To: Hon. Annette King, New Zealand Minister of
Health
Dear Madam,
Introduction
I am writing (somewhat belatedly) to thank you for your letter about
men’s health, dated 11 July 2002, to Ross Robertson MP, of which
he sent me a copy. Your letter was in reply to one which he wrote to
you on my behalf, for which I am most grateful to him.
The delay in my writing to you has been caused by the need to set aside
the time to give you a reply which puts a good case to support my initial
reaction to your letter, which was that the New Zealand Government is
carrying out a campaign of gendercide by neglect against the males of
this country. On re-reading your letter after all these months, I am
now able to discern positive elements in it, but my initial impression
that gendercide is involved here still seems to me to be justified.
Gendercide
The prima facie impression of an anti-male orientation is created by
the very first paragraph of your letter to Ross Robertson, where you
state:
“I … agree that New Zealand men appear reluctant to be
proactive in the pursuit of good health.”
It is not clear if Ross Robertson gave it the same emphasis that you
did, but to put such a statement at the very start of a reply on men’s
health (whether the writer is male or female) reeks of excuse-making,
and gives the appearance of discriminatory callousness towards the health
needs of men. Correct me if I’m wrong, but numerous government
health awareness and publicity campaigns have been directed at women,
Maoris, Maori women, etc – with absolutely no indication that
there was some prior requirement that (for example) Maori women showed
signs of proactive pursuit of good health ! As far as I know, however,
there have been no such government health awareness and publicity campaigns
directed at men – though I have noticed occasional items on men’s
health on television, of uncertain origin. In other words, the Government
spends taxpayer money to inform women and Maoris, etc. of their health
needs, and then spends money improving their health. In the case of
men’s health, on the other hand, the Government spends no money
informing men of their health needs, and then actually goes out of its
way to criticise men for not being aware of their health needs ! This
is the same sort of sexist, anti-male double standard that we are used
to seeing in the Justice system.
• According to the New Zealand Life Tables 1995-97, Figure 2.8,
there are more male deaths than female deaths in New Zealand for every
age-group under 80 years of age – presumably because there are
relatively few men who live as long as 80 years. That is an obvious
prima facie case for treating men as a target group for education, prevention
and treatment. Men – I must point out to you – pay more
taxes than women do, and deserve a return on this expenditure.
There is some callous Feminist propaganda around that tries to pretend
that men’s shorter life-span is somehow “natural”.
I refer you, however, to a different view in Vallin, Jacques (1995):
"Can Sex Differentials in Mortality be Explained by Socio-economic
Mortality Differentials ?" in "Adult Mortality in Developed
Nations," edited by A. Lopez, G. Caselle and T. Valkonen (Oxford:
Clarendon Press) ( http://www.soa.org/sections/farm/farm_vallin.html
). It also seems fairly clear to me that (hormones apart) there is no
biological explanation possible for male deaths being greater than female
deaths at every relevant age-group. The difference is probably caused
by man-hating Feminism and female selfishness, on the one hand, and
male chivalry and self-sacrifice, on the other.
Primary Healthcare Strategy
According to an article by Dr. Karen Poutasi, the Director-General
of Health, in the Dominion newspaper of 21.5.2002, about 30% of hospital
admissions for those under 75 are avoidable, and she wants to reduce
hospital costs by getting people to seek primary healthcare so as to
reduce the cost to hospitals. She also says that this type of (i.e.
avoidable) admission is higher for Maoris and Pacific Islanders than
for Pakehas. According to the webpage http://www.moh.govt.nz/moh.nsf/7004be0c19a98f8a4c25692e007bf833/773f92d8d97ead26cc256b6b00785b5e?OpenDocument
one goal of this new strategy is to "identify and remove health
inequalities".
A graph on page 237 of the 1996/97 New Zealand Health Survey shows
that fewer men than women are admitted to public or private hospitals
for all age-groups except the 65-74 age-group, when the proportion of
men admitted to hospital suddenly shoots up from about 12% to about
24%. In addition, page 198 of that document states that “Women
were more likely than men to visit a GP at least once in the previous
year,” and that “Women were also more likely than men to
make frequent visits to a GP.” Taken together, these three bits
of evidence constitute prima facie evidence that men neglect their own
health (while women pamper themselves), until suddenly they are hit
by a health crisis that forces them to be admitted to hospital. I am
sure that you have no way of denying this, because it is clear that
you and your Ministry have little interest in or knowledge about Men’s
Health. Taking this data in conjunction with Dr. Poutasi’s published
comments, it seems clear that men should be a target group in relation
to reducing hospital costs and improving men’s life-span.
Figure 99 of the 1996/97 New Zealand Health Survey shows that men in
the 75+ age-group (unlike younger men) visit GPs about as frequently
as women in that age-group do. This can be interpreted as meaning that
only those men who have developed the habit of visiting their GP regularly
live long enough to reach the age of 75. The Ministry of Health should
sack its sexist, Feminist, anti-male managers and hire people who are
prepared to give men’s health a fair go.
One of your senior Health ministry officials – a woman –
told me on the phone (she refused to commit herself to writing me an
email) that if the statistics showed that there was a need to target
men’s health, men’s health would certainly be targeted.
The graph mentioned above shows that to be a lie. You and your Ministry
neglect men’s health in a callous – not to say ruthless
– manner, and you should be taken to a Human Rights court for
that.
A search for "Women's Health" on the Ministry of Health
website on January 6th 2003 yielded 14 results and a search for "Men's
Health" yielded zero results. Similarly, the 1996/97 New Zealand
Health Survey at http://www.moh.govt.nz/moh.nsf/7004be0c19a98f8a4c25692e007bf833/d7b3cf1eee94fefb4c25677c007ddf96?OpenDocument
cites a 1996 Ministry of Health report called, “Women’s
Health Status in New Zealand”, but there is no reference to any
study on Men’s Health in New Zealand. It is not for nothing that
the logo on the Ministry of Health’s home page features a woman’s
face but no man’s face !
Positive comments
I am pleased that you state:
“There may be areas where men’s health could be improved
through preventative measures and access to medical advice or treatment.”
That seems to indicate that you have not closed the door on further
advances in the area of men’s health.
I also regard as positive the fact that (as you state) the National
Health Committee has contracted the New Zealand Guidelines Group to
undertake another review of the evidence surrounding screening for prostate
cancer, and that the Prostate Awareness and Support Society (PASS) is
participating in that review. That review was due to have been completed
by now, and I will soon see if I can find out what its conclusions were.
Another positive aspect of your letter is the fact that (as you state)
the Government pays the cost of the Prostate Specific Antigen (PSA)
test, rather than the patient.
However, ….
According to the page: http://unisci.com/stories/20012/0608015.htm
“Prostate cancer detection is currently based on three diagnostic
tests: serum prostate-specific antigen (PSA), digital rectal examination,
and transrectal ultrasonography.”
Unless there have been recent advances that I don’t know about,
the PSA test by itself produces too many false positive results and
too many false negative to be adequate on its own – which is why
the digital rectal examination is recommended in conjunction with the
PSA test. According to the webpage http://www.vmmc.org/dbProstateCancer/sec39165.htm
, transrectal ultrasonography is used if a GP’s examination indicates
that further investigation is required. That same webpage indicates
that even transrectal ultrasonography does not provide definitive results,
and has to be combined with a needle biopsy.
Although, therefore, it is good that the Government funds the PSA
test in New Zealand, it does not fund a GP’s digital rectal examination,
and I don’t know how long the waiting-lists are for transrectal
ultrasonography and needle biopsies in public hospitals. So there is
an obvious case for the Government to fund digital rectal examinations
as well, and to make sure that transrectal ultrasonography and needle
biopsy waiting-lists are not too long – given that the Government
funds cervical cancer and breast cancer screening programs for women
only (men do get breast cancer, as well as women), and there seems to
be a constant stream of women-only or mainly-women conditions, such
as osteoporosis, waiting in the pipeline for the Government to throw
targeted money at.
In addition, there is the issue of research funding. It is probable
that much more money is thrown at research into women’s diseases
than at research into men’s diseases – both in New Zealand
and world-wide. For example, the webpage: http://www.prostatepointers.org/ww/funding.htm
states:
“Although the breast cancer death rate and that of prostate
cancer are nearly equal, the research funding for breast cancer is
about seven times that for prostate cancer.”
The New Zealand Government has a responsibility to ensure that just
as much funding is directed at research into male-specific conditions
as at research into female-specific conditions.
Conclusion
If the NZEEF ever received an invitation to provide input to your Primary
Healthcare Strategy, I’m sure we would not have seen it as a priority,
because we would not have been aware of the implications. Men have to
educate themselves about Health Issues because (as shown above) out
Government is not interested in informing us about our health issues.
That needs to change.
Sincerely,
Peter Zohrab,
Acting President,
New Zealand Equality Education Foundation.
Subsequent letter in this series: Why
is Annette King like Sadam Hussein ?
