Plan,
Achievements & Current Projects
A
personal progress report in raising the standard of health services to young
people.
My
overall plan addresses the
following key
areas of Youth Health, which covers those aged 12 to 25 years old. These are:
(i)
Improved education of medical staff in understanding the developmental
and psychosocial needs and the psyche of young people;
(ii)
Systems and support services tailored to the needs of young people and
provision of appropriate hospital facilities for these patients;
(iii)
Development of policy and legislation at Government level to help protect
this vulnerable and forgotten patient group, and ensure a connectedness between
relevant Government Departments occurs throughout this initiative in
consultation with all interested organisations, NGO’s and consumers.
(iv) Appropriate data collection about the health of young people 12 to 24 years inclusive, to enable easier recognition of key health concern and the tracking of improvement to ensure timely intervention and directional changes as required in funding emphasis according to greatest need and maximum improvement in well being.
(v) Youth must be recognized as a separate group under the Health Funding Formula if our decision makers are serious about improving youth health.
This
plan, my statement, regarding this patient group, the endorsements from a number
of experts from the medical profession, and developments to date can be accessed
at the following website:
www.oocities.org/hotsprings/falls/4842
The
plan is estimated to take about ten years to may be 15 years to achieve as one
of the major stumbling blocks is in achieving an attitudinal change in many
doctors. Completion
is therefore conservatively estimated as between 2008 to 2013
List of my achievements so far in trying to bring about an awareness within the community and our health professionals of the plight of our young people in a health system that is simply not built to provide for their needs:
(i)
Produced the Elizabeth Ewing
Report. A report on the system as we found it over the 1994 to 1997 period
(approx 11500 words, Appendices and Summary included). Auckland District Health
responded by saying, “Your comments on the very positive aspects of
Elizabeth’s care and treatment have been greatly appreciated by staff. Thank
you for your compassionate and non-judgemental encouragement for us to keep on
examining and improving our practice.”
(ii)
The Summary from the original letter (pre-report form) was tabled at a
Patient
Quality of Service Committee Meeting in 1998. The Child Cancer Foundation
has found it useful in helping to improve services and systems for the care of
its families.
(iii)
Gathered endorsements of my statement on
“Adolescent/Young Adult Health – the forgotten patient group in the Health
Sector”. The endorsements focus key health
practitioners, such as, Professors, Medical Specialist in Adolescent Health,
Doctors, Psychiatrists and Play Specialist.
(iv)
Establishment of a website which includes my statement on the
plight of the Adolescent/Young Adult Cancer patient, with endorsements and
developments to date. The website address is given above.
(v)
Established the Regulations for the Elizabeth Ewing Award in
Adolescent/Youth Health in conjunction with the University of Auckland School of
Medicine Foundation.
(vi)
Wrote the Goals and Planning for Better Medical Support Systems and
Services, August 1999.
(vii)
Fund assisted by the National
Cancer Control Steering Committee to participate in the Cancer Strategy Control Workshop 99,
August 1999, as youth health advocate to ensure there was a voice for our young
people to help bring about improvement to preventative measures, support,
diagnosis, uniformity of treatment, palliative care and rehabilitation for all
New Zealanders. (Report written)
(viii)
Fund assisted by Youthline’s
Michael Fatua Scholarship Trust to participate at:
(ix)
Fund assisted by the Auckland
Cancer Society to participate in the
Inaugural New Zealand Cancer Conference, October 99. This helped me to
continue increasing the level of awareness within the Health Sector of the
plight of young people with cancer. (Report written)
(x)
November 1999, the Health Services Development Plan (HSDP), Project
Manager, Mr. Ian Wolstencroft, accepted my proposal that hospitalised young
people must be appropriately provided for in the planning of Auckland
Healthcare.
(xi)
December 1999, as a result of my presentation to Ian Wolstencroft, the HSDP
Adolescent Issues User Group was formed. I was invited to join this working
group established to ensure
issues relating to adolescents are considered throughout the HSDP design
process. We produced the document, Principles
of Adolescent Care,
for Auckland Healthcare. My role was very proactive in the researching of
material for this document.
(xii)
December 1999, fund assisted by the Statistics Department, Auckland
University (as a student) to participate in the Biostatistics Workshop on
Survival Data Analysis.
(xiii)
February 2000, my article was published in The New
Zealand Family Physician, (v27, no1, p26 –27), Our Adolescents –
forgotten in the health system. This is the journal of the Royal NZ
College of General Practitioners.
(xiv)
March 2000, I convened two separate meetings to ensure that feed
back was gained from:
(xv)
9th June 2000,
meeting with Mr Graeme Edmonds, Chief Executive Officer of Auckland Area
Health, to ensure he knew of the limitations of the HSDP document, Principles
of Adolescent Care and that he would ensure they would be carried out. Mr
Edmonds said, “I can confirm my commitment to you to ensure that the HSDP, Principles of Adolescent Care
are carried out in the implementation of
HSDP.”
(xvi)
Fund assisted by the Milford
Rotary Club to present my paper, Young People Constitute a
(xvii)
Involved in discussions in Wellington, 3rd to 5th
July, with NZAAHD, Ministry of Youth Affairs, Ministry of Health, the Prime
Minister’s Office and various other decision makers in relation to Youth
Health and the development of the Youth Health Policy and Youth Development
Strategy.
(xviii)
5th July 2000, meet with Dr Pat Touhy (Chief Advisor on Child and
Youth to the Ministry of Health) to discuss further issues, which must be
addressed in regard to adolescent health.
(xix)
14 September 2000, page 5 of the North Shore Times was the result of the
first time having agreed to utilise the media as a tool to help bring
awareness to the community of the difficulties faced by our young people in a
Health System that is not designed to address their needs.
(xx)
Provided Commentary on the United Nations Convention on the Rights of
the Child (UNCROC)
(xxi)
Provided Commentary on the New Zealand Standards for the Welfare of
Children and Young People in Healthcare Facilities, produced by
the Child Health Liaison Group.
(xxii)
17th October 2000, dinner speaker for Milford Rotary in
appreciation of their financial assistance to the 3rd Pacific Rim
Conference of IAAH, and also an opportunity to promote the educational trust to
help increase the number of health providers who understand our young people.
(xxiii)
October 2000, official approval to
study in 2001/2002 each of the three adolescent units in Sydney was
received. The units and Heads of Adolescent Health are: A/Professor David
Bennett of the New Children’s Hospital (formerly the Royal Alexander Hospital
for Children), Professor Kate Steinbeck of the Royal Prince Alfred Hospital, and
Dr Simon Clark of Westmead Hospital.
(xxiv) Gained approval (February 2001) from the Auckland Ethics Committee to undertake my research, Hospital Services as Experienced by Young People in NZ.
(xxv) Gained enthusiatic approval from the Clinical Directors of the Paediatric Services for my research, Hospital Services as Experienced by Young People in NZ. These areas of specialisation are Oncology, Haematology, Cystic Fibrosis and for Cardiology both the Paediatric and Adult Services.
(xxv)
4th April 2001, met
with Mr Neil Woodhams, Chief Operating Officer for ADHB, regarding
progress in the implementation of the HSDP policy document, Principles of
Adolescent Care.
(xxvi)
9th April 2001, met with Hon. Helen Duncan regarding an
amendment to the Social Security Act 1964, the putting pressure on
Ministry of Health to make young people a priority group, and the
comparison with international standards of health care delivery to our
young people.
(xxvii)
Breakfast speaker 17th April, and Dinner speaker 23rd April
at the Browns Bay and Takapuna North Rotaries respectively, to promote a
donation of $1000 each to the Elizabeth
Ewing Award in Youth Health.
(xxviii) Takapuna North Rotary and
East Coast Bays Rotary donate $1000 each to the Elizabeth
Ewing Award in Youth Health.
(xxiv) Member of the Reference Group for the Ministry of Health's, Youth Health Strategy, due to my committment to the needs and rights of young people who are sick.
(xxv) Achieved approval from Auckland District
Health Board for the adoption of the ADHB's document, Principles of Adolescent Care
as part of the Youth Health Strategy for New Zealand.
(xxv) Completed my Dissertation in Medical Statistics and thus my Post Graduate Diploma in Science (PGDipSci)as a forerunner to my thesis, Hospital Services as experisneced by Young People.
Summary list of current projects is to:
-
Help develop the Youth Health Srategy to ensure that young people who are sick receive the care, support and facilities appropriate to their developmental needs
-
Persuade the District Health Boards of New Zealand (DHBNZ) to make young people visible (ie included as a separate group) in the population based Health Funding Formula.
-
Try to convince the Chairman and members of the Auckland District Health Board (ADHB) to ensure funding is available to implement the Principles of Adolescent Care.
-
Approach the Clinical Training Agency CTA (Ministry of Health), and Royal College of General Practitioners about the training of both Post Graduate and Undergraduate Programmes repsectively.
- Raise the necessary capital
($50 000+) to ensure the Elizabeth Ewing Award in Youth Health,
through the Auckland University School of Medicine Foundation is operational
as quickly as possible.
- Continue promoting awareness of the neglect faced by
hospitalised adolescent/young adult patients to: influential people in
the medical fraternity, the community and our parliamentarians to help
ensure the necesssary changes happen sooner.
- Continue lobbying for the establishment of Youth Wards to
ensure that youth facilities in hospitals cover all necessary aspects of
care, and the coordination of support services.
- Accept speaking engagements to promote awareness within the
community that the Health System often fails adolescents, suggest possible
remedies, and challenge all to work together to gain the positive changes necessary.
- Research overseas policies
in regard to the creation of a Youth Health Policy for NZ.
- Continuing with the challenge put before me by Mr Graeme Edmonds
(Chief Executive Officer, ADHB) to research
adolescent units internationally and build a best model for an
Adolescent Unit for ADHB.
- Thesis – The building of a profile of hospital services for young people based on a literature review of adolescent units, and survey of adolescent patients who have had multiple hospital admissions and therefore have experience of hospital support services and facilities.
- Convince the Government to commission a Health and Safety Review of Hospitalized Young People
12 to 24 compared with the international best standards to give direction
for improvement of training in adolescent health, and a seamless coordinated
support service.
- Encourage Specialist Courses for health providers in adolescent
health, and increased exposure time in the training of General
Practitioner’s, in helping them understand the psyche and psychosocial
needs of our young people. Remind them that no one is too young to have
cancer.
- Write more for the NZ Family Physician,
the Journal of the Royal College of New Zealand General Practitioners as
suggested by Professor Rae West.
- Promote NZAAHD, Action for Children in Aotearoa,
and other Non-Governmental Organisations (NGO) supporting the needs of all
young people.
- Help unite like-minded organisations and individuals
to help push for recognition of the unique needs of our Youth and the
establishment of essential non-fragmented structures to support them.
- Complete the development of a Youth Health Strategy and Youth Development
Strategy.
- Establish a Youth and Family Action Group to provide a platform
for Commentary and Collective
View on
relevant documents and initiatives to improve the standard of healthcare to young people.
- Utilization of the media
to bring awareness of the plight of our young people in the Health System.
- Publish articles in a
more widely read journal, such as North & South or Metro Magazines as
recommended by the New Zealand Medical Journal and the NZ Family
Physician.
Last updated: August 17, 2001
Jane Ewing
Youth Health Advocate
National Council Member of the New Zealand Association for
Adolescent Health
and Development (NZAAHD)
Member
of the HSDP Adolescent Issues User Group - a researcher and writer of the
document,
Principles of Adolescent Care, (Auckland District Health Board)
Member
of the Bereaved Parents Research Group (Child Cancer Foundation)
Health Consumer & Youth Health Critic
Lecturer
- AUT (Auckland University of Technologgy)
Lecturer at the University of Technology Sydney (UTS)
Author of this Article : Jane Ewing,
written as a result of her experience.
Email Contact : jane.ewing@uts.edu.au
