Health span versus life span - Dr Sharad Paul on 'biohacking our genes'
With his latest book, globally renowned skin cancer surgeon Dr Sharad Paul, reflects on what habits and tweaks that may just allow us to hack into genomics to optimize our performance. Produced by Kadambari Raghukumar.
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RNZ News
12 hours ago
- RNZ News
Health Committee hears submissions on Medicines Amendment Bill
The Medicines Amendment Bill will continue to be considered by the Health Committee over the next two months. Photo: 123RF MPs on Parliament's Health Select Committee were told by the public this week that, while the government's Medicines Amendment Bill is a step in the right direction, changes are still needed to ensure it balances safety with efficiency. The bill, which amends the Medicines Act 1981, received its first reading in April, and is a component of a wider push by the government to loosen burdensome regulation across sectors. Under current settings, prescription medicines can take a long time to be approved, funded, and made available to the New Zealanders that need them. Historically, we have ranked well below the OECD average for access to medicines. In his oral submission on the bill, New Zealand Initiative chief economist Dr Eric Crampton suggested that New Zealand simply wasn't a desirable target market for medicine companies. "We are a small, relatively poor country at the far end of the world that will not be at the top of anyone's agenda in getting their regulatory affairs team to deal with paperwork… It can take years after a drug has been approved by at least two markets overseas before anybody puts it into the New Zealand approvals process." In his submission, Crampton mentioned the concept of an "invisible graveyard," referring to the people who may have died or been harmed as a consequence of not having access to unapproved medicines. The Medicines Amendment Bill seeks to shake up the status quo, improving patients' access to medication by doing three things. Primarily it would introduce what has been dubbed as 'the rule of two', whereby if a medication has been approved for use in two recognised overseas regulators, Medsafe (New Zealand's medicines regulator), can bypass its usual, often lengthy, assessment process. The government hopes this will reduce the time it takes for new medicines to reach patients. The recognised overseas regulators are those from Australia, Canada, the EU, UK, USA, Switzerland and Singapore. As well as these fast-tracking medicine approvals, the bill also expands the power to prescribe medicine to a wider range of healthcare professionals, such as nurse practitioners, midwives, dentists, and optometrists, so long as the medication falls within their scope of practice. Thirdly, the bill updates some of the settings around the Medicines Classification Committee, which makes recommendations to the Minister of Health around how new medicines should be classed. This week the Health Committee also heard from Dr Graeme Jarvis, CEO of Medicines New Zealand, which represents pharmaceutical companies. While in support of the bill's intent, he told MPs, it needs refinement in order to better achieve its goal outcomes. When asked by Labour's spokesperson for Health Ayesha Verrall, why he was sceptical of the automatic approvals that Dr Crampton had suggested to the committee earlier, Dr Jarvis suggested that doing so would create "unintended consequences around parallel importing and other activities". "People flood the market, and the product may not necessarily be what you think it is, you may end up with counterfeit products coming in. There is no clawback for the regulator to go after a sponsor who has been acting in an unsatisfactory manner." When New Zealand lawmakers look outward for policy inspiration, they tend not to just throw a dart at a map on the wall and hope for the best. There are generally agreed comparable countries, commonly drawn on as case studies for good lawmaking here, which vary depending on the topic. The Medicines Amendment Bill's 'rule of two' provisions reflects this tradition, using a familiar set of jurisdictions in its list of recognised overseas regulators. Members of the Wellington Community Justice Project, a volunteer group made up of Victoria University law students, suggested to the Health Committee that while these overseas regulators have been historically reliable, that does not mean they always will be. "While the bill allows the minister to make rules for verification through secondary legislation so they can be refined to reflect changes in best international practice, we feel as though there needs to be something within the text of the bill itself, ensuring that the regulatory authorities themselves are regularly assessed and upheld to the standards of best international practice," the students told the committee. They went on to cite the current changes being made to the United States FDA, which has long been the world leader in approving medicine. "The FDA's placement on this list, most notably for the reason that the FDA is currently headed by RFK Jr, a health secretary who has been described as a conspiracy theorist, and relevant to this bill, has cancelled or frozen billions of dollars of research grants for the development of the medicines. Clearly, this bill [will outlast] RFK Junior's appointment. However, this example illustrates the need for a process to review the regulatory authorities in Section 22A, so when the questions arise about jurisdictions' suitabilities to be on the two-step verification process, these are able to be addressed." The Medicines Amendment Bill will continue to be considered by the Health Committee over the next two months, before being reported back to the House by the 9 August. You can listen to the audio version of this story by clicking the link near the top of the page. *RNZ's The House, with insights into Parliament, legislation and issues, is made with funding from Parliament's Office of the Clerk.
RNZ News
2 days ago
- RNZ News
Nursing union members hold stop work meetings over stalled pay talks
File photo. The Nurses Organisation and Health NZ have been in bargaining since late last year. Photo: RNZ / Nate McKinnon Nurses are looking for better pay and higher staff-to-patient ratios after rejecting the latest Health NZ offer, a Nurses' Organisation delegate says. A series of stop-work meetings take place this week to discuss the next steps following a vote by members to turn down the offer. Wellington Hospital delegate Hilary Gardner said a commitment to improving staff-to-patient ratios was needed, and the pay increase was essentially a pay cut. "It's what's not in the offer that's the big concern for us. There's not a lot that commitment for health and safety and safe staffing." She said nothing was off the table, including strike action. Health NZ said it wanted nurses to return to the bargaining table to resolve the issue. Gardener said the rejected offer came after many days of bargaining already since their contract expired late last year. Health NZ regional deputy chief executive Dr Mike Shepherd said it believed the offer was fair. "The employment relations authority agrees with that view, we're really keen that our nursing colleagues return to the negotiation table, so we can continue this conversation, so we can continue delivering the care our community needs. "We really respect our nursing colleagues, we do need to be fiscally prudent, and we've made this offer. "We think nursing pay rates have had a number of uplifts over recent years and of course we're keen to continue to that conversation," he said. He said there was a system in place, set up in conjunction with the nursing union, that matches demand on the wards with the nurses available.
RNZ News
2 days ago
- RNZ News
Auckland woman shocked by 'menopause consultation' fee for HRT
Photo: Unsplash An Auckland woman charged $300 for a so called " menopause consultation" says she feels denied the medical care she needs. Carla asked her doctor about hormone replacement therapy (HRT), and said she was shocked by the fee. She was told she either needed to pay or book up to four regular appointments. "I mentioned I was keen to hop on HRT and she told me that I would need to make a separate appointment and 'I was like, that's cool, totally fine'," she said. "She then proceeded to tell me about the menopause clinics that they run and that is three back-to-back appointments at a cost of $300. And the math just didn't math to me ... because each appointment is $70, so 70 times three is not $300, so I didn't really understand how any of it made any sense." Carla told Checkpoint she knew of others prescribed HRT under much simpler circumstances. "When I said I couldn't afford that, I was told that I would then need to make three to four separate appointments to be prescribed HRT," she said. "It was just the fact that everyone else I know had been prescribed HRT with just a single appointment. I didn't understand what all the fuss was about." Carla said a friend of hers had been prescribed by the same doctor late last year and it was just a single consultation. She said the experience left her feeling "really diminished". Carla had considered finding a new GP but said leaving her practice of over 30 years would be daunting. She accepted if a doctor had concerns that would warrant a couple of appointments, but she said a single appointment should be standard practice. "That's not a problem at all, if it's necessary. But I just don't like this ... it just feels money hungry to me," she said. Carla said she felt taken advantage of. "Just the math not mathing with needing three back-to-back appointments and the costs being elevated because it's a menopause appointment," she said. "I thought in a normal 15-minute consultation with a $70 fee, you got the doctor's expertise. That's what you were buying for that." Royal NZ College of GPs medical director Luke Bradford said an in-depth menopause assessment does take longer than the standard 15-minute appointment, and many patients benefit from spending extra time discussing their options with their GP. He said the cost for non-standard appointments like this does vary across practices. "There are dedicated menopause clinics around NZ that typically charge $290 for initial 45-minute appointment and $120 follow up," he said. Checkpoint has asked Carla's medical practice and Health NZ for comment. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
