Monique Jonas for Ki Te Pae Tawhiti, the NZ Health Reform Collective.
When newly elected National MP for Rangitata James Meager (Ngai Tahu) addressed the House last December, he spoke of his childhood in South Timaru. He described growing up in hardship and the challenges that he overcame to become Head Boy and Dux and qualify as a lawyer. Meager drew a lesson from his experiences: good outcomes come from hard work, families taking responsibility, and community support, not state intervention.[1]
Meager’s story exemplifies the master narrative of personal responsibility that the parties to the National-led Coalition Government campaigned on.[2] It was enshrined as a guiding value in the Coalition agreements, which promise to “restore national unity, and boost social cohesiveness, alongside the rights and responsibilities of being a New Zealand Citizen”.[3] The ideology of personal responsibility sits uneasily alongside a commitment to equity. Although Minister of Health Dr Shane Reti maintains that “we all want to address health inequities”[4] the Coalition Government’s actions in their first 100 days raise doubts about the seriousness of that commitment.
Some of the moves that appear most detrimental to equity were campaigned on and widely anticipated. The disestablishment of Te Aka Whai Ora (the Māori Health Authority) is a case in point. Te Aka Whai Ora was established in part to address inequities in health outcomes experienced by Māori across generations, recognising that “one-size-fits-all” approaches do not serve the needs of all, and can disadvantage Māori.[5] However the Coalition Government has set itself against “race-based policies” and embraced a mantra of equal rights (and responsibilities) for all New Zealanders.[6] Te Aka Whai Ora appears to have been doomed by its mission to enable Māori to enact Māori health aspirations rather than by its results, which arguably could not yet be properly judged. The abandonment of Te Aka Whai Ora is the first in what is likely to be a pattern of health policy calls that favour services designed “for all New Zealanders” over those that aim to meet the needs of underserved communities. Given that the inequities experienced by Tangata Whenua and priority groups within Tangata Tiriti, such as Pacific Peoples, have emerged under regimes of largely “mainstream” health services, it is difficult to see how health inequities will be addressed, let alone reduced, under such an approach.
The Coalition partners also broadcast their intention to repeal the Fair Pay Agreement Act 2023 before its inclusion in the Government’s 100-day plan. Fair Pay agreements enabled cross-sector bargaining to increase workforce power to negotiate with employers. Their introduction was viewed as likely to relieve entrenched low pay and poor working conditions.[7] Sectoral bargaining has been found to reduce pay disparities for women and people of colour.[8] As a 2015 International Monetary Fund analysis traced New Zealand’s rising inequality since the 1980’s to a diminution of collective bargaining via unions, Fair Pay Agreements were a promising equity measure.[9] ACT’s Brooke Van Velden, the Minister for Workplace Relations and Safety, made it clear to Parliament that her Government’s concerns were not with income inequalities and low-income workers: “We are doing this bill to send a clear signal to businesses that this Government understands the pressures that businesses have faced.”[10]
Other actions taken in the first 100 days were less expected and strengthened the impression of many that the Coalition Government’s strongest loyalties lie with business, not communities facing disadvantage. Their repeal under urgency of celebrated, recently introduced tobacco control measures has been called immoral and prompted disbelief, anger and questions about how the tobacco industry stands to benefit and their influence on government policy.[11] The repealed measures were expected to reduce smoking rates in 2025 to 7.3% for Māori and 2.7% for non-Māori (from 31.8% and 11.8% respectively in 2022) and substantially lessen all-cause mortality gaps between Māori and non-Māori.[12] New Zealand First MP Casey Costello, who spearheaded the repeal, has faced scrutiny over her links with the tobacco industry, her use of notes that evoke tobacco industry talking points and her reasons for slowing down progress towards a smokefree future.[13] Health Coalition Aotearoa co-chairperson Boyd Swinburn has likened her to a “minister for the tobacco industry.”[14] The Government faces two Waitangi Tribunal claims about their policy’s lack of consultation with Māori and expected increased loss of Māori lives.[15] Pacific peoples, who bear a disproportionate share of smoking harms, also stand to lose from the Coalition Government’s moves to slow down achievement of smokefree goals.[16] Finance Minister Nicola Willis conceded that the Coalition Government would use the billion dollars of projected additional excise tax from more smoking to deliver National’s promised tax cuts, prompting health leader Sir Collin Tukuitonga to observe that “Māori and Pacific people are going to pay for the price of tax cuts.” [17]
The Government’s first 100 days have seen it defund section 27 cultural reports, which provide information for sentencing judges about an offender’s background, support systems, and efforts to address their offending. New Zealand Law Society President Frazer Barton said that the reports were designed to support equitable sentencing and called the removal of funding tantamount to a “racial weapon” which would reduce access to justice for those without the means to pay.[18] In a paper presented to the Cabinet 100 Day Plan Committee, the Office of the Minister of Justice recognised that defunding cultural reports would disproportionately affect Māori and Pacific peoples, including families of offenders and Māori who had been in State care.[19] However, the Legal Services Amendment Bill was still passed under urgency, without consultation with Māori as Treaty partners, or other affected groups, including victims of crime.
The Government has used urgency to link changes in benefit rates to inflation.[20] This undoes Labour’s tethering of benefits to wage growth, designed to improve the standard of living for the least well off and address child poverty. Whilst this is anticipated to yield a slightly higher benefit rate in the short term, ultimately it will lead to significantly lower benefit levels. Ministry of Social Development and Treasury analysis indicates that women, people living with disability, Māori and Pacific peoples will be disproportionately affected by the reduction in benefit entitlements.[21] Relief of child poverty, which Prime Minister Luxon committed to during the election, will also be set back.[22]
In his 2023 speech to the National Party Conference, Christopher Luxon, then in opposition, reminded delegates that “Governments are defined by their priorities.”[23] Now Prime Minister, Luxon has described his Coalition Government’s achievements in their first 100 days as “kick-arse.”[24] The priorities that have defined Luxon’s Government thus far could be described as anti-equity. Those who are feeling the Government’s kicks most acutely are Māori, children like James Meager growing up in poor households, those hoping that collective action could lift them out of low incomes, and those who have experienced tobacco harm first hand.
As we look out to the next 100 days, more troubling prospects for health equity lie ahead. The lunch programme for schools facing the largest socioeconomic challenges is set for review.[25] Increased “check ins” and use of sanctions for job seeker allowance recipients have been announced.[26] Government-funded discounts for young people to use public transport will cease.[27] The Arms Act has been set for review with an eye towards liberalisation, despite the concerns of the Muslim community.[28] Equity seems to be a commitment that this Government intends to honour more in the breach than in the observance.
[1][1] https://www.parliament.nz/en/pb/hansard-debates/rhr/combined/HansDeb_20231206_20231206_44
[2] https://twitter.com/dbseymour/status/1667273232150581248; https://www.1news.co.nz/2023/03/24/winston-peters-nz-first-would-remove-maori-names-from-govt-depts/; https://www.national.org.nz/speech_to_the_87th_national_party_conference_real_consequences_for_crime
[3] https://assets.nationbuilder.com/nationalparty/pages/18466/attachments/original/1700778592/National_ACT_Agreement.pdf?1700778592
[4] https://www.parliament.nz/en/pb/hansard-debates/rhr/combined/HansD_20240227_20240228
[5] https://www.health.govt.nz/system/files/documents/publications/h-and-d-full-interim-report-august-2019.pdf; https://forms.justice.govt.nz/search/Documents/WT/wt_DOC_195476216/Hauora%202023%20W.pdf; https://www.health.govt.nz/system/files/documents/publications/new-zealand-health-strategy-oct23.pdf
[6] https://www.nzherald.co.nz/nz/act-promises-colourblind-health-system-including-scrapping-prioritised-surgical-waitlists-for-maori/YV3SNMSULBDMHCPFOBMJ3A3O6Q/#:~:text=Act%20leader%20David%20Seymour%20yesterday,assign%20care%20based%20on%20ethnicity.
[7] https://www.americanprogress.org/article/lessons-from-new-zealands-new-sectoral-bargaining-law/
[8] https://www.americanprogressaction.org/article/combating-pay-gaps-unions-expanded-collective-bargaining/
[9] Florence Jaumotte and Carolina Osorio Buitron, “Inequality and Labor Market Institutions” (Washington: International Monetary Fund, 2015), figure 7, available at https://www.imf.org/external/pubs/ft/sdn/2015/sdn1514.pdf. Cited in
https://www.americanprogress.org/article/lessons-from-new-zealands-new-sectoral-bargaining-law/
[10] https://www.parliament.nz/en/pb/hansard-debates/rhr/combined/HansDeb_20231212_20231213_40
[11] https://www.healthcoalition.org.nz/smokefree-law-repeal-immoral-105-organisations-sign-open-letter-to-luxon-peters-seymour-reti-and-willis/
[12] https://tobaccocontrol.bmj.com/content/early/2023/01/10/tc-2022-057655
[13] https://www.stuff.co.nz/politics/350193128/officials-urged-associate-health-minister-casey-costello-retain-parts-smokefree; https://www.rnz.co.nz/news/political/508224/casey-costello-says-she-s-done-nothing-wrong-in-tobacco-excise-tax-saga
[14] https://www.rnz.co.nz/news/political/507522/health-advocates-opposition-slam-associate-health-minister-casey-costello-s-proposed-tax-freeze; https://thespinoff.co.nz/the-bulletin/02-02-2024/the-curious-case-of-casey-costello-and-the-tobacco-taxes; https://www.parliament.nz/en/pb/hansard-debates/rhr/combined/HansDeb_20240227_20240228_28; https://www.phcc.org.nz/briefing/tobacco-industry-interference-new-government-meeting-its-international-obligations
[15] https://www.rnz.co.nz/news/national/508034/government-s-smokefree-changes-show-clear-breach-of-treaty-maori-health-experts; https://www.1news.co.nz/2024/02/04/govt-faces-another-waitangi-tribunal-claim-over-smokefree-legislation/
[16] https://www.smokefree.org.nz/smoking-its-effects/facts-figures#bookmark-2
[17] https://www.newshub.co.nz/home/politics/2023/11/nicola-willis-admits-scrapping-smokefree-laws-will-help-fund-tax-cuts-in-newshub-nation-interview.html; https://www.nzherald.co.nz/talanoa/top-pasifika-doctor-sir-collin-tukuitonga-slams-plans-to-repeal-smokefree-laws-says-most-vulnerable-will-suffer/USONMCETMJATXB5H2PQGISVIBQ/
[18] https://www.stuff.co.nz/nz-news/350172976/law-society-condemns-government-proposal-significant-breach-fundamental-rights; https://www.auckland.ac.nz/en/news/2023/08/22/cultural-reports-university-auckland-law.html
[19] https://www.justice.govt.nz/assets/Documents/Publications/Proactive-release-Legal-Services-Amendment-Bill_FINAL.pdf; https://newsroom.co.nz/2024/02/28/goldsmith-says-nixing-cultural-reports-likely-to-put-more-maori-in-prison/
[20] https://www.parliament.nz/en/pb/hansard-debates/rhr/combined/HansDeb_20240213_20240214_08
[21] https://www.treasury.govt.nz/sites/default/files/2024-02/sar-msd-imbi-jan24.pdf
[22] https://www.cpag.org.nz/media-releases/cpag-pm-luxon-on-track-to-break-election-promise-on-child-poverty
[23]https://www.national.org.nz/speech_to_the_87th_national_party_conference_real_consequences_for_crime
[24] https://www.nzherald.co.nz/nz/politics/christopher-luxons-tone-problem-resurfaces-over-change-to-coalition-tax-deal-audrey-young/N6VQYJPQQBB4XDFEOOFLR4F37E/
[25] https://thespinoff.co.nz/kai/06-03-2024/who-gets-free-school-lunches-what-are-they-eating-and-whats-the-cost
[26] https://www.rnz.co.nz/news/political/509590/benefit-sanctions-to-ramp-up-with-work-check-ins-minister-louise-upston
[27] https://www.1news.co.nz/2024/03/09/govt-axes-kids-youth-public-transport-discounts-funding/
[28] https://www.rnz.co.nz/news/political/511798/watch-christopher-luxon-speaks-on-anniversary-of-mosque-attacks; https://www.1news.co.nz/2024/02/28/semi-automatic-weapons-on-the-table-in-shake-up-of-gun-laws/
100 “Kick-Arse” days in Government: implications for equity.
Monique Jonas for Ki Te Pae Tawhiti, the NZ Health Reform Collective
When newly elected National MP for Rangitata James Meager (Ngai Tahu) addressed the House last December, he spoke of his childhood in South Timaru. He described growing up in hardship and the challenges that he overcame to become Head Boy and Dux and qualify as a lawyer. Meager drew a lesson from his experiences: good outcomes come from hard work, families taking responsibility, and community support, not state intervention.
Meager’s story exemplifies the master narrative of personal responsibility that the parties to the National-led Coalition Government campaigned on. It was enshrined as a guiding value in the Coalition agreements, which promise to “restore national unity, and boost social cohesiveness, alongside the rights and responsibilities of being a New Zealand Citizen”. The ideology of personal responsibility sits uneasily alongside a commitment to equity. Although Minister of Health Dr Shane Reti maintains that “we all want to address health inequities” the Coalition Government’s actions in their first 100 days raise doubts about the seriousness of that commitment.
Some of the moves that appear most detrimental to equity were campaigned on and widely anticipated. The disestablishment of Te Aka Whai Ora (the Māori Health Authority) is a case in point. Te Aka Whai Ora was established in part to address inequities in health outcomes experienced by Māori across generations, recognising that “one-size-fits-all” approaches do not serve the needs of all, and can disadvantage Māori. However the Coalition Government has set itself against “race-based policies” and embraced a mantra of equal rights (and responsibilities) for all New Zealanders. Te Aka Whai Ora appears to have been doomed by its mission to enable Māori to enact Māori health aspirations rather than by its results, which arguably could not yet be properly judged. The abandonment of Te Aka Whai Ora is the first in what is likely to be a pattern of health policy calls that favour services designed “for all New Zealanders” over those that aim to meet the needs of underserved communities. Given that the inequities experienced by Tangata Whenua and priority groups within Tangata Tiriti, such as Pacific Peoples, have emerged under regimes of largely “mainstream” health services, it is difficult to see how health inequities will be addressed, let alone reduced, under such an approach.
The Coalition partners also broadcast their intention to repeal the Fair Pay Agreement Act 2023 before its inclusion in the Government’s 100-day plan. Fair Pay agreements enabled cross-sector bargaining to increase workforce power to negotiate with employers. Their introduction was viewed as likely to relieve entrenched low pay and poor working conditions. Sectoral bargaining has been found to reduce pay disparities for women and people of colour. As a 2015 International Monetary Fund analysis traced New Zealand’s rising inequality since the 1980’s to a diminution of collective bargaining via unions, Fair Pay Agreements were a promising equity measure. ACT’s Brooke Van Velden, the Minister for Workplace Relations and Safety, made it clear to Parliament that her Government’s concerns were not with income inequalities and low-income workers: “We are doing this bill to send a clear signal to businesses that this Government understands the pressures that businesses have faced.”
Other actions taken in the first 100 days were less expected and strengthened the impression of many that the Coalition Government’s strongest loyalties lie with business, not communities facing disadvantage. Their repeal under urgency of celebrated, recently introduced tobacco control measures has been called immoral and prompted disbelief, anger and questions about how the tobacco industry stands to benefit and their influence on government policy. The repealed measures were expected to reduce smoking rates in 2025 to 7.3% for Māori and 2.7% for non-Māori (from 31.8% and 11.8% respectively in 2022) and substantially lessen all-cause mortality gaps between Māori and non-Māori. New Zealand First MP Casey Costello, who spearheaded the repeal, has faced scrutiny over her links with the tobacco industry, her use of notes that evoke tobacco industry talking points and her reasons for slowing down progress towards a smokefree future. Health Coalition Aotearoa co-chairperson Boyd Swinburn has likened her to a “minister for the tobacco industry.” The Government faces two Waitangi Tribunal claims about their policy’s lack of consultation with Māori and expected increased loss of Māori lives. Pacific peoples, who bear a disproportionate share of smoking harms, also stand to lose from the Coalition Government’s moves to slow down achievement of smokefree goals. Finance Minister Nicola Willis conceded that the Coalition Government would use the billion dollars of projected additional excise tax from more smoking to deliver National’s promised tax cuts, prompting health leader Sir Collin Tukuitonga to observe that “Māori and Pacific people are going to pay for the price of tax cuts.”
The Government’s first 100 days have seen it defund section 27 cultural reports, which provide information for sentencing judges about an offender’s background, support systems, and efforts to address their offending. New Zealand Law Society President Frazer Barton said that the reports were designed to support equitable sentencing and called the removal of funding tantamount to a “racial weapon” which would reduce access to justice for those without the means to pay. In a paper presented to the Cabinet 100 Day Plan Committee, the Office of the Minister of Justice recognised that defunding cultural reports would disproportionately affect Māori and Pacific peoples, including families of offenders and Māori who had been in State care. However, the Legal Services Amendment Bill was still passed under urgency, without consultation with Māori as Treaty partners, or other affected groups, including victims of crime.
The Government has used urgency to link changes in benefit rates to inflation. This undoes Labour’s tethering of benefits to wage growth, designed to improve the standard of living for the least well off and address child poverty. Whilst this is anticipated to yield a slightly higher benefit rate in the short term, ultimately it will lead to significantly lower benefit levels. Ministry of Social Development and Treasury analysis indicates that women, people living with disability, Māori and Pacific peoples will be disproportionately affected by the reduction in benefit entitlements. Relief of child poverty, which Prime Minister Luxon committed to during the election, will also be set back.
In his 2023 speech to the National Party Conference, Christopher Luxon, then in opposition, reminded delegates that “Governments are defined by their priorities.” Now Prime Minister, Luxon has described his Coalition Government’s achievements in their first 100 days as “kick-arse.” The priorities that have defined Luxon’s Government thus far could be described as anti-equity. Those who are feeling the Government’s kicks most acutely are Māori, children like James Meager growing up in poor households, those hoping that collective action could lift them out of low incomes, and those who have experienced tobacco harm first hand.
As we look out to the next 100 days, more troubling prospects for health equity lie ahead. The lunch programme for schools facing the largest socioeconomic challenges is set for review. Increased “check ins” and use of sanctions for job seeker allowance recipients have been announced. Government-funded discounts for young people to use public transport will cease. The Arms Act has been set for review with an eye towards liberalisation, despite the concerns of the Muslim community. Equity seems to be a commitment that this Government intends to honour more in the breach than in the observance.