The desecration of public health
We might have a new Minister of Health, but the same destructive approach remains. A focus on easily measurable targets while concurrently dismantling preventative measures, gutting public health, and a refusal to adequately fund health services, resulting in unsafe staffing levels, broken-down health infrastructure, and general feelings of ill-will and frustration towards the government gambling with our nations health.
We need a radically different approach to health. The neoliberal, capitalist approach reduces us down to the bare minimum that is physically required for economic productivity, before discarding us entirely.
I think of the influx of colonial settlers to Aotearoa in the 1800’s and 1900’s, who were desperate to escape the grinding poverty of England and hoping to build a new life in the antipodes, away from the workhouses, slums, and poor health endemic in the cities - the very conditions this government seems hellbent on recreating.
In contrast to the poor health of the general populace in England, the logbooks of various sea captains record their observations of pre-colonial Māori as being fit, healthy, and vibrant1. The average life expectancy of Māori was consistent with other parts of Europe - and better than in most parts of Asia.
Captain Cook observed in the 1770’s2:
They [Māori] are also exceedingly vigorous and active. Their teeth are extremely regular and as white as ivory ... they seem to enjoy high health and we saw many who appeared to be of a great age.
Captain Cook's botanist, Joseph Banks, wrote3:
A further proof, and not a weak one, of the sound health that these people enjoy, may be taken from the number of old people that we saw … who, if we may judge by their grey hairs and worn out teeth, were of a very advanced age. Of these few or none were decrepit: the greater number seemed in vivacity and cheerfulness equal to the young, and indeed inferior to them in nothing but the want of equal strength and agility.
Māori knew what worked for the health and wellbeing of their people, had observed and implemented a range of public health measures across a raft of dimensions. What we could now call ‘holistic’ was a way of life.
In contrast, the concentration of wealth and land in the hands of a few, who then exploited both land and people to consolidate their wealth, had severely negative consequences for the English population. The response of the ruling class was to create workhouses, tut about slums and overcrowding, and scornfully dismiss those in poverty as lazy ignoramuses who contributed to their own demise.
Sound familiar?
At any rate, changing around the face of the Minister, without any actual meaningful change to policy or practice, is pointless tom-jiggery and an attempt to garner more positive press while simultaneously undermining our collective health.
Source: Durie, M. H., (1994), Whaiora: Māori Health Development, Oxford University Press, Auckland
Source: Rout, M., & Reid, J. (n.d.). Culturally determined Indigenous human needs. In Contemporary Research Division Series: Indigenous insights into human needs. Ngai Tahu Research Centre. Retrieved from https://www.canterbury.ac.nz/content/dam/uoc-main-site/documents/pdfs/reports/ntrc-contemporary-research-division/Indigenous-insights-into-human-needs.pdf
Source: Banks, J. (1896). Journal of the Right Hon. Sir Joseph Banks during Captain Cook’s first voyage in H.M.S. Endeavour in 1768–71 to Terra del Fuego, Otahite, New Zealand, Australia, the Dutch East Indies, etc. New York, NY: The Macmillan Company. As cited in Cram, F. (2014). Measuring Māori Wellbeing: A commentary. MAI Journal, 3(1), 18–32. https://www.journal.mai.ac.nz/system/files/MAI_Jrnl_V3_Iss1_Cram.pdf
Ngā mihi. The brief history lesson highlights just how massive was Dr Reti’s sellout - he abandoned every one of his claims to being a Christian, Māori Doctor out to do no harm, yeah right!
The deliberate defunding of our health service is a ticking time bomb, threatening to worsen health outcomes and create a two-tiered system. The goal? To redirect public funds into private providers pockets or push people into buying health insurance, essentially creating a queue-jumping privilege for those who can afford it.
Middle-income families who opt for insurance will face higher healthcare costs, while those who can't afford it - or choose to remain in the public system - will be left with a deliberately underfunded and inadequate system. This means poorer health outcomes, reduced mortality, and a healthcare system that's a mirror of the dreaded USA system, where it’s about profit not people. (Note: USA has the highest cost healthcare costs with the poorest health outcomes in the developed world - Commonwealth Fund report 2020).
But hey, health profiteers will be laughing themselves all the way to the bank, while everyday Kiwis suffer.
All NZers need to understand this.