09 May 2019

2nd Sustainable Health Care in Aotearoa Forum

It was a useful & informative day at the Medical School in Newtown yesterday for the forum, and the organisers managed to cram 18 presentations and a ministerial address from the Associate Minister of Health, Hon Julie Anne Genter, into the day. This was particularly timely, given the introduction of the Zero Carbon Bill earlier in the day. A few notes from key presentations:

Dr Ashley Bloomfield, Director-General of Health: Opening address on the Zero Carbon Bill, upcoming Wellbeing Budget (which we believe will be world-leading), and the Government’s priority for environmental sustainability are now key drivers of health policy. Noted that hospital builds/rebuilds are a major opportunity to hard-wire environmental sustainability and promote wellness for the people who work in and use the facilities. Minister Genter is pressing him for progress and the Ministry of Health aims to deliver.

Mark McKenna, engineering consultant, Norman Disney & Young (Sydney): Designing & building health care facilities that thrive on natural light, with superb insulation, modern ergonomics and plentiful shared space is both environmentally sustainable but also encourages happier workforces who stay longer. Tying a building into its community and broadening the understanding of what a building is for. As always, stakeholder clarity is essential if expensive rework is to be avoided. Greenstar building ratings are a useful guide to the success of a sustainable build.

A/Prof Cassie Thiel, NYU-Wagner (via Zoom): life cycle assessment and principles of industrial ecology to analyse and improve the environmental performance of medical systems, hospital design, health care practice, and medical technologies. 10% of the US’ total emissions are derived from the health sector, and much US practice is excessively wasteful. Example of Aravind Eye Care System in India that adopts production-line and recyclable process that maximises re-use; tiny environmental impact at 1/10th the cost of US procedures. Also example of Fred Hollows Foundations’ new sustainable procurement strategy. (Probably unaware that Hollows was a NZer).

Dr Richard Jaine, Ministry of Health: Ministry’s sustainability team seems to consist of 1.2FTEs (mostly him). Genter asked MOH to survey DHB sustainability practice; 19 DHBs responded and 16 have a sustainability manager. (Based on the discussion in the room, it may be that these are the only sustainability employees in DHBs). DHB procurement practice highly variable, and none are actively considering measures to adapt to climate change. Only half of DHBs are measuring their carbon footprint. Discussed suggestions for a national sustainable health care unit and green health building standards.

Dr David Galler & sustainability officer Debbie Wilson, Counties Manukau Health: Innovative hospital food systems, Wiri Prison farm initiative, Manurewa High School farm.

Margriet Geesink, NDHB: Surveyed Northland’s decarbonisation efforts. Good progress on EVs and energy efficiency, but Whangarei hospital reliance on natural gas generator (cheap to run, bad for the environment) will be expensive to address. This is a problem across many hospitals. Their three other, smaller hospitals are all full-electric and have a much lower emissions profile.

Andrew Eagles, NZ Green Building Council: The NZ Building Code is drastically below international best practice and achieving change is hard in notoriously conservative industry. The health system can promote change by setting a good example. Healthy buildings are more productive and welcoming for patients and staff.

Ben Masters, BECA: Engineer working on Taranaki Base Hospital expansion. Relying on heat pump technology & hoping to take some other, older hospital buildings off the natural gas generator and switch to heat pumps too.

Johan Rockström & Walter Willett, EAT-Lancet Initiative launch (Youtube presentation, 27 min): ‘The EAT-Lancet Commission on Food, Planet, Health brought together more than 30 world-leading scientists. Prof Walter Willett (Harvard University) and Prof Johan Rockström (Potsdam Institute and Stockholm Resilience Centre) present the report at the EAT-Lancet Launch Lecture in the University of Oslo Aula, January 2019. The Commission delivered the first full scientific review of what constitutes a healthy diet from a sustainable food system, and which actions can support and speed up food system transformation’. How to build a Planetary Health Diet (hint: more fish, nuts and legumes).

Anna DeMello & Jono Drew, University of Otago: Medical students delivered detailed findings of the environmental impacts of different eating habits, which have a great potential to shape our carbon footprint. To be published later 2019, and created much excitement in the room.

Patrick Morgan, Cycling Action Network: Designing healthy streets and putting humans back at the centre of transport systems. Advocating cycling is about ‘not selling the ingredients, it’s selling the cake’: how good do people feel when they have safe cycling options? Parking allocations displace healthy transport options; streets are the biggest public space in all cities and we should be open about re-envisioning how they are used.

Hon Julie Anne Genter, Associate Minister of Health: Yes, she did cycle to the Med School. Zero Carbon Bill introduced today; urged participants to have their say. There will be major health co-benefits if we achieve zero carbon; we need to measure progress, incentivise positive and healthy behaviour, and stop waste. The Wellbeing Budget, Treasury’s Living Standards Framework, and the UN Sustainable Development Goals. Developing procurement guidelines and had initially wanted national leadership but MOH preferred to let DHBs innovate and see what works. Minister seemed to now be leaning towards pressing MOH to provide more leadership, because sufficient progress hadn’t been made.

Other notes:
  • The planned Q&A sessions were mostly ditched to catch up time when presenters ran over-long, which was fortunate, because the clinicians in the room were poor at asking questions. Instead they preferred long, rambling statements, even when questioning the Minister. NZers in general are poor at Q&As. Facilitators: always remember to pick a female questioner first (most of the air-time went to mouthy males) and specify that all contributions must be brief and all must be actual questions!
  • Used ‘Catch-Box’ soft cube remote mic that can be chucked quickly around the auditorium to pick up audio from the floor. Cool but super expensive.
  • Wholly vegetarian catering was a good idea, although you do emerge ravenous.

07 April 2019

Honour & glory are excellent things, but so are silver & gold

[The Cruisers & Convoys Act 1708, which concerned naval prize money, and which was still in force during the Napoleonic Wars] laid down the proportions into which the value of the prize was to be divided. There were certain Droits of the Crown, but these were kept in reserve; in general, the full value of the prize, ship and cargo, went to the captors, as follows: the captain had three-eighths, of which he gave one to the flag officer under whom he served; the other officers, down to sergeant of Marines, had three-eighths, in three categories which ensured that the more senior had the bigger share; and the remaining two-eighths went to the rest of the crew, again shared according to seniority. Nor was this all: in the case of warships captured or destroyed, Admiralty paid head-money at the rate of £5 per head of the enemy crew at the commencement  of the engagement. This was to encourage doubtful captains to engage warships rather than seek the easier and more lucrative merchant prizes; moreover, a successful engagement with a warship meant probable promotion, which never rewarded captors of merchantmen [...]

[As a result of the October 1796 action in which the frigate HMS Naiad captured the treasure-laden Spanish frigates Santa Brigida and Thetis late of Vera Cruz, the prize money granted was lavish]. Besides a cargo of valuable commodities such as cochineal and indigo, the two ships had between them about a thousand boxes each containing 5000 silver dollars, besides odd bags and kegs and some gold. There can have been few literate persons in the squadron who were not doing pleasing little sums during the short voyage to Plymouth, where they arrived on the 21st November. The treasure was conveyed in sixty-three wagons to the citadel of Plymouth, and thence to London. The prize-money was divided thus:

Each Captain: £40,730
Each Lieutenant: £5091
Warrant-Officers: £2468
Midshipmen, etc.: £791
Each Seaman & Marine: £182

One has to consider that the rate of pay per annum did not exceed £150 for a frigate captain, £75 for a lieutenant, and £12 for an ordinary seaman. A captain would have to serve for 250 years to earn the money he picked up in a couple of easy days; and even the humblest seaman could set himself up in a cosy pub. It was very wise of the Admiralty to allot these astounding prizes; it was like the football pools and the lotteries: I know that the chance is remote, but all the same, people have in fact won such prizes, and why should the next one not be me? Honour and glory are excellent things, but so are silver and gold; and if all are to be had in the same engagement, let us go heartily about it!

- James Henderson, The Frigates, London, 1970, p.119-121

See also:
HistoryIn fear of the Tsar's navy, 5 November 2011
History: Chatham Historic Dockyards, 5 August 2010
History: Nauticalia in Portsmouth, 12 April 2007

23 March 2019

Early overland mails between Auckland & Wellington

During the [eighteen-] forties the Post Office first attempted a mail route overland between Auckland and Wellington. The only feasible route was by the west coast, where foot messengers could avoid the dense bush and tangled undergrowth that covered most of the central parts of the island. The path went from the Waikato Heads to Kawhia Habour, and thence by way of Mokau to New Plymouth. From Wellington the messenger would take mail to Wanganui and on to New Plymouth by way of Hawera (then called Waimate). The Government Gazette makes mention, in September 1843, of the intended monthly service from Auckland to Kawhia Harbour. It was to start on 15 September 1843. Nothing more is heard of it. In 1844 Felton Mathew, then Acting Deputy Postmaster-General, advertised that a fortnightly mail would commence on this route in August of that year. We know a Thomas Scott of Rangitikei (now Bulls) was carrying mail between Wellington and Wanganui for nine months in 1844-45, but it is not clear how much of this overland route was in use at that time. This earliest use of the overland route between Wellington and Auckland did not last long; it had ceased when the British Commissioners visited New Zealand in 1846.

The Wellington-Wanganui section was reopened in 1849. Thomas Scott answered the call for tenders by promising to carry the mail by horsed postmen. They were to go from each end and exchange mail at Ohau "which is as near as possible halfway". A mail was to traverse the whole distance in three and a half days. Thomas Scott's bid was regarded as too high, and the government decided to use police instead.

The whole route between Auckland and Wellington seems to have been put to use by 1856, for Henry King of New Plymouth reported that the mails were arriving and departing "with much regularity". It was a long and difficult journey to go the whole length of the route. If a mail, for example, left Wellington on a Wednesday, it reached Wanganui on Saturday, arriving in New Plymouth the next Friday, reached Mokau the following Monday, and arrived in Auckland, all being well, on Saturday - two and a half weeks after leaving Wellington! One reason for the long schedule was the refusal of the Maoris [sic.], who had become professed Christians, to carry mail on Sunday. It was a day of rest.

- Howard Robinson, A History of the Post Office in New Zealand, Government Printer, Wellington, 1964, p.57-8.  

See also:
Blog: NZ postal rates 1936, 1 January 2018
Blog: Writing to the New Plymouth colony, 28 November 2015 
Blog: The arrival of an English mail in 1853, 26 January 2015
Blog: Posting the empire as the royal word, 9 January 2013