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Ending healthcare's postcode lottery remains a distant dream

Ending healthcare's postcode lottery remains a distant dream

NZ Herald4 days ago

Analysis
When the Health NZ - Te Whatu Ora behemoth was rolled out three years ago, one of its core purposes was that New Zealanders with the same health needs should get the same treatment, no matter where they lived.
A single, centralised health agency would end fragmentation and spread

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Research Launched Into Impacts Of Endometriosis In NZ
Research Launched Into Impacts Of Endometriosis In NZ

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  • Scoop

Research Launched Into Impacts Of Endometriosis In NZ

Endometriosis New Zealand and the University of Canterbury have launched a major new research project aimed at building a comprehensive picture of how endometriosis impacts the lives of those living with the condition in New Zealand. Titled Barriers and Facilitators of Endometriosis Care in Aotearoa New Zealand, the research will involve a series of short surveys running from June 2025 to March 2026, exploring topics such as diagnosis, treatment, work, education, finances, and patient experiences in the healthcare system. "This is a landmark study for the 120,000 New Zealanders living with endometriosis," says Endometriosis New Zealand Chief Executive Tanya Cooke. "For too long, their experiences have been under-recognised in health and policy settings." "This research will provide the information we need to push for meaningful change and inform the development of a future National Endometriosis Action Plan." The project is open to anyone over the age of 18 in New Zealand with suspected or confirmed endometriosis. Participants can choose to complete one, some, or all ten monthly surveys, each taking around 10 minutes. All data will be confidential and managed under strict University of Canterbury ethical guidelines. Lead researcher and PhD candidate Katherine Ellis said the research would fill significant gaps in our understanding. "We know endometriosis has wide-ranging impacts on people's lives, from chronic pain and fertility issues to lost income and disrupted education. Currently we have to rely mainly on international data to try to understand these issues," says Ellis. "This research will provide us with New Zealand-specific data to inform health system responses, influence government policy and help target support." "This project is about turning the lived experiences of those with endometriosis into insights that can contribute towards better policymaking in future." The first survey, which collects demographic information and connects with the subsequent surveys, is now open. Participants who complete each month's survey will also go into the draw to win a $100 gift box, generously donated by Miller Road Fragrances. "This is your chance to help change the future of endometriosis care in Aotearoa," says Cooke. "We are asking everyone who is eligible to share their story." You can sign up and undertake the initial demographic survey, for more information see link below.

Inside the rise of injectables and the new age of cosmetic tweaks
Inside the rise of injectables and the new age of cosmetic tweaks

The Spinoff

time8 hours ago

  • The Spinoff

Inside the rise of injectables and the new age of cosmetic tweaks

From TikTok facelifts to 'baby Botox', cosmetic fixes are booming. What's driving the quest for perfection, asks Catherine McGregor in today's extract from The Bulletin. An age-old industry, a new face Devoting a Bulletin to cosmetic procedures might seem a bit left-field, but with Alex Casey's cover story on Botox leading The Spinoff this morning, it's the perfect chance to take stock of how – and why – so many New Zealanders are choosing to change their faces. From a few discreet units of 'baby Botox' to the full ordeal of a surgical lift, cosmetic medicine is broader and more accessible than ever. Just look at the global fascination with Kris Jenner's new face, or the TikTok shockwaves caused by Michelle Wood, the American woman who recently went to Mexico for a frankly incredible face lift that cost her just US$14,000 (NZ$23,000). It's no wonder 'cosmetic tourism' is booming, with places like Thailand luring New Zealanders seeking cheaper fixes than they can get at home. But as plastic surgeon Chris Adams told The Project in 2023, bargain shopping for your face comes with serious risks. 'I have seen patients who've come back, who've had much greater costs managing complications than they would've had if they'd funded the surgery in New Zealand,' he says. Is everyone using Botox? While a Mexican face lift is a step too far for most of us, Botox is firmly in the mainstream – as Alex discovered firsthand. At 33, she's decades away from needing (or wanting) major surgery, but the sight of lines starting to etch themselves onto her face led her to a cosmetic nurse's office. 'Also, every day on Instagram I see women twice my age with foreheads that look 10 years younger than mine and it makes me feel insane so yeah, no wonder I have fucking frown lines,' she writes. In her piece, Alex talks to women who swear by injectables, women who recoil from them, and women – like herself – who feel both tempted and furious about the prospect. As she leaves the injector's office, 'I am bubbling with an incandescent fury that I don't know where to direct,' she writes. 'I am angry at the nice nurse for hurting my feelings, but I am angrier at myself for asking her to.'​ Selfies, filters and 'Instagram face' What's driving this collective obsession? Part of the answer is in our pockets. As Julia Coffey wrote for The Conversation, selfie-editing apps like FaceTune and FaceApp give people a glimpse of a new and improved version of themselves with smoother skin, bigger eyes or sharper cheekbones. Cosmetic procedures offer a chance to make that fantasy self a reality. And as Jia Tolentino explored in The New Yorker (paywalled), all those subtle digital edits are helping to create a new beauty monoculture: 'Instagram Face', which Tolentino described as 'a single, cyborgian face… young … of course, with poreless skin and plump, high cheekbones. It has catlike eyes and long, cartoonish lashes; it has a small, neat nose and full, lush lips … it's distinctly white but ambiguously ethnic.' What began with the Kim Kardashians of the world has trickled down through celebrities, influencers and selfie-editing apps to become an achievable (if expensive) aesthetic standard for women everywhere. Social media – or something else? While social media is an easy villain, the real driver could be more basic: it's simply easier than ever to buy a better face. As Martha Gill puts it in The Guardian, 'it is more affordable, more widespread and more advertised. Another huge barrier to treatment is meanwhile falling away: stigma.' That new openness is something Alex's piece lays bare. For many women she spoke to, the deciding factor wasn't a celebrity's wrinkle-free forehead, but a friend's. One got her first injections after complimenting a pal: 'She said, 'thanks, I get Botox' – then I looked into it and started getting it too.' One user summed up how many of us feel: 'So many of my friends get it, and it makes you feel like you're in this race against time – and everyone else.'

New 'rules of engagement' with alcohol lobby
New 'rules of engagement' with alcohol lobby

Otago Daily Times

time9 hours ago

  • Otago Daily Times

New 'rules of engagement' with alcohol lobby

By Guyon Espiner of RNZ New "rules of engagement" for health officials dealing with the alcohol industry are coming after a senior staffer complained a public health manager had been "way too friendly" with booze lobbyists. In May it was reported that Ross Bell, a manager with the Ministry of Health's Public Health Agency, had close engagement with alcohol lobbyists, who were granted input into the development of alcohol policies. References to a review of safe drinking guidelines were removed from a Health New Zealand website after an alcohol lobbyist complained to Bell. On the day the story was published, Deputy Director-General of Health Dr Andrew Old sent an email to staff saying Bell had "acted entirely appropriately" in his engagement with the alcohol industry. "Engaging with industry can, and has, yielded meaningful health gains for New Zealanders in the past - and will do so again," the email said. "However, we also know that some industry interests lead to public health harm, and so our engagement needs to be careful, mature, and intentional." Old invited Ministry of Health staff to respond. Dr Clair Mills, who provides advice to the Public Health Advisory committee, took issue with the engagement with the alcohol industry. "I do think there is a problem - at the very least, in terms of perception," she wrote to Old, in emails released under the Official Information Act. The alcohol industry's fight against Local Alcohol Policies - where communities set their own conditions for sale - revealed its motivations, Mill said. It contrasted with the "lack of community voice and power". RNZ's reporting revealed a series of emails between Bell and alcohol lobbyists, which showed close relationships, multiple meetings and exchanges of information. "I think the tone of the emails was way too friendly," Mills, whose career includes serving as Medical Director for Médecins Sans Frontières' and as Medical Officer of Health in Northland, said in her email to Old. "In my experience… these alcohol interests have zero interest in reducing harm (or sales of booze) and a huge purse to fund their lawyers." 'Perception becomes reality' Old responded to Mills saying stronger processes for health officials engaging with the alcohol industry were being prepared. "All good points - perception becomes reality after all," he told her. "Given we are expected to engage with industry, whether that's alcohol, food or anything else (except tobacco!) it would help to have some clear rules of engagement. I'm picking that up with our central MOH team." Tobacco lobbyists are shut out of policy making because New Zealand is a signatory to the Framework Convention on Tobacco Control (FCTC). Under the FCTC countries protect policy development from the "vested interests of the tobacco industry" as there is an "irreconcilable conflict between the tobacco industry's interests and public health policy interests". In contrast, the alcohol industry has input into policy development in New Zealand, including managing Fetal Alcohol Spectrum Disorder (FASD) and spending the Alcohol Levy, a $16 million fund to reduce alcohol harm, estimated in a 2024 report by NZIER to cost $9.1 billion a year. RNZ used the OIA to obtain 85 pages of emails detailing engagement between the Ministry of Health (MOH) and alcohol lobbyists, with Ross Bell emerging as the main conduit. One document describes a 90 minute meeting between lobbyists and MOH staff in February 2025 as "Alcohol industry reps and Ministry of Health regular meeting". The documents show the plan to manage FASD has been given to the alcohol industry. "Thanks for sharing the draft FASD plan," a wine lobbyist says in an email to public health officials, copying in a lobbyist with the spirits industry. The documents show alcohol lobbyists made their own submissions to MOH on how they believed FASD should be managed. The Spirits New Zealand submission runs to four pages but is entirely redacted by MOH under a section of the OIA designed to protect "the confidentiality of advice tendered by Ministers of the Crown and officials". RNZ has asked the Ombudsman to investigate whether the MOH can legitimately use this section of the OIA to protect correspondence from a spirits industry lobbyist. Alcohol industry's input The documents obtained by RNZ show Bell was receptive to requests from the alcohol industry. In November 2024 the Brewer's Association complained to Bell that references to a review of the low risk drinking guidelines were still on the Health New Zealand website, after it had already complained to him about it. It also took issue that the site linked to what other countries, including Canada, were doing with their advice on low-risk drinking. Bell intervened in an email to Health New Zealand in December 2024. "All work on this project will now pause. You will update relevant Health NZ websites to remove references to the review and also to other jurisdictions' guidelines (including the Canadian one)." Bell refused to be interviewed by RNZ but in a previous statement he said the material was removed from the website to avoid confusion, as the drinking guidelines were now led by the Ministry of Health not Health New Zealand which runs the website. He said that was an internal decision by MOH and that a review of the drinking guidelines was now on hold while the ministry considered its priorities. The documents obtained by RNZ show that Bell also shared the Alcohol Levy investment framework with wine and beer lobbyists in a November 2024 email. "As discussed and as promised, attached is the draft Alcohol Levy Investment Framework for your consideration and feedback," he wrote. The alcohol lobbyists then provided at least three pages of feedback on how the money should be spent. But again MOH is keeping all that information secret under the section of the OIA designed to protect "the confidentiality of advice tendered by Ministers of the Crown and officials". Minister for Mental Health Matt Doocey turned down RNZ's request for information on the Alcohol Levy but did release correspondence from alcohol lobbyists. Those documents included a July 2024 email to Doocey and his Cabinet colleague Shane Reti where the wine, beer and spirits industries pushed for greater involvement in setting alcohol policy. "We still believe industry has a lot to offer as government seeks to reduce harmful drinking," the booze lobbyists wrote. They pointed out that they funded the main education programme which teaches students about the impacts of alcohol. "We also fund, through our own social investment charity - The Tomorrow Project, an in-school theatre-based better drinking education programme called Smashed," the lobbyists told the Ministers. "Smashed is independently run and delivered by The Life Education Trust and reaches over 20,000 year 9 students every year." Filings with the Charities Services show that the beer, wine and spirits industries each paid $105,000 towards The Tomorrow Project, a charity entirely funded by the alcohol industry. The alcohol lobbyists also make a pitch for the government to "partner with industry" in deciding how to spend the Alcohol Levy and say they should be "working directly with officials" on reducing alcohol harm.

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