Hospitals too valuable to politicise

LAST week’s Government announcement that $224 million is to be spent upgrading Whangarei and North Shore hospitals highlighted the use of healthcare as a political weapon.

Both hospitals are deemed to be in dire need of investment and few New Zealanders would see the announcement as anything other than necessary.

For a government frequently scolded for farming out decisions to working groups, decisive announcements like this should be applauded. It is unfortunate, though entirely predictable, that such announcements always seem to come with associated insults directed at previous governments, a trait as true of the last administration as of this one.

Prime Minister Jacinda Ardern said the new money would ‘‘make a real difference to patients and their families and to staff working at the frontline after years of underfunding of facilities in the northern region’’.

Those years of underfunding Ms Ardern referred to were, presumably, the nine years the Labour Party spent in opposition.

Context is important here. For most of Helen Clark’s term as prime minister, New Zealand spent about 5.5% of GDP on health. For most of John Key’s term, the spend was above 6%.

It is also worth remembering that during the last government’s nine years, North Shore Hospital was the recipient of a $50 million redevelopment, including an expanded and redesigned emergency department and an assessment and diagnostic unit.

Of course, since then the population that hospital serves has increased while the hospital itself has aged. There is no question capital investment is an ongoing need.

But the repeated refrain that our health system’s woes are the fault of previous governments leads us no closer to understanding what exactly it is we want our public health system to look like. Do we want it to be worldclass in every respect, with the constant acquisitions required to keep equipment, practices and medicines at the cutting edge, while also ensuring it is free for all and largely free of wait times? That can probably be delivered, though the associated bill would be immense.

At the other extreme, do we want a safetynet system, which provides nofrills care for those unable to afford it while the rest pay for their healthcare, either as they need it or through an insurance scheme?

The answer for most New Zealanders is likely to be somewhere in the middle. But it would be illuminating to hear our major political parties explain exactly what their goal is for our health system, how much the realisation of that goal is likely to cost, and what is going to be sacrificed to pay for it.

It would be illuminating to hear what could be done to encourage people to take personal responsibility for behaviours that end up costing taxpayers huge sums.

It would also be illuminating to know what level of repair hospitals around the country must adhere to before being considered unusable, what the monitoring of such a system would cost, and the cost of implementing the necessary building and maintenance programme.

New Zealand’s health spend as a percentage of GDP is about average across the OECD, though it does fall short of many countries we traditionally compare ourselves to. Whether we should increase our spend is a worthy conversation. But it is one best prefaced with a nonpolitical caveat — successive governments have spent considerably less than what other nations do. That means decades of low spending would need to be accounted for if equipment, infrastructure and staffing levels are to be brought up to a far higher standard.

It would require crossparty support. And it would require a far deeper conversation than the glib political pointscoring we are used to. It is a discussion best conducted by mature, learned, earnest leaders.

Perhaps, therefore, a healthier political system may need to come first.