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Health fares poorly in Aotearoa/New Zealand election campaign

As Australians head to a referendum vote this weekend, an election will also be taking place in Aotearoa/New Zealand.

Alison Barrett reports on the health issues at stake, as well as some cautionary messages for the next Federal election in Australia.


Alison Barrett writes:

The election campaign in Aotearoa/New Zealand has been marked by “overt and shameless racism” and a lack of focus on critical public health issues including the climate health crisis, according to health leaders.

Gains in Māori health are also at risk, with National, ACT and NZ First parties planning to scrap the Te Aka Whai Ora/Māori Health Authority if they form government.

Health system reform and health workforce shortages have been the key health concerns in focus during the election campaign.

Dr Dermot Coffey, co-covenor of OraTaiao: The New Zealand Climate and Health Council, said the lack of focus on public health issues throughout the campaign was a “failure by the major parties and the media”.

“I have yet to hear health spokespeople being quizzed on their respective party’s social or climate policies, which would have a much larger impact on population health than promises of improved funding in secondary care,” Coffey said.

Emma Rawson-Te Patu, President-elect of the World Federation of Public Health Associations and Director of ManuKahu Associates Limited, echoed these sentiments. She told Croakey that mainstream media and politicians have not generally focused on public health concerns.

Racism

The election campaign has been dominated by racism and race-baiting, according to Rawson-Te Patu and Coffey.

Three of the major parties, who on present polling are most likely to form the next government – National, ACT and NZ First – have repeatedly used perceptions of Māori advantage to appeal to a sadly sizeable sector of the Pākehā population who are seemingly ignorant of their own privileges, Coffey said.

These have included statements that are false (“Māori are not Indigenous,” according to the leader of NZ First), worrisome (ACT suggesting a referendum on Te Tiriti o Waitangi would be a bottom line for them in any coalition negotiations), and dangerous, according to Coffey.

“This is the seventh consecutive election for which I have been in New Zealand, and it is the one that has had by far the most overt and shameless racism on display,” Coffey said.

Dominic O’Sullivan, Adjunct Professor at Auckland University of Technology and Professor of Political Science at Charles Sturt University, echoed these sentiments in a recent article published by The Conversation.

He pointed to a few examples of racism in the election campaign including vandalism of campaign billboards for te Pati Māori (the Māori Party), inappropriate comments about the Ministry for Pacific Peoples and angry shouts when Labour MP Willow-Jean Prime spoke some Māori words at a campaign debate.

O’Sullivan highlighted similarities between claims of “division by race” in the Aotearoa election and Australia’s Voice to Parliament referendum campaigns.

The race-baiting electioneering “takes the focus off actually addressing the actual needs and system failures”, and also feeds into a “general lack of understanding about the upstream determinants of health and how we need to move as a nation to address those,” Rawson-Te Patu told Croakey.

According to recent polls, it appears a coalition of the National, Association of Consumers and Taxpayers (ACT) and NZ First parties could form the new government, with a swing away from centre-left Labour coalition.

Māori health outcomes at risk

One of the biggest threats to improving Māori health outcomes is the National, ACT and NZ First parties’ plans to introduce legislation to scrap the Te Aka Whai Ora/Māori Health Authority if they form government.

Coffey told Croakey that shutting and subsuming Te Aka Whai Ora into the wider Health New Zealand structure “would be a hugely retrograde step”.

Health Coalition Aotearoa – a group of health professors and organisations – urged all parties to retain Te Aka Whai Ora, which was only established in 2022, as a Māori-led, independent agency.

“Policies to scrap the entity – after just over one year in existence – are politically-motivated, without the regard for the years of evidence, planning and collaboration that underpin it,” HCA board member Grant Berghan (Ngāpuhi, Ngātiwai and Te Rarawa Iwi) said in a statement.

“Stop playing party politics with our people’s health. It will take 20 years to turn back the damage this will do.”

HCA co-chair Dr Lisa Te Morenga (Ngāti Whātua Ōrākei, Te Uri o Hua, Ngāpuhi and Te Rarawa) added that “Te Aka Whai Ora has real decision-making power and this creates a stronger platform to have our voices heard and acted on”.

Climate and health

Discussions about climate and health have been absent throughout the election campaign, according to Rawson Te-Patu and Coffey.

In a separate statement, co-convenor of OraTaiao Summer Wright said: “The side-lining of the climate as ‘just another topic’ during this election campaign – and the failure to highlight how it interweaves with wider social issues – is seen most starkly with respect to health.

“The overall message from our scorecard [below] is that politicians still fail to recognise the health risks of climate change, and lack commitment to optimise the health and equity gains from well-designed and Te Tiriti-centred climate action.”

Coffey told Croakey that two of the bigger minor parties (te Pati Māori and The Opportunities Party) lacked capacity to respond to OraTaiao’s questions about the election and were left out of the analysis.

“The utter lack of discussion and ambition on climate policy has been embarrassing, with the important exceptions of the Green Party [currently polling in the low teens) and Te Pati Māori [in the low single digits),” Coffey told Croakey.

Coffey pointed to two examples of lacking climate ambition – one, during a debate between the Labour and National parties, the two leaders “offered up the pathetic example of doing the recycling as their personal contribution to climate mitigation”.

RNZ’s climate change correspondent Eloise Gibson said this showed the two leaders were poorly informed about climate action, which is one of the Public Health Association of New Zealand’s key election considerations.

PHA NZ calls on parties’ to prioritise emission reductions, waste minimisation, water source protection, disaster prevention and promote sustainable practices.

Source: OraTaiao: NZ Climate and Health Council, with permission

Mental health and workforce

Mental health is another significant area of concern, with demand for support increasing, according to Dr Hiran Thabrew, Chair of the RANZCP Tu Te Akaaka Roa, New Zealand National Committee.

“Whilst we welcome the health commitments announced by the National Party and Labour to boost the number of psychiatrists in the system to deliver the critical mental healthcare New Zealanders need, much more needs to be done to improve the current state of the crumbling mental health system in the country,” Thabrew told Croakey.

He cited inequitable access to timely and effective treatment and chronic workforce shortages as some of the barriers to accessing support.

Ongoing impacts of colonisation and harmful political, social and economic policies, as well as “stigmatisation within healthcare” compounded mental healthcare access for Māori people.

“An increase in funding is necessary if we are to have a sustainable, home-grown workforce and all the advantages that provides including an understanding of culturally appropriate services for Māori and Pacific Peoples, including supporting them to provide mental healthcare developed and delivered by them,” Thabrew said.

Similarly, the Australasian College for Emergency Medicine called on parties to commit to measures that may help restore NZ Emergency Departments and staff, including through the delivery and appropriate staffing of all mental health facilities pledged in the 2019 mental health budget package.

PHA NZ also call for more attention on mental health through reducing “structural and institutional policies that perpetuate discrimination”.

Investing in accessible and culturally sensitive mental health support should be a top priority, they said.

Lessons for Australia

Given Australia experiences many of the same stresses in the health sector as Aotearoa, Coffey said he expects health to be a major topic in our next Federal election.

He hopes that “Australian media can hold politicians to account by focusing on health in the broadest sense and the effect of their social and climate policies on population health”.

Thabrew told Croakey that the incoming NZ Government “has an opportunity to set an example for Australia, a country similar in many respects and battling similar workforce challenges in their mental health infrastructure, by investing in psychiatrists and mental health workforce to deliver the reform needed to cater to the increasing mental health challenges amongst our populations”.

Full statements

Read the full statements in response to Croakey’s questions below.

Statement by Australasian College for Emergency Medicine

Statement by Dr Dermot Coffey,co-covenor of OraTaiao: The New Zealand Climate and Health Council

Statement by Emma Rawson-Te Patu, President-elect of the World Federation of Public Health Associations and Director of ManuKahu Associates Limited

Statement by Dr Hiran Thabrew, Chair of the RANZCP Tu Te Akaaka Roa, New Zealand National Committee. RANZCP’s full election platform can be read here.

From Twitter

Read the article here.

Read RACP’s election priorities here.

Read the article here.


See Croakey’s archive of articles on climate and health.

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