By Chris Bullen
The Government Policy Statement on Health Government Policy Statement on Health 2024–2027 | Ministry of Health NZ signals the Coalition Government’s priorities for health over the next few years. Included are some significant statements that, at first reading, seem surprisingly positive and give cause for hope:
“The Government is particularly focused on accelerating action to address five non-communicable diseases: cancer, cardiovascular disease, respiratory disease, diabetes and poor mental health…Improved prevention of these non-communicable diseases will be achieved through addressing five modifiable risk factors: alcohol, tobacco, poor nutrition, physical inactivity, and adverse social and environmental factors.”
Great rhetoric – but we know that these health risks are only going to be shifted in a healthy direction through bold actions by our political leaders, actions such as were recommended by countless reports on the harms of alcohol and on the marketing of unhealthy beverages and diets of children and so on. These reports all recommend the urgent need to impose evidence-based controls on access, marketing, labelling and pricing – but almost all have been dismissed by successive governments.
The one ray of hope where it seemed bold political leadership could be sustained was tobacco control, but that was extinguished when the world-leading Smokefree Environments and Regulated Products Amendment Act was hastily repealed in the coalition negotiations. So much for ‘accelerating action’.
The positive ‘public health’ rhetoric continues under the sub-heading “Partnering to respond to the broader determinants of health.”
“Social determinants and environmental factors such as education, employment, income, housing, transport and climate account for the majority of health loss, but when strengthened, these same factors also provide a significant opportunity to improve health outcomes. We will address the social determinants by partnering and influencing across sectors nationally and with communities at local and regional level.”
A commitment to what seems to be a health-in-all policies approach is heartening because it is fundamental to stemming the tide of widening health inequities and demand on the health system from many preventable diseases.
The Policy Statement continues the thread on the need for greater intersectoral collaboration to tackle the social determinants of health:
“This will involve taking stronger action at all levels of the health system. At a local community level, local planning processes can support actions to respond to local needs, including with Iwi-Māori Partnership Boards (IMPBs) where appropriate. At a regional level, this would be enabled through planning and collaboration between the health system and key regional roles, including Regional Public Service Commissioners. Nationally, work to improve the social determinants would be supported by cross-government strategies and actions, such as the Child and Youth Wellbeing Strategy and the Oranga Tamariki Action Plan, and policy development and commissioning that supports cross-government collaboration around broader social outcomes.
Local work will be important, and with their wider view of cross-sectoral action, IMPBs will likely insist on it. But changing the dial on many of the risks to health – tobacco, alcohol, food and nutrition, activity and environments – sits with national policymakers. My concern is that the Policy Statement pays lip service to the hard collaborative intersectoral work that this work would entail.
