Kakapo and Grommets

New Year fireworks in Queenstown

Another New Year with its fireworks and resolutions has come and gone. We delighted in fifteen minutes of spectacular fireworks on the Queenstown waterfront and tried not to think about how much money was being burned. Because if money is spent on something, like fireworks, it isn’t spent on something else, like housing for people who have nowhere to live, or improving the sewage system because the underperforming local sewage plant has to discharge effluent into the Kawarau River.

I’ve tried to discuss this issue – rationing of monetary resources – with many people. I had a notable conversation with a winegrower who couldn’t comprehend that decisions have to be made between kakapo and grommets and became vociferous about the matter at a formal dinner. Put simply, there’s a limited amount of money for any government to distribute and decisions have to be made as to what the available money will be spent on. We can save more kakapo or put more grommets in children’s ears. We like to think we can do both, because kakapo money comes from the Department for Conservation and grommet money from the Health Ministry, but the bottom line is it all shared out from the Government Consolidated Fund.

A similar example of decision making is the current reduction of international aid funds as the world moves into defence mode. In particular, EU countries are reducing their aid budgets while ramping up military and domestic spending. Hardly surprising…when there’s less money you want to spend it on your own country rather than someone else’s, is an obvious choice, especially when you want to get reelected.

I was particularly thinking about government choices when reading a summary of a recently funded research proposal regarding the effect of music on people with dementia. The Auckland researchers have been awarded $853,000 by the Marsden Fund to collaborate with Yale University on why dementia patients still respond to music even as their memory fails.

The utility of music therapy for people with dementia is well known. A review of literature found listening to music had the greatest effect, followed by singing, and noted music therapy improved quality of life. It is hypothesised that music stimulates multiple areas of the brain and can invoke positive emotions. However, there’s great heterogeneity in the responses. This isn’t very surprising…individual people’s relationship with music is very different in terms of how much music has been part of their lives and the type of music they have listened to or participated in. The review also noted there was little long term effect of musical interventions.

The New Zealand study wants to gather evidence about the benefits of music…although these have already been demonstrated. What my brain clicked into was calculation mode – how much music could be played to how many patients if $853,000 was used to pay musicians, rather than conduct a research study?

Musicians supposedly earn an average of $60,000 a year (as opposed to the cost of researchers at around $250,000 a year to support the person and the massive research infrastructure behind them). Musicians typically cobble together multiple sources of income to make enough money to survive. So a musician might be very happy with being paid $30,000 over a year, because they’d find the rest elsewhere while knowing they would be able to pay their rent. Ireland has recognised this in a trial of ‘Basic Income for the Arts’, where creatives were paid 325 euros a week, and this has now been turned into a permanent source of funding for 2000 people.

With $853,000, we could pay 28 musicians $30,000 each for a year. Or, to parallel the Marsden grant which was for three years, we could pay 9.5 artists $30,000 a year for three years to play music to people with dementia. If the requirement was for artists to play music with people half-time, there’s 28,500 hours of music playing that could be done over three years (I’m exaggerating here because the musicians would have to travel between locations and that should be paid also). There are around 70,000 people with dementia in New Zealand…if the musicians played with 5 people on average each session, they could provide 2 hours of music to every person in New Zealand with dementia for that amount of money. Of course that would never happen, because administration would chew up a whole lot of the money but you can start to see the potential impact from simply playing music to people vs researching playing music to people. The musicians would learn what music people related to, and the best ways of interacting with individuals, and could modify their music sessions as a result. Learning by doing…

The researcher who received the Marsden on music for dementia patients is calling for the government to fund more research, saying he was lucky but lots of other researchers were not so lucky. But I wonder, do we want more research funded? Or do we want more doing, where we already know enough of the answers to act?