Children

Russell Wills FRACP, MPHCommunity and General Paediatrician, HBDHB

Children’s Commissioner

Why should we care about children?

• The foundations of adult health are laid in childhood.

• Children are vulnerable.

• Children are 25% • of our population. • Children have no

political power. • Evidence base.• UNCROC.

Attainment of University Entrance Standard by School Leavers by Ethnic Group and School Socioeconomic Decile, New Zealand 2008

0

10

20

30

40

50

60

70

80

1-2(Most Deprived)

3-4 5-6 7-8 9-10(Least Deprived)

School Socioeconomic Decile

Pe

rce

nta

ge

(%

) Asian

European

Pacific

Māori

Immunisation coverage at 24 monthsHawke's Bay vs New Zealand

0%

20%

40%

60%

80%

100%M

ar-1

0

Jun-

10

Sep

-10

Dec

-10

Mar

-11

Mar

-10

Jun-

10

Sep

-10

Dec

-10

Mar

-11

Mar

-10

Jun-

10

Sep

-10

Dec

-10

Mar

-11

Mar

-10

Jun-

10

Sep

-10

Dec

-10

Mar

-11

Maori Pacif ic NZ European Total

Year to

Haw ke's Bay New Zealand

B4SC referrals by type and quintile to 7 Jan 2010

0%

10%

20%

30%

40%

50%

60%

70%

80%

Q1 Q2 Q3 Q4 Q5/Q0

Quintile

Refe

rrals

Vision

Hearing

Grow th

SDQ

PED

Immunisation

Gen Health

Dental

% of quintile checked to 7 J an 2010

0%

20%

40%

60%

80%

100%

120%

Q5/Q0 Q4 Q3 Q2 Q1 Total

Quintile

Oucome of referrals 16/3/09-22/01/2010

76%

14%

8% 2%

Accepted

Already known

Declined at triage

Parent declined

Lessons and opportunitiesBig problems require a plan

Local solutions to local issues, with national standards• Immunisations, B4SC, FVIP, ASH…• Can reduce inequalities

National solutions• PSNZ clinical networks• Annual “State of the Nation’s Children Report”• Scorecard• Green Paper

– Difficult choices with uncertain answers• Universal entitlement vs targeted to guarantee needs met?• Parents’ rights vs state’s right to require behaviours?

– Engage media to discuss the issues, c.f. conflict– Opinion pieces, public debates & presentations