How to trim $20m from the Waikato DHB budget – find the fatties first and fire them

The savings will be bigger if the tubbies go first.


Alf is reluctant to trespass on to the electorate domains of his National Party mates, David Bennett and Tim Macindoe.

But he can’t resist throwing some advice on the matter of the Waikato District Health Board’s efforts to deal with a financial shortfall for the coming financial year of about $20 million.

As that pointer shows, Alf picked up the news from Radio NZ –

Chief executive Craig Climo has told employees the board will have to find savings of $20 million for the year beginning in July this year and a further $5 million in each of the two following years.

And if savings can not be found in other areas, staff reductions are among the cost-cutting options.

“Staff reductions” is an apt expression in the case of the Waikato DHB, because it has been sending staff to Weight Watchers to slim them.

It has a thing about fatties. Earlier this year it was pointing the finger at fast food while huffing and puffing about obesity, diabetes and what have you.

The intense marketing of fast food is one of the reasons why obesity and type 2 diabetes have grown, according to a discussion paper issued by Waikato District Health Board’s Population Health service.

The paper, “Obesity, diabetes and fast food – the impact of marketing to children”, looks at how modern “obesogenic” environments including car-based urban design, sedentary jobs and passive forms of recreation promote the over-consumption of food and drinks and limit opportunities for physical activity.

“The aim is to get communities and individuals thinking how they can change to a healthier environment – for the sake of their children’s future health,” says the paper’s author Nick Chester, Population Health policy analyst.

We may assume that if Nick Chester is not a Food Nazi, then he has been listening to the Food Nazis, because he is banging on about being bothered by the marketing of energy-dense, nutrient-poor food to children.

He says one in five New Zealand children are overweight, and one in twelve are obese.

Children who are obese are more likely to remain obese into adulthood, adding to the likelihood of future ill health and the cost of treatment.

Alf does not take this issue lightly.

But is it a growing problem?

Apparently not, because Chester also says obesity prevalence in children has remained relatively steady in recent years.

That’s good news, surely.

Especially when you consider how many more fast-food outlets and what-have-you have opened in recent years.

Let’s not ignore the perturbing facts –

• Obesity prevalence has risen in New Zealand from 16.6% of males and 20.6% of females in 1997 to 24.8% of males and 26.0% of females in 2006/07. One in five New Zealand children are overweight and one in twelve are obese.

• Obesity is the result of a number of factors including genetics, but the rapid increase in the prevalence of obesity suggests that genetics are unlikely to be the main cause of the epidemic.

• There is a disproportionate burden of obesity and diabetes in Māori and Pacific populations, and those living in more deprived areas.

But should we be focusing on children and the fast food industry?

The DHB’s media statement referred to a 2006/07 Health Survey which found that 70% of children between the ages of 2 and 14 years ate fast food at least once a week, 14% ate fast food twice a week and 7% ate it three or more times a week.

Then comes the assault on fast food ahead of – say – mums who drive their brats to and from school and do nothing to encourage them to engage in healthy outdoor activities that would burn off any excess energy.

The figures suggest to the DHB

…that the consumption of fast food is a common and well established pastime for the majority of New Zealand children.

Within the Waikato region, there are over 70 fast food chain outlets operating; over half of these are in Hamilton City. Many other takeaway food outlets operate in all areas; dairies, supermarkets and petrol stations all sell a wide variety of unhealthy food.

Promotion of energy-dense, nutrient-poor food has reached almost saturation levels through conventional advertising and indirect marketing within local communities such as sponsorship.

The DHB paper presents a number of interventions that may address concerns with marketing, at both a policy level and also at a local level through health promotion, education and community partnerships.

The DHB is spending money on several Waikato programmes such as
NourishMEnt (discussing barriers to good nutrition and how these can be overcome in a local community), Kai @ the Right Price (aimed at increasing consumption of fresh fruit and vegetables) and Project Energize (a project within Waikato primary schools to improve nutrition and increase physical activity of children, so – fair to say – good old fashioned exercise is not overlooked).

Funny thing is, lots of fatties work for the Waikato District Health Board.

Just this week it confirmed it had spent $41,580 to send about 100 staff to Weight Watchers.

The Ministry of Health had funded the programme to the tune of $60,000, or roughly 200 workers.

The DHB signed up to the Weight Watchers on-site programme last June.

Health Waikato chief operating officer Jan Adams said a healthy workforce was a good workforce.

“If you have got healthy staff who feel good about themselves, it should, and probably will, translate to lower sickness and absenteeism,” she said.

But as others have noted, the Waikato DHB is looking to shed more than just a few kilos from its workers and is looking into cutting $25 million from its budgets by mid-2013.

Because it looks like some staff must be culled, Alf has a suggestion.

Fire the fatties first. Or shed them. Or whatever word for giving staff the heave is in vogue these days.

That way you will save (a) on the wages and (b) on the Weight Watchers fees.

A sort of cost-cutting double burger, you could say.

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