Monday, November 18, 2013

Good news on vaccinations

There are times when instead of handing out brickbats, one is obliged to hand out a bouquet as well. And one such time was signaled on Friday by the news that vaccination rates among Maori and Pacific children had improved to the point where vaccination rates for Maori children exceeded that of Europeans in some District Health Board areas (Tony Ryalls' press release is here).

This is terrific news. Vaccination rates for Maori and Pacific children lagged behind for many years, and low vaccination rates were a significant contributor to these children being admitted to hospital for preventable diseases. Certainly a consequence of improved vaccination rates has been a fall in the number of hospital admissions for some diseases. It seems prevention really does deliver longer-term savings.

There are a couple of lessons to be drawn from these improvements. The first is that reversing long-term trends does not happen overnight: immunisation rates for Maori and Pacific children have been rising since the early 1990s but  improvement was painfully slow. The great leap forward came in 2005 when the Immunisation Advisory Centre pushed the Ministry of Health to set up a National Immunisation Register to measure, monitor and provide feedback on he progress of the national vaccination programme. The improvements were also helped along by setting a national target. It's been 8 years of hard slog, and well past the generally accepted political timeframe of three years but it has paid off.

The other lesson is that sustained improvement needs buy-in from the community, and collaboration across different sectors. Successive governments have talked for years about collaboration, joined-up government and all manner of other trendy nonsense, but genuinely collaborative efforts are rare. Here, the different players in the health sector realised they had a problem and acted at all levels: community, front line health providers, PHOs, District Health Boards, and the Ministry of Health.    

But the really good news is that this shows with some effort, not a whole lot more money and a political commitment to improving public health services, New Zealand's health equity gaps can be reduced or eliminated. 

Well done IMAC and everyone else involved. A well-deserved bouquet.