Lees-Galloway Iain: Reports — Inquiry into Improving Child Health Outcomes and Preventing Child Abuse with a Focus from Preconception Until Three Years of Age (Volumes 1 and 2)Text is incorporated into the Bound VolumeLees-Galloway Iain: Reports — Inquiry into Improving Child Health Outcomes and Preventing Child Abuse with a Focus from Preconception Until Three Years of Age (Volumes 1 and 2)[Sitting date: 10 December 2013. Volume:695;Page:15466. Text is incorporated into the Bound Volume.]IAIN LEES-GALLOWAY (Labour—Palmerston North): The opening paragraph of the Health Committee’sInquiry into improving child health outcomes and preventing child abuse with a focus from preconception until three years of age states: “The major recommendations of this inquiry ask the Government to put more focus on and investment into the pre-conception period to three years of age and take a proactive health-promotion disease-prevention approach (based on scientific evidence) to improving children’s outcomes and diminishing child abuse.” That is the central theme of this report a report that has received support from across the House. In the spirit of bipartisanship that is on display today I want to gently—gently—point out that to achieve the aims stated in that first paragraph will require a significant change in policy from that which has been currently implemented by the National-led Government. I want to look at the current health targets and relate them to the aims of a proactive health-promotion disease-prevention approach to health.First of all we have shorter stays in emergency departments. That is a target focused on what you do after a child becomes ill or they are injured. It is not focused on preventing illness or injury. Improved access to elective surgery actually does not affect children all that much but again it is what you do after someone becomes unwell. Shorter waits for cancer treatment are again not about preventing cancer from happening but about how we respond how our health system is reactive to illness. There is increased immunisation and this is the one place where the Government can pat itself on the back. I notice that this is the one thing that the National Party members hang on to for dear life because it is the one place that they can be proud of. But I would point out that what is interesting is that in the fight against rheumatic fever one of the big objectives for the Government is to find a vaccine for rheumatic fever. That sounds to me like it is trying to find a vaccine for poverty. What we should be doing is preventing rheumatic fever by ensuring that our children grow up in warm dry homes and have good nutrition. The target for better help for smokers to quit again is what you do after someone becomes a smoker; you then try and help them quit. Having more heart and diabetes checks is not about preventing cardiovascular disease or preventing diabetes but measuring it finding it and then trying to do something about it. These targets reflect a health system that is reactive not proactive.It is fantastic that this evidence-based report that has support from all parties in Parliament promotes a proactive disease-prevention approach to our health system one which is quite different from what we have at the moment. Chapter 5 of this report refers to the social and economic determinants of health and well-being. Recommendation 18 says “We recommend to the Government that it continue to actively consider the recommendations inSolutions to Child Poverty in New Zealand: evidence for action and at least establish an overall action plan for reducing child poverty or Better Public Service targets …” for child poverty. As has been well debated in the House over the last week and the preceding weeks there is no target for this Government to reduce child poverty. There is no target for reducing child poverty and I am pleased that this report clearly recommends that we need a target for child poverty reduction.Finally I want to refer to chapter 5 which is about improving nutrition and reducing obesity and related non-communicable diseases. It says again that a health promotion approach directed through communities is what we need. We need a primary disease-prevention approach. It is sad that programmes like Healthy Eating - Healthy Action were cut by this Government because those are precisely the programmes that this report recommends. This is great report. It will be a report that future Governments referto and I look forward to its being fully implemented whatever Government is in place in the future.