New Zealanders were social distancing long before Covid.
ANALYSIS:
“Social distance” is one of several terms - “lockdowns”, “masking-up”, and “bubbles” are others - that entered everyday language as part of the Covid-19 pandemic.
But New Zealand experienced ‘social distancing’ of a different kind well before Covid-19: the clustering of the well-off and the marginalised in very different social worlds.
In recent years, perhaps particularly because of the longstanding effects of the global financial crisis, there has been growing concern about this form of social distancing.
Analysis by Max Rashbrooke and Peter Skilling of data from the International Social Survey Programme shows the last couple of decades have seen increasing anxiety about inequality, conflict between economically defined groups, and fairness.
In the 2020 survey results 73 per cent of people polled in New Zealand considered income differences were “too large”. This had risen from 63 per cent in 2009, after a period between 1992 and 2009 - in the aftermath of the values shift engineered by the 1980s - when the public had seemed less concerned about the size of income differences.
There was also a surge between 2009 and 2020 in people who believed there were “intense conflicts between poor people and rich people” (up to 37 per cent from 33 per cent in 2009), “intense conflicts between the working class and middle class” (up to 19 per cent from 11 per cent in 2009), and “intense conflicts between management and workers” (up to 33 per cent from 23 per cent in 2009).
Measurements of perception should sometimes be treated with caution: for example, recent commentary drawing out public concern about crime does not align with evidence that youth crime has declined since 2014.
But perception of entrenched economic difference is grounded in sound evidence that class is a significant feature in contemporary New Zealand society, as demonstrated by Rashbrooke’s book, Too Much Money.
Rashbrooke shows elite wealth became settled soon after early waves of British colonisation: by 1893, for example, 1 per cent of New Zealanders owned 65 per cent of all assets. He traces a “U-shaped story” of wealth inequality in New Zealand: wealth inequality dropped between 1930 and 1980, before rising to a point where 1 per cent of New Zealanders held a 25 per cent share of all wealth by 2018.
Stuart Hall writes that “race is the modality through which class is lived”, and class bigotry and racial prejudice can operate in interlocking ways. As a result, while racism can operate independently of class prejudice, class tends to have a racial pattern in this country.
The way our society is structured in its approach to gender, disability, sexuality and gender identity is also a driver of disadvantage - and shapes our socially distanced community.
For example, persistent inadequate social welfare support has left 29 per cent of New Zealand sole parent households (predominantly sole mothers) in material hardship, compared to 19 per cent of equivalent households in the European Union, according to the latest Ministry of Social Development child poverty report. That hardship too often limits the ability of these households to participate as fully as others in society, despite these sole parents’ resourceful efforts to raise their families in constrained conditions.
It is inevitable that people find their own groupings within a bigger country and world: bonding around common cultural backgrounds and experience is comforting, nurturing, even empowering. What’s damaging is when different social worlds are tied more tightly to advantage and disadvantage, when these different social worlds are slotted into a hierarchy of power, and when the distance between those worlds grows so great as to tear apart any sense of shared society or social fabric.
So what can be done about this form of damaging social distancing that predated the pandemic?
There is no silver bullet or single solution, but universal services are one way to rebuild community, cohesion, and common experience.
Universal services are what we are meant to have in education, healthcare, and our libraries: services that are free to all, controlled by the public, without pressure to profit. That’s why we can go to primary school and high school for free, don’t pay for hospital visits, and get out books for free at our local library. These services aren’t means-tested: they’re provided to all of us, even though the wealthier among us might be able to fund their own schooling or private healthcare or books.
Of course the reality is that there are holes in these supposedly universal services. Uniform costs and GP fees are examples where costs have crept into these services.
But, creeping costs aside, public education, public healthcare, and public libraries are services that bring us together. In public schools we learn how to live in a community. In public healthcare facilities we recognise the value of pooling collective resources to respond to need. In public libraries we share books through a community and encounter each other in a shared space.
A 2017 report by UK-based economists used the term “universal basic services” to propose expanded provision of healthcare, education, legal services, shelter, food, transport, and information. At a time when state capacity was being rebuilt in the aftermath of the global financial crisis, the phrase was coined as a counterpoint to “universal basic income” proposals, which involve a greater focus on transfers to individuals.
Since then campaigners and activists have used the term more vocally, with the New Zealand Public Services Association launching a “universal basic services” campaign ahead of the 2020 New Zealand election, and Auckland Action Against Poverty calling for “universal services” as part of ongoing campaigning.
At the core of the 2017 report on universal basic services is the claim that expanding the frontiers of services provided for free could address social division. Professor Henrietta Moore, in her foreword to the report, argues that universal basic services “will make accessible a life that includes participation, builds belonging and common purpose and potentially strengthens the cohesion of society as a whole”.
It stands to good reason that expanding universal services - bringing dental into the public healthcare system, for example, or removing GP fees, or making public transport fares-free - could help to build back community.
First, removing the cost of essential services frees up resources for greater involvement in community life. The recent Ministry of Social Development Child Poverty Report notes that “half the children in households in material hardship come from... working households”: in other words, New Zealand faces significant in-work poverty, where work is not paying enough to lift people out of hardship. Delivering in-kind transfers, like free dental, can increase disposable income, enabling money to be spent on going to the movies or on an outing to the beach, and reducing the need for indebtedness and the shame that sometimes comes with it.
Second, as James Belich and Louise Humpage have discussed, delivering services universally rather than in a means-tested way may secure greater political buy-in and solidarity, since middle class people and others are also able to benefit from a service. Means-tested services, limited to those most in need (such as legal aid or income support), may more easily lose political support since some may (wrongly) find it hard to imagine that they might rely on that service over the course of a lifetime. Universal services also eliminate the stigma - and bureaucracy - of means-testing.
Third, at the level of values, universal services involve taking some things out of the market: in the words of another 2019 UK report on universal basic services, recognising that some things are too important to be left to the market. This can make dental or transport, for example, less of a commodity: it’s a way of decommodifying these services. Shrinking the space in our society in which market values (like competition and individualism) dominate can itself rebuild community. At the same time, universal services can help us to reclaim social mobility as a collective, and not merely an individual, value. Through universal services like expanded public education we can do more than lift single individuals out of poverty; we can ensure entire groups of people are lifted up in what we are able to do and achieve.
Of course, there are still other barriers to accessing services, beyond cost. Institutional racism might discourage people from using the public healthcare system. So the “universal” in “universal services” shouldn’t be romanticised; it is also important that recent migrants are not carved out of access to these services, as has happened in the past.
In Aotearoa New Zealand, the state also needs to be put in its proper place, guided by Te Tiriti o Waitangi. Article two of Te Tiriti, with its protection of tino rangatiratanga, may require Māori delivery and control of services alongside the Government, operating in its own sphere. Public health expert Michael Marmot has outlined a vision of “proportionate universalism”, which makes clear that universal services can sit alongside other targeted interventions - in our context that might mean adapting universal services to include distinct, Te Tiriti-consistent approaches for Māori.
Finally, it is true that universal basic services come at a cost, usually out of general taxation. But that cost should always be weighed against the benefit of avoiding downstream harms that might come from leaving people to fund their own dental care, or transport costs, for example. It might be a price well worth paying for raising the floor of basic social protections, and reducing underlying social divisions.
So what’s an example of how universal services might be expanded? Recent weeks have seen further calls for universal dental, bringing dental within the public healthcare system, following the release of a report by the Association of Salaried Medical Specialists (ASMS), Tooth Be Told: The Case for Universal Dental Care in Aotearoa New Zealand.
The report notes that New Zealand has the highest unmet need for adult dental care among 11 comparable countries in 2020, and that 40 per cent of adults cannot afford dental care. It points out that the Government has extended dental coverage from a $300 emergency special needs grant to $1000 worth of coverage, but that this was long overdue with the grant not having increased since 1999. The right approach, the report says, is a universal approach to dental care, along with a dental workforce plan, better oral health training for medical students, and improved data collection on oral health.
I called Brooke Stanley Pao, co-ordinator for Auckland Action Against Poverty, who has long advocated for free dental care as part of an expansion of universal services. Pao said the current position was untenable: “a whole portion of our community and our society can’t access dental because they can’t afford it”. “Is this the kind of society we want to build in Aotearoa?” she asked. What’s important about universal services, Pao went on, is that they “say something about the care that we are owed and that we are all owed because we are human”. But we’ll have to fight for it, Pao said: “If we want these things, we have to work together to demand them.”
I also spoke to Dr Hugh Trengrove, a publicly funded Auckland-based dentist, employed by Te Whatu Ora, who backed the report at its launch last month. From a health perspective, he referred to the range of flow-on consequences of poor dental health: pain and disruption in day-to-day life, an inability to eat, discomfort and disruption of sleep, even ICU treatment and death in extreme circumstances. The World Health Organisation recently confirmed the links between poor oral health and other chronic diseases in a report backing universal coverage for oral health.
Trengrove acknowledged that bringing dental care into the public health system would have a cost. Costings have estimated between $600 million and $1.5 billion for the move: still only an annual cost that amounts to 1.2–3 per cent of the Government’s Covid Response and Recovery Fund.
But “nobody’s taking a health and a social perspective”, said Trengrove. “For every dollar invested in oral health there’s a $1.60 return,” he added, and even more of a return in terms of downstream wellbeing. He ended on a similar note to Pao, highlighting that this was about values and what we can expect as human beings as part of a good life. With a thoughtful and planned approach to universal dental, he told me, you “start to change the social fabric, because people have opportunities that they otherwise wouldn’t have”. “It’s a small step down the pathway,” he observed, “of saying we value you as a human being.”
Social division in this country won’t disappear overnight. Addressing the root causes of deep-seated social distancing - which include colonisation and capitalism - will take time and effort. But universal services may be one move - what Hugh Trengrove called a “small step down the pathway” - to a different kind of society. Universal dental is just one example of that approach in practice, but an approach that may well be necessary and even popular as we edge towards election year 2023.
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