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Given the health and education challenges many New Zealand children face, it is surprising (and even depressing) how little crossover and collaboration there is between these two vital sectors.

The inequities in and are both cause and symptom of the lasting socioeconomic disadvantage experienced by so many young New Zealanders. And yet the known interconnection between health and education rarely translates into policy or action, despite of the reciprocal benefits.

Meanwhile, increasing numbers of children are starting school with health needs. At the same time, show conditions such as rheumatic fever, respiratory illness and skin infections remain unacceptably high.

Poor health affects , and contributes to . Correspondingly, education is a of social wellbeing, and is a of later good health.

But decades of neoliberal economic governance have led to the health and education sectors existing in silos, with no formal directive to collaborate. Introducing a more integrated approach would make a real difference to the long-term education and health prospects of young New Zealanders.

Legal requirement to collaborate

The lack of any legal requirement for the health and education sectors to collaborate runs counter to overwhelming evidence of the likely .

In the United Kingdom, for example, stipulates the need for cooperation between key agencies such as education and health to promote child wellbeing. Responsibility sits with local authorities, and relevant agencies must cooperate.

While New Zealand’s declares children’s welfare and best interests should be paramount, there is no formal requirement similar to the UK’s. Furthermore, the New Zealand , passed in 2020, does not set out any need for schools to actively collaborate with the health sector.

While there are school initiatives led by the Ministry of Health – mainly concerning , and education guidance for teaching staff – they don’t amount to a coherent collaboration between sectors.

To compound matters, initial teacher education (ITE) programmes in New Zealand provide scant preparation for dealing with health issues. The programs are largely driven by Teaching Council requirements that graduates meet its professional .

Apart from a general commitment to “learner wellbeing”, they provide no requirement that ITE providers prepare student teachers for managing student health. Not surprisingly, teachers can find themselves unqualified to deal with real .

School as health entry point

Primary schools in particular do not appear to be a focus of any central planning or policy for delivering accessible health care.

This is despite the effectiveness and potential shown by a programme such as . Introduced in 2012, it provides primary health care services to roughly 34,000 children aged 5-12 in 88 low-socioeconomic schools and in Counties Manukau.

International research has consistently shown that access to health services in schools between the education and health sectors, and promotes improved outcomes for children.

While some health resources – usually public health nurses – are available to publicly funded primary schools in New Zealand, the provision is fragmented, has no national framework or service delivery standards, and fails to recognise the potential of school nursing to deliver services.

In an ideal world, regardless of the funding priorities set out in the Ministry of Education’s , every primary school would be collaborating with local healthcare providers, with a recognised referral pathway (including for mental health).

Implementing a national, standardised school health services programme would include developing school nurses as a critical workforce. Many international studies have shown to student learning outcomes, and are accepted by school staff as the most appropriate health professionals to work with.

Towards a holistic approach

While the 2023 hints at greater collaboration between sectors, its fate under a ³Ô¹ÏÍøÕ¾-led coalition government can’t be predicted.

And although the ³Ô¹ÏÍøÕ¾ Party’s and its grouped health and education together, the policy details were distinct. It seems likely the current approach won’t change.

But the siloed nature of the education and health sectors, as well as a lack of shared understanding of their interrelatedness, has made aligning and coordinating their work difficult.

To sustain real collaboration, directives and mandates from the respective ministries would require state-funded schools and health service providers to work together. And this less fragmented and more would be more cost-effective than the present system which sees too many fall through the gaps.

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.