Everyone knows that we are in a health funding crisis. We know it because we experience it. Everyone has their horror stories of waiting, waiting, and waiting: for doctor’s appointments, for specialist referrals, for medical procedures. If it was bad under the last Labour government, it is even worse under Christopher Luxon.
A key policy of the National-ACT-NZF coalition is to cut public services to fund tax cuts for the rich. They have already phased in tax cuts for residential landlords by allowing them to deduct interest payments from their earnings. They are now considering a cut in the Corporate Tax Rate in the next budget, even though it already stands at a historically low level of 28 percent.
Reports on the health crisis abound in the mainstream media. One, last July on RNZ, begins: “More cancer patients are waiting too long for potentially life-saving radiation treatment”. An example was given of a breast cancer patient who paid privately for a biopsy to avoid the 6-8 week wait to get diagnosed in the public system. She said: “If I had continued privately it was going to cost up to $80,000, so I opted to go back into the public system”. She waited 16 weeks for radiotherapy. “I was anxious for those 16 weeks – it’s cancer… When I put it to the radiologist why it was taking so long, he said he didn’t have an explanation for it, they were just short-staffed and that was it”. This example highlights how the under-resourcing of the public system pushes people to go private, yet only the well-off have the option.
Running the health service in crisis is proving to be a political hot potato. Controversial health decisions have been made which have stoked anger, such as the loosening of controls over tobacco. In January health minister Shane Reti was unceremoniously sacked and demoted, and the health portfolio handed over to Luxon loyalist Simeon Brown. Then in February Health New Zealand – Te Whatu Ora chief executive Margie Apa resigned.
On 18 February Consumer New Zealand reported on the findings of their Sentiment Tracker. Their headline finding was: “New Zealanders continue to grapple with financial uncertainty and growing concerns about healthcare services”. 39% of respondents cited healthcare as a key issue, up from 23% a year ago. Whilst Consumer New Zealand found health to be the second-biggest issue, a more recent poll by Horizons Research indicates that improving the health system has become voters’ first concern. This bad news for the Coalition is reflected in their standings in recent opinion polls. The left bloc has caught up with the right bloc, and is poised to overtake it.
The reasons for the public’s dissatisfaction are not hard to fathom. The public health service is fundamental to our wellbeing, and when we do interact with health staff we are treated splendidly with skill and care. There is a bond between ordinary working people as consumers and health workers who bear the effects of under-funding in being stressed-out and over-worked.
Organised action has ramped up pressure on the government. Since the Coalition came to power, there has been strike after strike by doctors, nurses, healthcare assistants, midwives and laboratory workers.
Back in May last year, junior doctors in the Resident Doctors’ Association held 25-hour and a 49-hour strikes. In that same month, and in June, blood laboratory workers in the Public Services Association took action leading to a pay rise being agreed.
On 3 December last year the New Zealand Nurses Organisation held an 8-hour strike over staffing levels and pay amongst its affected 36,000 members. The action was followed by rolling strikes, and the union is set to ballot for further strikes unless an improved offer is received.
Nurses and medical receptionists at Sexual Wellbeing Aotearoa (formerly Family Planning) voted to take strike action on 17 and 18 March. The threat won an improved offer and the action was called off.
After a two-day strike in February, the APEX union issued strike notices on 6 March to three private laboratory companies: Awanui, Pathlab and Medlab. At the time of writing, over 850 laboratory workers were set to carry out regional rolling strikes of at least 72 hours from 22 March.
Industrial action has forced the government into concessions. Militant unionism is a bulwark against the government’s freedom of action. The government and health service management have to reckon on the unions. Strikes are our most valuable weapon, but political action is also important. The resistance against cuts to the proposed hospital in Dunedin has been a thorn in this government’s side. Last September 36,000, a huge number, marched in Dunedin at the call of the Dunedin City Council.
In February this year there was a hīkoi in Whakatāne in protest against the closure of obstetrics and gynaecology services at the local hospital due to the lack of staff. The hīkoi’s spokesperson was Nándor Tánczos, a local councillor and former Green MP. He said the hīkoi “represented the community, with families, kaumātua and kuia, medical staff and midwives, and iwi and hapū all taking part”.
On 7 March the new Health Minister, Simeon Brown, addressed the BusinessNZ Health Forum. His most significant remarks were related to privatisation. He announced that he has asked Health New Zealand “to work with the private sector to agree on a set of principles that will underpin future outsourcing contracts”. He is calling for longer-term multi-year agreements for elective surgeries and: “Long term, I want as much planned care as possible to be delivered in partnership with the private sector, freeing public hospitals for acute needs”.
On the same day as Brown’s speech to business vultures, Chris Hipkins addressed another set of business people at the Auckland Business Chamber. Hipkins launched Labour’s priorities for the next general election, making health one of the three priorities for a Labour government, along with jobs and homes. This is, of course, opportunism by Labour, but at the same time it is a welcome step. Labour’s record in government in keeping a tight rein on health spending means that it has a scepticism hurdle to overcome. The party could dissipate some of that scepticism if it presented a credible financial plan for the transformative level of funding needed for health and other public services. The obvious plan would be to tax the rich. Unless Labour adopts such a plan it will be pilloried with the charge that its spending promises are unfunded. Unfortunately, Hipkins made no reference to taxing the rich in his speech. In fact, Hipkins defended bipartisanship, saying that a Labour government under his watch would not roll back the Coalition’s projects.
The health service crisis can be turned around, but passively waiting for a Labour-led government to deliver would be a mistake. It is good that Labour has prioritised health, but to hold them to meaningful change will need a massive build-up of pressure from below. More important than the colours of the governing parties is the readiness to struggle in the here and now. The health unions have already shown that industrial action can win concessions from a thoroughly reactionary government. We will need working-class unity in action – strikes and demonstrations – to fight for an adequately funded public health service and to fend off privatisation.
Image credit: Hospital Cuts Protest, Dunedin, New Zealand, Sat. 28 Sept. 2024 (CC BY 4.0 – Photo by Mark McGuire),
