Maternity funding needs another look

Clutha Southland MP Hamish Walker and Lumsden midwife Sarah Stokes stand at the spot where a baby...
Clutha Southland MP Hamish Walker and Lumsden midwife Sarah Stokes stand at the spot where a baby was delivered recently. Photo: Supplied
Sometimes, things make a splash in the media when normally they wouldn't. Subsequently, awareness shines on an issue which may previously have lacked much attention at all.

So it has been with the recent reporting and subsequent discussion of maternity services in the South. A woman gave birth in an ambulance parked on the side of the road in Southland. She was on her way to Southland Hospital - another hour away - at the time.

The ensuing discussion has been healthy and considered but, essentially, the problem is not a mystery. Maternity facilities, especially fully stocked and staffed ones, cost money. Money is tight in public health.

The beauty of this issue making headlines in the week of the ``Wellbeing Budget'' was that it forced us to ask how we order wellbeing, and how we allocate and contrast the spending needed to achieve it. It's a question we have been asking in one form or another for many thousands of years.

For all that time, we have been prioritising childbirth. The family, the group, the community has worked together - as much as possible - to ensure healthy children are born safely.

It could be argued everything else has been built around that need - to ensure we can be healthy enough, protected enough, and well resourced enough to bring children into the world and see them grow and blossom. It seems to be the point of society as we know it.

If we look at our country not from the top down, but from the deep-past forward, we would be likely to accept ensuring our expectant mothers have the best possible access to healthy and safe birthing facilities would be at the top of our priority list.

But running a country isn't so simple. Maternity funding is tied in with the health budget, and that is a pool of cash with numerous undeniably reasonable demands on it. There will never be enough money to satisfy all those demands.

As such, the money available must be spread as far and as cleverly as possible while being as effective as possible.

This is a momentous task and one often savaged by opposition politicians and the public, too. Yet the truth is no government has managed to keep everyone happy in the health spending area, and none ever will.

For us in the South, the job of spreading that available money is in the hands of the Southern District Health Board. It does a good job under enormous pressure and against considerable odds - as the years of the population-based funding model have made balancing its budgets all-but impossible.

How does the board ration the available funds? Often, by consolidating facilities and resources. That is an entirely sensible and reasonable approach. But when something as fundamental as being able to give birth somewhere more suitable than an ambulance on the side of the road is at stake, perhaps we need to reset our perspectives.

We can all point to examples where the driving force behind the spending of our tax dollars seems more tied to political outcomes than the essential needs of the taxpayers themselves. Money can seemingly be lavished in one area while, in another, slavish care is required to meet basic needs.

Maternity funding should not be stretched so thinly but, as long as it remains one of many competing needs within the health funding pool, it seems it always will be. Perhaps, then, it is time maternity funding be ring-fenced to ensure all New Zealand women have reasonable access to decent maternity facilities - including those in wide-reaching rural areas like ours.

Because for all the frills and fancies those in control of the public purse like to champion, there is surely nothing more important and human to champion than the health and safety of our newborn babies.


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