Thursday, July 11, 2024

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."

Saturday, June 29, 2024

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.


Thursday, June 13, 2024

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?



Saturday, May 11, 2024

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.






Sunday, May 05, 2024

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.

Thursday, April 25, 2024

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.










Thursday, April 18, 2024

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.

Sunday, April 14, 2024

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.


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.

Thursday, April 11, 2024

Welfare: Just two timid targets from the National government

The National Government has announced just two targets for the Ministry of Social Development. They are:

- to reduce the number of people receiving Jobseeker Support by 50,000 to 140,000 by June 2029, and

- (alongside HUD) to reduce the number of households in emergency housing by 75 percent, by June 2029 – this is fewer than 800 households in emergency housing.

The first of these targets is incredibly timid and disappointing.

A reduction of Jobseekers down to 140,000 by June 2029 is still more than there were in June 2019 (136,233). 

To put the target in context, in the year to January 2024, NZ added 133,800 net migrants. If just a third of these found work (assuming the balance are students or dependents of the primary migrant) that represents 44,600 extra jobs. In one year. How hard can it be to find a job if you really want and need one?

Interviewed by Mike Hosking earlier this week, former WINZ boss Christine Rankin said that the target reduction "can be done in way under the time frame they've put on it". She should know.

To achieve the target the government says there will be, "a stronger focus on helping 18–24-year-olds on Jobseeker Support into jobs." Announcing where a stronger focus will be risks the pressure going off other beneficiaries in the minds of both case managers and clients. Numbers on the Sole Parent Support (ex DPB) have been increasing steadily. Given sole parent households contribute  substantially to inter-generational dependency, they merit no less focus than Jobseekers.

Reaching the reduced goal will happen by, "making it easier for people with work obligations to understand and meet expectations."  How hard can it be to understand an obligation to find work? Isn't this simply an acknowledgement that over the past six years, obligations became fuzzy and weak? So why is a reversal of Labour's soft approach couched in such ... soft language?

And what about those who don't have work obligations?

In 2012, during Paula Bennett's time as minister, obligations were placed on single parents to return to work earlier if they had an additional child while receiving a benefit. Carmel Sepuloni removed that requirement effectively allowing the birth of more babies to be used to avoid working. 

As it is sole parents have no work obligations until their youngest turns three (and then it is only to seek part-time work.) Three years is inconsistent with the time most working mothers take out of the workforce.

The government's second target appears no less lacking in ambition.  Emergency housing numbers have already been tracking down. Depicting them next to the 2029 target looks like this:

A continuation of whatever policy operated between 2022 and 2024, which saw a 39 percent reduction in emergency housing, would see the target of 750 met much sooner than 2029.

Come on National.

You were elected to be bold. Kids in emergency housing don't have the luxury of time. 

Neither does the rest of country. Our deep-seated, long-standing dependency problem, which is an economic handbrake and social disaster, needs urgent reform - not timid targets.


Thursday, April 04, 2024

Cuts will only scratch the surface

While this morning’s news heralded 134 job losses at the Ministry of Health, the Ministry of Social Development has just announced their own plan to achieve the 6.5% savings requested by the new government:

We will begin by offering people in some parts of our organisation the choice of voluntary redundancy. People will be able to apply until April 15. At this stage we don’t have a specific target of how many voluntary redundancies we are seeking. Those in frontline roles will not be able to apply for voluntary redundancy.

After this voluntary redundancy process, it is likely there will be a further process targeting role reductions in some areas, mainly within our National Office in Wellington. 

Of course, opposition parties, left-wing media and unions are describing these cuts as cruel and disgraceful.

But has anyone looked at the growth that has preceded these cuts?

In 2018, according to their annual report, MSD had “6,725 full-time-equivalent staff positions”.

By 2023 that had grown to “9,329 full-time-equivalent (FTE) staff positions”. 

That’s a 39 percent growth in full-time staff.

RNZ is reporting that MSD is “calling for mass voluntary redundancies.”  The word “mass” does not appear anywhere in the MSD release. That’s RNZ’s own invention. If it was possible to achieve “mass” redundancies in affected areas, apparently “human resources, policy, strategy and communications” that indicates those departments are well and truly over-staffed anyway.

Looking at MSD’s core responsibilities it is fair to say the extra 39% staff added in the last 5 years has achieved no improvement.

Their key message is, “We help New Zealanders to be safe, strong and independent.”

Yet there are many more people on benefits (including more children in benefit-dependent households) and people are staying dependent longer. And it would be a stretch too far to claim that people are feeling safer.

What is disappointing is that the staff cuts (like those across the whole public service) will not take levels back to where they were in 2017/18 (with possible allowance for population growth). They will merely continue the growth of government in the entrenched 3 steps forward – 1 step back pattern that has become all too familiar over many decades.





Sunday, March 10, 2024

What media bias looks like

When news media took a pummeling last week at both TVNZ and TV3, a number of critics said part of the reason ratings are poor is the public don't trust them. The public believe that the media is biased.

The print media is similarly suspect. An article in Stuff today (which may feature in the Sunday Star Times) provides a great example of indiscriminate reporting. The headline reads:

Mum: Ex ‘hiding income to avoid child support’

It features a single mother of three complaining about her self-employed ex hiding his income to avoid child support.

    'Full-time single mum-of-three Janet says she is left struggling to get by because one of her children’s fathers is able to conceal how much he is earning ... "I am unable to work as I also have a disability my legs are swollen and I’m still recovering from recent hernia surgery." '

As an unemployed single mum she must be receiving a benefit but nowhere in the article is this spelt out. Her desire for income privacy does not extend to her ex's.

    'She said he was meant to pay just over $1100 a month between January and April but had only paid $473 in February. From May his support will drop to $623 a month.'

This is where it gets interesting. It was only August last year that the new child support pass-on rules kicked in. Prior to that IRD kept child support payments to offset the benefit cost.

It seems the mother has now become concerned about how much the father is earning as she stands to pocket more of it.

If the liable father is artificially reducing his declared income, perhaps this development is a factor? The business editor omits mention of this possibility. 

The mother has a younger son to a subsequent partner who she is not complaining about because he doesn't earn an income. He is on a benefit (which he may be staying on to avoid paying more than the minimum child support ... another unexplored angle.) 

She says the first father hasn't given his sons birthday or Xmas presents for 14 years. So she has raised them alone for some years. Only now, when she stands to receive the child support directly, has life turned into a terrible "struggle" with her children needing support from charity - this despite a benefit-dependent single mother with two or more children receiving on average of around a $1,000 weekly net.

Without proof, the report creates an impression that self-employed fathers are hiding income to avoid paying child support. This  despite the income difference between self-employed fathers with liabilities versus all taxpayers being just two percent.

The only sensible comment in the entire piece is from a tax partner at Deloittes who points out that self-employed fathers with child support liabilities may have lower incomes because they often share care of their children and work fewer hours.

This is a biased piece of journalism. It's uncritically sympathetic to the mother and accusatory of the father. Note the reporter does not say he was approached for comment.

Ultimately the piece raises far more questions than it answers. An attempt to answer the questions might have provided some balance.

Thursday, March 07, 2024

Is real change on the cards?

Sometimes the gems are buried. My ears pricked up when the following statement was reported on a news programme playing in the background:

"MSD staff assessing anyone applying for emergency housing will increase their scrutiny of whether they have unreasonably contributed to their immediate emergency housing need ..."

I googled Minister for Social Development Louise Upston's press releases to confirm that's what she actually said. Indeed she had.

If the government means it, this is hugely significant.

It has been clear for decades that NZ's approach to welfare has gone awry. The late Roger Kerr, of the NZ Business Roundtable, once said to me, "The only way forward is to go back to the concept of 'deserving' and 'undeserving'."

To be honest, at the time I thought this was slightly draconian. But the passage of the years has only brought me further around to his view. By protecting people from the consequences of their own foolish actions NZ has only created more 'need'. In other words, the 'undeserving' have been rewarded.

This is a direct offshoot from the philosophy of 'non-judgementalism' which is absolutely rife through the social services and charity sectors, and even health and education. It is formally taught. Every needy individual is a 'victim' of circumstances, never their own poor decision-making.

I am personally a great believer in second chances and the right to redeem oneself, and have certainly had occasion to avail myself of these principles (or lived with the consequences of not being forgiven or excused.) But like many pendulums, the one called 'tolerance' has swung too far.

The welfare system is now the lifeblood of criminals. People who trash other people's property, who threaten and abuse neighbours, who keep aggressive dogs as status symbols, who have not a skerrick of regard for others, turn up at WINZ demanding to be placed in emergency housing. And they are.

(Not to mention the tens of thousands of other people who took no responsibility for their own education, go on to produce children recklessly and, in turn, take no responsibility for theirs.)

Between the passage of the Social Security Act in 1938 and the early 1970s the percentage of working-age people on a benefit never exceeded two. Today it stands at almost twelve, with the time people stay dependent growing every year.

As a society we have created this level of reliance by believing and acting on a bad idea. That we must not judge others. We must not mention their faults and shortcomings. We must bend over backwards to not blame the person responsible for their own troubles. That's the kindness and compassion we are taught to aspire to.

Until Louise Upston said something quite contrary but actually terribly sensible.

In assessing applicants for emergency housing case managers must take into account whether they have "unreasonably contributed" to their need.

One assumes that if the answer is positive, there will be no emergency housing offered.

Quite right too.

My theory is that the emergency housing crisis - putting people into motels, lodges and motor camps - came about because the Labour government created an expectation that anyone who showed up at the newly-generous WINZ department asking for a house would get one (or something akin). If people had been turned away they would have found their own solutions. Living with friends or family usually. If friends and family wouldn't have them - presumably because they were undeserving - why should the taxpayer fork out to put them into place where they can wreak anti-social havoc on nearby neighbours?

It's the individual who should experience the consequences of their own unwise actions - not everybody else.

So let's support Upston and encourage her to take this new approach further. I would vouch that the majority of New Zealanders want to help people who, through no fault of their own, need a benefit and public housing. But that willingness does not extend to people who chronically cause their own misfortune.

Monday, February 26, 2024

Child poverty - complex or simple?

Question: Do you understand how the child poverty statistics are derived?

Clearly some people do not.

Last week the latest child poverty statistics were all over the media. But there are a number of misunderstandings that need addressing. Like this one from NewstalkZB’s John MacDonald who wrote:

"Living in households that get-by on less than half the median income, before basic living costs are taken into account. 

Now I’ve looked-up online to find out what the median income is in New Zealand and there seems to be all sorts of numbers available, but one figure I’ve seen is $91,400. So, let’s go with that one, for the purposes of today’s discussion. 

Half of that is $45,700. So, it’s kids living in households where less than $45k is coming in the door annually.  

With tax, that takes it down to about $38,000. Or about $730-a-week to live off."

But the median income Stats NZ produces isn’t actual – it’s equivalised. In the past I have attempted to explain how this process works, probably unsuccessfully. But now Stats NZ has helpfully produced a pictorial explaining the process:

 (Left click on image to enlarge.)

The first household becomes relatively rich compared to the third household. But in reality, their household incomes are identical.

Similarly RNZ demonstrated their misunderstanding reporting:

"One in six children (or 17.5 percent) lived in households with less than half of the median household disposable income after household costs - that was up 3 percentage points on last year."

In this case the median household income has been described as “disposable”. That’s wrong too.

The disposable income of a household is all income ‘earned’ by members aged 15 or older after taxes and transfers. Disposable income then undergoes equivalisation for the purposes of creating official child poverty statistics.

Teresa Tepenia-Ashton of Unicef said:

“It’s unacceptable for a single child to be in poverty in this country. With 1 in 8 children experiencing material hardship, we need Government to prioritise the interests of children in any decisions relating to welfare changes, so we can bring this number down to zero.”

A target of zero children in poverty is an impossibility because of the way poverty is measured. It is relative.  Zero poverty could only occur if every single household in NZ had the same equivalised income. It’s pure nonsense (similar to other ludicrous loony-tune ideas like Road to Zero 2030, Predator Free 2050 and Smoke Free Aotearoa 2025.)

There’s also been a great deal of handwringing over the higher poverty rates for Māori and Pasifika children.  But that is at least partly a facet of the equivalisation process. Pacific households in particular tend to be large, include children and are often inter-generational. It follows that their equivalised incomes will therefore be lower than households with fewer members.

The complexity inherent in the multiple measures of child poverty does nothing to instil confidence in their veracity. What the complexity does do is create a bias towards overstating poverty – a useful tool for proponents of greater wealth redistribution.

I tend towards a simple view. One which rarely rates a mention. The strongest correlate for child poverty is the rate of single parenthood. In New Zealand it is high. Among Māori it is very high.

Fixing that – an outcome largely in the hands of individuals – will go a long way towards reducing childhood hardship and deprivation.






Sunday, February 18, 2024

National needs to go further

In today's State of the Nation speech Christopher Luxon talked repeatedly about getting young people off welfare. It seems that National has devised a traffic light system which will use increasing levels of sanctions - welfare deductions - when beneficiaries fail to meet their obligations. He uses the word 'tough' a lot.

In his speech he made the following observation:

"Kids born this year will be turning 16 in 2040."

Well, because I can tell you something about them,  let's look at the children born in 2022 who will be turning 18 in 2040.

By the end of their birth year 12,639 of them were dependent on a benefit provided to their parent or parents. That's 21.5% of all babies born that year. Over one in five.

Then consider that the link between a child's early entry into the benefit system and later benefit dependence in their own right, is strong.

MSD's own commissioned research showed:

 - Nearly three quarters (74%) of all beneficiaries up to age 25 had a parent on benefit while they were a child, and just over a third (35%) had a parent on benefit throughout their teenage years.

 - The greater the family benefit history the longer the client tended to stay on a benefit, particularly for the Jobseeker benefit.1

It's laudable to talk about getting 18 year-olds off welfare. Better still though to discourage their entry into the welfare system in the first place.

The focus of reforms must be two-fold. Dealing with 40,000 young people on Jobseeker right now is critical. But so is looking to the future and turning off the tap that feeds inter-generational dependence.

Labour's soft-on-sole-parents approach has to go. That means ending the nonsense of not naming fathers and reintroducing work obligations for parents who add children to an existing benefit.

But more broadly, the cash-for-kids scheme has to stop. The assistance provided to unemployed parents who refuse jobs  should be through 'money management' - a system used for youth beneficiaries. The rules are:

    -your rent or board and things like your power bill and any debts will be paid straight from your payment. You won't get this money yourself.

    -you will get paid a weekly allowance of up to $50 into your personal bank account.

    -any money left over will be put onto your personal payment card. This is like a debit card that you can use to buy your food and groceries at approved stores.2

Until cash incentives that equal incomes from work are removed, the inter-generational problem will continue to plague New Zealand. Yes, there will be downsides to money management. But will they be any worse than the devastating social outcomes that come from unconditional welfare?



Thursday, February 08, 2024

Labour hid developing welfare crisis

When National became government in 2008, Finance Minister Bill English's determination to understand the extent of benefit-dependency led them to commission Taylor Fry to produce annual actuarial reports. These were duly published at the MSD website every year but ceased when the government changed in 2017. Now however, an Official Information request by the NZ Herald has revealed that the reports actually continued - only their publication ceased.

In my columns I have referred repeatedly to the worsening depth of dependency using the sole measure available - one solitary statistic published in MSD's annual reports not typically subject to public scrutiny.

So while I am not shocked by the content of the latest Taylor Fry report, the detail is staggering.

According to The Herald:

    "... recipients of the main Jobseeker payment [are] now expected to spend an average of 13 years on a benefit."

    "Sole Parent Support clients are projected to spend an average of 17 working-age years on a benefit (up from 12.5 years in 2019), but the upper quartile of this group – about 18,700 people – are expected to spend more than 25 years in the system."

    "...about 2000 teens on the Youth Payment or Young Parent Payment [are] now expected to spend an average of 24 working-age years on a benefit – a 46 per cent increase from the 2019 estimate. About 500 of them are expected to be on income support for more than 38.5 years, almost the rest of their working lives."

Against a scenario of "record low unemployment" - which Labour leader Chris Hipkins campaigned vigorously on - these increases are unfathomable. Unless one weighs up the amount that benefit incomes have increased by over the same period. Unsurprisingly paying people more not to work means they stay on welfare longer. A child could figure that out.

That was compounded by a raft of actions which included diverting case managers away from an employment focus to checking beneficiaries were receiving their full and correct entitlements;  abolishing early work requirements for sole mothers who added a subsequent child to an existing benefit; temporarily suspending medical certificate requirements and the annual jobseeker reapplications; significantly reducing the use of sanctions to enforce work obligations; and generally fostering a sense of entitlement due to gender and race victimhood. 

In response to the discovery of the reports, former MSD minister Carmel Sepuloni says she did not recall being briefed on the research by officials.

She then had the utter gall to state:

    “What these trends show are an absolute need to create and maintain sustainable pathways to employment … National have talked a big game in opposition and now they need to show us their plan to get people into work.”

"These trends" are the direct result of bad policies implemented by Sepuloni who then kept their devastating impact hidden.

Though it shouldn't be Sepuloni primarily carrying the can. It was the Prime Minister, Jacinda Ardern who appointed Cindy Kiro to lead a bunch of leftist academics and activists to produce the most ill-advised welfare policy recommendations imaginable, many of which were implemented.

Ardern's unique brand of 'kindness' morphed quickly into cruel incompetence.

As Taylor Fry's analysis apparently suggests, people on benefits tend to have more precarious family, living and financial situations with worse life satisfaction and more contact with police and mental health services than they otherwise would.

Crucially, the longer people stay on welfare, the harder it is to get off.

Monday, February 05, 2024

A terrible trend in desperate need of turning

When did you last read a headline in MSM about more children being raised on welfare? Yet latest Ministry of Social Development benefit statistics (1) show at the end of 2023 the number reached a new high of 222,500.

I predicted this would happen when Jacinda Ardern became Prime Minister, making herself Minister for Child Poverty Reduction to boot. In a nutshell, I believed that her plan to increase benefit income would only draw more parents onto them. She began by introducing the Best Start Payment of $60 per week for newborns - her simplistic solution to income inequality being ever more state redistribution of wealth. This was followed by increases to basic benefit rates; removal of financial penalties for failure to name liable fathers; pass-on of child support and increased family tax credits.

In effect she decided to pay parents more not to work by further closing the gap between income from the state and income from employment. In fact, for a sole parent with a couple of children,  there is now no gap between income from a benefit (with all the add-ons like accommodation supplement and family tax credits) and an average paying job. By April last year the average benefit income for this family type was $1,057 weekly. (2)

So, even against a backdrop of low unemployment, it is no surprise that the number of children in benefit-dependent homes has risen. Why does it matter? If these children have been technically lifted out of poverty, isn't that a good thing?

For one, homes where no-one is employed lack routine and discipline. Who gets the kids up and ready for school?

Look at the stats (3&4) for Northland: lowest regular school attendance at just over a third (34.2%) and highest dependence on a single parent or jobseeker benefit (14.5% of working-age population). Christchurch has the highest regular attendance at almost a half (49.4%) and second lowest reliance on the same benefits (6.4%). Mere coincidence?

But the more insidious aspect of benefit-dependent homes is the lack of appreciation for education. Who needs to be literate and numerate when WINZ puts money in your bank every week       regardless? In the absence of teachers, this attitude is the main message being sent and received.

Yes, some people fall on hard times and need a period of financial help. But they are not seduced or sedated by benefits long-term. They pick themselves up and get back into the real world taking their children with them. New National MP James Meager (5) talks about watching his own solo Mum on a benefit, "...juggle three kids, part-time work, correspondence school..." She drove home the importance of education. She inspired her children. But the same MP also says, "Too many children in our country will grow up without that opportunity."

He is right. It is a statement of fact. Too many children will never experience living with a parent who works. The expected average future years on a benefit (6) measured from a point in time is now 13.6 - up from 10.7 when Ardern became Prime Minister. Another mere coincidence?