Sustainable burial options for a greener goodbye
Many of us feel the pressure to be more eco-friendly and sustainable in the way we live, but what about when we or our loved ones die? Six million kilos of Carbon dioxide is released into the atmosphere every year from cremations in New Zealand, while for every burial about 40 kilograms is emitted. But as well as carbon emissions, there is also the issue with space, as many cemeteries and urupa are running out of room or at capacity. Louise Ternouth took a look at what more sustainable burial options are available.
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RNZ News
an hour ago
- RNZ News
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The government's plan will allow some patients to go longer between prescription renewals. Photo: 123RF In the annual flood of Budget coverage a few weeks back, one of the big announcements for the health sector was a move to allow 12-month prescription renewals from 2026. But how is it going to work and how will it affect your health services? RNZ is here to explain it all. The current maximum prescription length for most medicines is three months, but the government's new plan would extend that to 12 months for many medicines. This means that some patients will no longer need to visit their GP every three months to get their standing medication renewed. While some repeat prescriptions can be filled without a doctor's visit now by contacting their office, guidelines by the Medical Council of New Zealand on good prescribing practice say "patients receiving repeat prescriptions should be assessed in person on a regular basis" and repeats are given only with a doctor's discretion. In announcing the plan , Health Minister Simeon Brown said the current system "creates unnecessary barriers for patients on stable, long-term medications like asthma inhalers, insulin for diabetes, and blood pressure tablets. It means added costs for patients and more paperwork for health professionals, taking time away from patients with more urgent or complex needs". Medicines will still have to be dispensed every three months from pharmacies. "It's a win-win for patients and the health system - fewer avoidable hospitalisations, better health outcomes and reduced long term costs," Brown has said. Not until the first quarter of 2026. Luke Bradford of the Royal New Zealand College of GPs. Photo: supplied This is expected to mostly affect people on long-term medicines, the Ministry of Health said. The increased prescribing limit will also apply to oral contraceptives, which currently have a six-month prescribing limit. Royal New Zealand College of GPs medical director Dr Luke Bradford said that during consultation on the plan, the college had supported a six-month prescription renewal instead of 12. "We submitted on this and said 12 months is probably too long, six months would be reasonable." Dr Bradford said there would not be a centralised list of drugs that are part of the scheme and physicians will need to determine who benefits from 12-month renewals. "It's very much going to be a patient by patient situation and we can't put blanket rules across this. It depends on a whole raft of things but predominantly depends on conditions being managed." If you have multiple prescriptions for multiple conditions, you are far less likely to get 12-month renewals as a physician needs to monitor your ongoing health and possible interactions. "Prescribers will be responsible for determining the clinically appropriate prescription length and can prescribe for up to 12 months, or for shorter periods if they consider that most appropriate," a spokesperson for the Ministry of Health said. Controlled substances - which include opiates such as morphine and fentanyl - are not included. Controlled substances will not be included. Photo: 123RF/Steve Heap 2016 The Budget allocated $91 million over four years "to support this change". "It is expected this change will increase patients' access to medicines and therefore create a higher demand for medicines. Funding is required for the Combined Pharmaceutical Budget to meet the increased demand for medicines," the Ministry of Health spokesperson said. "The Budget includes $10m initial funding in the 2025/26 financial year, with outyear funding held in contingency, pending information gathered from the initial uptake." Some patients won't have to go to the GP quite as often, in theory. GP visits are charged differently from place to place and can run anywhere from $20 to $90 depending on the complicated calculation of fees at individual doctors' offices. The Ministry of Health has said that the average patient who renews prescriptions four times a year could save up to $105 a year on GP fees. It also has said the change could mean less time off work or school for appointments and it could make life easier for people in rural and remote areas who travel to get to their doctor. No. The $5 co-payment for most prescriptions - which was brought back under the current National-led government - will remain unchanged. And you'll still need to go back to the pharmacy every three months to have your prescriptions dispensed even if you're on a 12-month renewal from your doctor, Dr Bradford said. "There's some safety mechanisms built into this in that they're not going to dispense 12 months of medicines. People aren't going to suddenly have huge boxes of medicine at home." In a statement to RNZ, the Pharmaceutical Society of New Zealand said it cautiously supported the move, but had concerns. "PSNZ support the increased period in principle, but with some provisos - as always, it's the detail that will matter and we are waiting to receive that. "For example, there is currently no indication that funds to support the extra monitoring and counselling that may be required, when patients are picking up their medication every three months without any interacting with their general practice." If people visit their GPs less often, it will affect the income their practices receive. In its submission on the proposal , the Royal College said prescriptions account for between seven to 10 percent of practice revenue. "The financial impact on practices that rely on revenue from current prescription renewals could be substantial, e.g., one specialist GP calculated a $320,000 loss in a patient population of 14,500," that submission also reported. "There will definitely be an impact on that," Dr Bradford said. At the same time, it won't necessarily reduce the admin work needed. Doctors will still need to do the legwork with their patients to keep on top of ongoing records, tests and screening, he said. Health Minister Simeon Brown. Photo: RNZ / Nick Monro On its website, the Ministry of Health said the Medicines Regulations will need to be amended to increase the maximum length of prescriptions, and IT systems will need to be updated to allow this change. The Medicines Regulations 1984 will need to be amended. Pharmac will make changes to the Pharmaceutical Schedule, while Health NZ will work to support GPs, other prescribers and pharmacies with updating systems and the transition. The Pharmaceutical Society said it also would work to ensure the prescription plan changes go smoothly. "PSNZ will use this time to engage with officials to support a smooth transition and highlight any unintended consequences, particularly any changes in workload and financial pressures that this change could place on pharmacists and their teams," it said in its statement. General Practice Owners Association chair Dr Angus Chambers recently told RNZ that many patients with chronic conditions needed regular reviews by a doctor or nurse. "Just to leave someone for 12 months to have their diabetes deteriorate may well lead to more emergency department visits and hospital admissions." Everyone manages their conditions differently, Dr Bradford said, and no two cases are quite the same. "If you're on five different meds for diabetes you're going to need three-month checkups." In announcing the plan, Simeon Brown said it would give GPs a breather. "Instead of spending time on routine repeat prescriptions, they can focus more on supporting those with complex or deteriorating health needs." Dr Bradford said the current three-month renewals do give a "safety net" for physicians to keep on top of issues. "By taking that away we either say we've still got to do that or the pressure goes on GPs to do it anyway and have to sit their own reminders for those periods of time and follow it up in their hour of clinic time." "The majority of patients will be fine," but a visit to a GP involves a lot more than just checking off a prescription renewal box, Dr Bradford said. "The moment you come in we're watching how you're walking, we're looking at your body language and listening for cues and we're reminding you of the screening you haven't done. "Those things that happen because you come in and say, 'Oh, I'm just here for my asthma medicine, doc,' are at risk of being lost." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
RNZ News
11 hours ago
- RNZ News
Sucrose doesn't stop long-term impacts on preterm baby development
By Mia Mclean of This story was originally published on The Conversation. Babies born before 32 weeks gestation who have procedures in hospital that cause pain, such as the routine heel prick, suffer long-term consequences. Photo: Neil Salter Infants born very preterm spend weeks or even months in the neonatal intensive care unit (NICU) while their immature brains are still developing. During this time, they receive up to 16 painful procedures every day . The most common is a routine heel prick used to collect a blood sample. Suctioning of the infant's airways is also common. While many of these procedures provide critical care, we know they are acutely painful . Even tearing tape off the skin can be painful. We also know, from decades of research, that preterm babies' exposure to daily painful invasive procedures is related to altered brain development , stress functioning and poorer cognitive and behavioural outcomes . The commonest strategy to manage acute pain in preterm babies is to give them sucrose, a sugar solution. But my recent research with Canadian colleagues shows this doesn't stop these long-term impacts. In New Zealand, there is no requirement to document all procedures or pain treatments. But as the findings from our Canadian study show, we urgently need research to improve long-term health outcomes for children born prematurely. We collected data on the number of procedures, clinical exposures and sucrose doses from three NICUs across Canada. One of these sites does not use sucrose for acute pain management. This meant we were able to compare outcomes for children who received sucrose during their NICU stay and those who did not, without having to randomly assign infants to different care as you would in a randomised controlled trial - the gold standard approach. Very early born babies can spend weeks and months in a Newborn Intensive Care Unit. Photo: RNZ / Cole Eastham-Farrelly At 18 months of age, when children born preterm are typically seen for a follow-up, parents report on their child's behaviour. Our findings replicate earlier research: very preterm babies who were exposed to painful procedures early in life showed more anxiety and depressive symptoms by toddlerhood. Our findings are similar regarding a child's cognition and language , backing results from other studies . We found no link between preterm babies' later behaviour and how much sucrose they were given to manage pain. Sucrose is thought to activate centres of the brain that modulate pain and lead to the release of endorphins , but the exact mechanism remains unclear. It has become the worldwide standard of care for acute neonatal pain, but it doesn't seem to be helping in the long term. About one in 13 babies are born preterm each year in Aotearoa New Zealand. Some 1-2% are very preterm, two to four months early. Māori and other ethnic minorities are at higher risk . Studies in New Zealand show children born very preterm have up to a three-fold risk of emotional disorders in preschool and by school age . This remains evident through adulthood. Sucrose may stop preterm babies from showing signs of pain , but physiological and neurological pain responses nevertheless happen. As is the case internationally, sucrose is used widely in New Zealand, but there is considerable variation in protocols of use across hospitals. No national guidelines for best practice exist. Infant pain should be assessed, but international data suggest this isn't always the case. What's more, pain isn't always managed . Routine assessment of pain and parent education videos are useful initiatives to encourage pain management. Minimising the number of procedures is recommended by international bodies . Advances in clinical care, including the use of less invasive ventilation support and the inclusion of parents in the daily care of their infant, have seen the number of procedures decrease . Pain management guidelines also help, but whether these changes improve outcomes in the long-term, we don't know yet. We do know there are other ways of treating neonatal pain and minimising long-term impacts. Placing a newborn on a parent's bare chest, skin-to-skin, effectively reduces short and long-term effects of neonatal pain. For times when whānau are not able to be in the NICU, we have limited evidence that other pain management strategies, such as expressed breast milk , are effective. Our recent research cements this: sucrose isn't helping as we thought. Understanding which pain management strategies should be used for short and long-term benefits of this vulnerable population could make a big difference in the lives of these babies. This requires additional research and a different approach, while considering what is culturally acceptable in Aotearoa New Zealand. If the strategies we are currently using aren't working, we need to think creatively about how to limit the impact of pain on children born prematurely.
RNZ News
13 hours ago
- RNZ News
Boyracer apologises for 'Levin invasion' car meet chaos
A boyracer charged over his involvement in the 'Levin invasion" said he's written apology letters to people disrupted by the event and is selling the now impounded car he used to do a burnout. Police say a crowd of about thousand gathered at the event last Friday. Four bystanders aged between 16 and twenty years old were hit by vehicles and one woman had both her legs run over. One of the drivers charged admits it was a dumb thing to do, and said he regrets getting involved and doesn't want to be associated with the impounded car. He spoke to Lisa Owen.
