Interview with Dr Colin Tukuitonga: from crisis to action in Pacific communities

The island communities in the Pacific contribute very little to global carbon emissions, yet they are among the most vulnerable to the effects of climate change. Dr Colin Tukuitonga, a general practitioner by training, was born and raised on Niue Island in the Pacific. He has held senior public health roles in the New Zealand Government and, since 2014, has served as Pacific Community Director-General. He spoke to us about how climate change is affecting the health of people living in Pacific Island countries and the relevance of Australia’s climate change policy responses to these neighbouring countries

The future of Pacific regionalism: Challenges and prospects

Fakaalofa lahi atu, Bula vinaka. Bonjour. Kia ora and Good Evening. It’s a great pleasure to be here today. I want to say vinaka vaka levu and thank Professor Steven Ratuva for inviting me to speak. I have been asked to cover one of the great challenges of our region: The Future of Pacific Regionalism. More specifically, I’ve been asked to speak on the challenges and prospects for regionalism. Regionalism has always been a goal of Pacific leaders, yet somehow the benefits have been elusive. The regionalism theme in the Pacific is not new. In the 1970s one of my predecessors at the Pacific Community, Dr Macu Salato of Fiji, defined Pacific regionalism as “unity in diversity” – recognising the region’s rich diversity of geography, cultures, and so on, and many common interests and challenges – not least the shared resource of the Pacific Ocean. The Pacific Islands region is one of contrast – from Papua New Guinea with more than seven million people, to Niue and Tokelau, each with populations under two thousand. It is clear that development potential varies considerably, along with the capacity and capability of Pacific Island Countries and Territories (PICTs). First, let me tell you a little about the Secretariat of the Pacific Community (SPC)–an organisation that I now have the honour of leading

New Zealand's Primary Health Care Strategy: early effects of the new financing and payment system for general practice and future challenges.

Since 2001, implementation of a New Zealand's Primary Health Care Strategy (the Strategy) has led to an increase in the proportion of primary health care services which are publicly funded, the development of 82 primary health organisations (PHOs) to oversee primary health care services and universal public capitation funding of PHOs. This approach has replaced the previous system of fee-for service targeted public subsidies paid to individual general practitioners (GPs). Patient copayments, although at a reduced level but still set by individual practitioners, have remained a core feature of the system. This paper focuses on the implementation and impact of key policy changes over the first five years of the Strategy. Although patient copayments have fallen and consultation rates have increased, the new funding and payment system has raised a number of unresolved issues - whether to retain the new universal funding system or revert to the former targeted approach; how to achieve the potential gains from capitation when GPs continue to receive their income from a variety of sources and in a variety of different ways; and how to manage the potential for 'cream skimming'. Recent improvements in access may, in time, improve health status and reduce inequalities in health, but there is no guarantee that a universal system will necessarily improve average health or reduce inequalities. Much depends on the services being delivered and the populations that are benefiting most - something New Zealand needs better evidence on before determining future policy directions in primary health care

WHO global strategy on diet, physical activity and health: How can Codex Alimentarius take action to support its implementation?

No Abstract. South African Journal of Clinical Nutrition Vol. 18(2) 2005: 107-10