Labour's Jacinda Ardern and National's Nikki Kaye on what can be done to improve New Zealand's health system.
JACINDA ARDERN
There's a reason why the Health portfolio in politics is considered a bit of a poisoned chalice. People get sick, and not all of it can be prevented. Now more than ever, health is becoming a much harder area to manage. We are essentially paying for a 1970s Mini and expecting a brand new Porsche, a reality we are yet to fully acknowledge, but expect the health sector to deal with on a day to day basis.
The same pressures that we face managing an impending boom in the number of supernatants are some of the same pressures we face in health. We have an aging population who are living longer. Couple that with the fact that health technologies have improved but are costing us more, and you have a perfect storm.
It won't surprise you that I disagree with the Government's current approach to health. Almost as soon as National came into power, the focus shifted away from preventative healthcare, the very thing that stops an illness from escalating from a cough, to respiratory issues, to a hospital admission, and instead focused on things like elective surgery targets. Of course, making sure waiting times are brought down is important, but a mere 1.3% of the health budget is spent on primary healthcare. It's no wonder then that 5000 children were admitted to hospital last year for avoidable conditions such as skin infections and respiratory illness.
Case in point: rheumatic fever. This is a third world issue; a sore throat that, if left untreated, can damage a young child's heart for life. We have an epidemic of rheumatic fever in parts of New Zealand. The first DHB to try and tackle this issue did so by squeezing money out of an already stretched budget, but saved the health system millions in the process. This is the kind of initiative that all DHBs should be properly supported to undertake but Instead, the government has created false hope by announcing a rheumatic fever prevention programme and then failed to fund it properly. An area like Counties Manukau, which has nearly half the cases of rheumatic fever, is receiving less than a third of the total funding.
True preventative healthcare cannot be seen in isolation; it also means addressing social deprivation. I remember hearing the story of a family where the father had lost his job. Both parents were struggling to support their family when they were struck down with a bout of scabies. They were unable to afford a doctor's visit until the infection meant the kids could no longer attend school. When they finally did scrape together enough for treatment, a lack of power meant they did not have hot water to wash their bedding and clothes and get rid of the infestation altogether.
There is no question that poverty and health are linked. Last year the Regional Public Health Unit in Wellington found, for instance, that a family on the minimum wage would need to spend 51% of their weekly income to put a healthy meal on the table. Addressing healthcare issues also means addressing the gap between rich and poor in New Zealand. Labour's focus on creating a fairer tax system; making the first $5,000 everyone earns tax free; raising the minimum wage to $15 an hour; and removing the GST off fresh fruit and vegetables: all of these will make a difference. But so will a greater focus on preventative healthcare.
You won't hear Tony Ryall stand up and acknowledge that there are limits to our health dollar though. In fact, instead of facing our limitations and having a fundamental look at where that dollar is best spent, the current Minister of Health seems more concerned with making false claims about the health budget, such as: "we're spending a record amount on health." The reality is that funding in the last two Budgets fell millions of dollars short of meeting the growth in population and costs for delivering our health services, leaving district health boards with a shortfall that can only be met through service cuts. It's time the Minister acknowledged that just like every other area, the health spend is all about priorities.
I make no apologies for the fact that Labour takes an end to end approach to healthcare, and that, of course, means our focus will also stay on the public system. But I also acknowledge that we have a private system in New Zealand, and we should not ignore that. That means leveraging off it where appropriate, but my bottom line is that I never want to see here what I saw in India, a man collapse outside of my hostel and the staff refuse to call for help because "who would pay?" No one's access to healthcare should be determined by their wealth, but nor should wealth determine a person's wellness and, currently in New Zealand, there's no denying that it does.
If we want a health system where the dollar goes a little further and where people are supported and can take charge of their own health and wellbeing, we have to look at the bigger picture. Let's start with the basics and, maybe one day, health won't be that poisoned chalice.
Jacinda Ardern is on Facebook and Twitter @jacindaardern
NIKKI KAYE
