have enough money.’

She had no sympathy for the counter arguments that growing up fatherless (72% of last year’s welfare babies had caregivers on the Sole Parent Support benefit) and in jobless households, is also harmful for children. Ardern was happy to risk more of both in order to claim a poverty reduction.

In 2016 when I wrote a paper demonstrating the strong link between failing family structure and growing child poverty, Ardern responded flippantly in a Sunday Star Times column:

This week I opened the paper to find some astonishing "news" - a lack of marriage is to blame for child poverty.

I've spent the better part of six years reading and researching the issue of child poverty, and what we need to do to resolve this complex problem in New Zealand

And yet here it was, the silver bullet we have all been looking for. Marriage. Getting hitched. Tying the knot. It turns out that we didn't need an Expert Advisory Group on child poverty, or any OECD analysis for that matter - apparently all we really need is a pastor and a party.

No matter that the strongest correlate for child poverty is the sole parent rate. The collapse of the stable two-parent family – particularly for Maori whereby last year 82.5 percent of babies were born to unmarried parents – has had a dramatic effect here and around the western world. Yes, many more parents live together without “tying the knot” but the stability of de facto relationships does not match the stability of marriages, especially with the advent of children. Ardern herself must have eventually felt some regard for the institution or wouldn’t have entered into herself.

But the genie that is unpartnered parenting is not going back in the bottle. The too-frequent accompanying feature - being born and raised on welfare - is now firmly part of the NZ social landscape.

Are there any glimmers of hope for future change?

I had anticipated that the significant reduction in teenage births post 2008 would put a clamp on one of the main feeder mechanisms to long-term dependency. Initially, Sole Parent Support recipients aged 18-24 reduced but for the last six years, the numbers have stuck despite further drops in the relevant birth rates.

National has not included sole parent benefits in its two welfare reform targets. New MSD Minister Louise Upston has been a single mother and called it “the hardest time of my life.” Her approach seems to be a softly, softly plan to help single parents into work. She does not have the bit between her teeth in quite the same way her predecessor Paula Bennett did.

On a brighter note, NZ’s culture may yet be positively influenced by our fastest growing minority – Asians. This group is by and large family-oriented, self-reliant and takes care of its young as evident below:

(Note: When their youngest child turns 14 the parent/caregiver moves onto Jobseeker benefit. They remain on Sole Parent Support if younger children are under 14.)

What these immigrants (and subsequent generations) think about NZ’s lackadaisical benefit system can only be guessed at. But their attitudes will find political expression in the coming years.

NZ may not be willing or able to continue fully subsidising the cost of raising children long-term at the rate of one in every five. While Jacinda Ardern might consider it our “collective challenge” to do so, I prefer the restoration of committed stable partnerships between parents as a far more worthy goal. But to achieve that, damaging incentives have to go.

The case for cultural connectedness

A recent report generated from a Growing Up in New Zealand (GUiNZ) survey of 1,224 rangatahi Māori aged 11-12 found:

Cultural connectedness was associated with fewer depression symptoms, anxiety symptoms and better quality of life. 

That sounds cut and dry. But further into the report the following appears:

Cultural connectedness is important for mental wellbeing, however it may not support depression and anxiety symptoms and quality of life in exactly the same way.

Meaning?

The group of children was divided into three sub-groups determined by their degree of ‘structural disadvantage’ (material hardship, severe housing deprivation/homelessness, and food insecurity): persistently low, intermittently high and persistently high.

The following chart shows the greater the cultural connectedness is (horizontal axis) the higher the anxiety symptoms are (vertical axis) for the persistently low (yellow) and persistently high (blue) disadvantaged groups.

(Left click on image to enlarge.)

There is no attempt by the authors of the paper to explain why this may be the case. What they do say is, “…the paper makes an important contribution by exploring whether cultural connectedness buffers the harms caused by structural disadvantage on rangatahi mental wellbeing.”

Based on the above finding cultural connectedness exacerbates the harm, at least in respect of anxiety symptoms.  

The relationships between disadvantage and a/depression and b/ quality of life are also explored showing positive correlations BUT:

… none of these relationships were significant, indicating that cultural connectedness did not have a buffering effect on depression symptoms. There was also no significant buffering effect of cultural connectedness on quality of life scores for rangatahi Māori.

Obviously disappointed in what they describe as “mixed evidence” the authors suggest, “this finding is not surprising as it would be unreasonable to expect that having a strong sense of identity and feelings of belonging in early adolescence might undo generations of harm caused by colonialism and racism and the multiple and interacting structural disadvantages that play out in the lives of rangatahi Māori.”

Having established cultural connectedness has no demonstrable usefulness as a buffer against adolescent depression or anxiety the authors then change tack and argue another reason for its importance:

Achieving the government’s vision … requires actions that will enable rangatahi Māori to develop a strong cultural connectedness not as a resilience or coping strategy but rather as part of a broader Treaty-compliant, pro-equity, anti-racist and human rights-based approach. Anti-racism action will require a commitment to invest in strategies that will systematically dismantle the structures that contribute to inequities in rangatahi Māori mental wellbeing (1,21). This paper provides new insights into the powerful potential of policies that address structural disadvantage and enable rangatahi Māori to flourish in their identity as Māori.

The paper provides nothing of the sort.

What it does provide is evidence that the GUiNZ study has been captured by politicised academics pushing their own racist agenda.

The future funding for GUiNZ is currently under a question mark. According to RNZ, “The current uncertainty over funding for the study comes amid wider fears about science funding.”

Science? You be the judge.