Submission

19 th November 2004             

Damian O'Connor

Associate Minister of Rural Affairs

Parliament House

WELLINGTON

Dear Damian,

Re: Rural Women New Zealand Key Issues as at 31 st October 2004

Following the Rural Women New Zealand National Council meeting, we write to inform you as Associate Minister of Rural Affairs, Associate Minister of Education and Associate Minister of Health regarding the issues as found in rural communities.

You may recall that we put up a proposal regarding a Rural Health secretariat on 17 th August. In regards to rural health this is a key area of Rural Women New Zealand's concerns for rural communities. It would appear that we have significant issues to address in this area and would like to pursue a rural secretariat in some form in order that rural issues are addressed in light of the lack of rural representation on District Health boards under the Single Transferable Voting System.

Below we have noted the issues of concern to Rural Women New Zealand (RWNZ) and what we have done or are proposing to do. We do seek advice as to where and how we can achieve positive outcomes for rural communities.

1.0 Health

•  Lack of Rural Representation in District Health Boards

This analysis has been made difficult because the Ministry of Health refused to identify Rural candidates, therefore RWNZ has relied on it's own members to make a judgement call as to the candidates rural affiliations.

•  Key areas to date noted as without rural representation are :

Northland, South Waikato, Taranaki, Westland , North Otago, Bay of Plenty

•  Areas noted with large rural areas but not more than 1 representative :

Wairarapa has one known rural representative, but there is no rural representative north of the Wairarapa

There is still District Health Board areas to be investigated but we are noting our findings as they come to hand in order that the appropriate ministerial appointments can be made.

However we would note that in South Canterbury the effect of the STV voting system has been illustrated in that where a large metropolitan base exists, rural candidates are unable to gain the numbers to be voted on. The assumption that all candidates are equal when seeking election is incorrect when a rural candidate will be representing a small population base.

To counteract this Rural Women New Zealand propose that the Rural Ward system be re-established. This will provide a rural voice on a District Health Board and access to health services for rural people.

•  Homecare provision for ACC victims, elderly, disabled, early discharge from hospital patients.

•  Key areas of chronic shortage of homecarers are Canterbury and Westland which have large geographical areas, large numbers of rural clients and limited providers.

•  Shortages of carers in rural DHB's such as South Canterbury , Wairarapa, Gisborne etc will be acutely felt over this Christmas period.

•  The document regarding Homecare quality services does not include any consultation with rural consumers.

•  Emergency services.

Over the years the rapid numbers that identify rural properties have not been adhered to and as far as RWNZ knows from queries directed to the Ministry of Health there is no one entity that is driving the fact that rapid numbers assist in emergency services locating rural based accidents or events.

•  Rural Women have researched this issue and find that emergency services rely on the rapid number as well as a physical location to locate rural people.

•  RWNZ have spoken twice to Ministry of Health officials who are uninterested in emergency services. We are approaching Local government to see who or what Ministry will ensure Rapid numbers are distributed to rural areas for emergency service purposes.

•  Fridge magnets noting appropriate information for emergency services have been distributed throughout flood affected areas in the North Island . Further distribution is proposed through an ACC farmer post out on the issue of slips trips and falls.

•  Dental Therapists

The lack of therapists has meant that there is less preventative work being done and only extreme cases being seen. The result is a decline in rural children's teeth overall. If a child has dental problems there is generally a wait of up to 3 months before the therapist revisits.

We have noted both the Ministry of Health and Dental Association is concerned with the lack of therapists and this is exasperated in that the course has been extended from 18months to 3 years. We have replied to the discussion paper on recruitment of Dental Therapists, but we note it will take time to correlate the data and no mention was made or rural area's being affected.

•  RWNZ have announced 2 scholarships for Dental Therapists wishing to return to work and do not have the new Dental therapist qualification.

•  Breast screening .

Whilst the government has not appointed a breast screening body the care of women in the 50-65 age group in rural areas' is declining. The mobile services go to urban areas but not strategic rural areas. It is also noted that the medical council advocated the 40-50age group receive breast screening as evidence exists that that group develop the more aggressive types of cancer that only early detection can save them. However, difficult to reconcile when rural are not getting seen.

•  Prostrate cancer , there is no focus on rural men for this disease. Few rural papers feature any information, as the target seems to be urban men.

•  Elderly Rest Homes . There is the problem of failing elderly resthomes as they are too small to function under the current onerous regulations, therefore options for rural elderly care is diminishing.

•  Rural Doctors . We are still seeking information how the PHO (Public Health Org) will resolve the retention of doctors and better access to medical services for rural communities. We have been visited by Debbie Woodhouse and Sally Stuart over this issue. However they do not know how rural will fit into the proposed model given the low population base, rural GP's concerns and the diverse needs of rural communities.

•  Drinking water . The change to legislation will require increased compliance costs to rural for drinking water systems they have put in and monitored themselves. Not only is the standard of drinking water increased but also the scope to include small water suppliers has increased. Final outcome of this proposal is unknown.

•  Mental Health issues . RWNZ have discussed with Plunket and homecare providers about the issue of post natal depression and mental health issues going largely undiagnosed in rural areas. We have made two requests to see the Director of Mental Health, Dr Janice Wilson, but there has been no acknowledgement to our request. Instead we were asked to fill in yet another discussion document. This we complied with, but are restricted in putting the case for rural as it is a tick box questionnaire with limited opportunity to note individual cases and issues related to rural.

2. Land

2.1 Land Access

Rural Women New Zealand does not believe that the objective of public access to public areas will be achieved through legislation. Goodwill has existed towards the public in providing ready access to waterways and other areas of interest. Information as to appropriate access, landowner contacts and seasonal restrictions is needed, rather than heavy-handed legislation.

RWNZ understands there is a report looking at issues of biosecurity, OSH , trespass laws etc and we would like to see such a report released to the public.

2.2 Rates paid by rural ratepayers.

The addition of the STV voting system to the Local Government bill was opposed by RWNZ for the same reasons the organisation opposed STV in DHB elections, lack of rural representation.

RWNZ presented a proposal of an isolation index to note the services rural were not receiving despite paying the bulk of the council rates. The strategy of an isolation index would provide a discount where services were not available.

Rural Women New Zealand has sought a meeting with Jim Anderton, as Minister of local Government, to the Rural Women New Zealand Board Meeting. The Minister cancelled and has not made another appointment. A follow up letter was sent, and there has been no reply.