Fact-checking the final debate

The pitches were more polished but the arguments largely the same in the final leaders debate of this campaign.

On either side of TVNZ’s moderator Mike Hosking, Labour’s Jacinda Ardern hit back at ‘‘negative campaigning’’ from National, while Bill English disagreed that voting for the incumbent party would mean ‘‘more of the same’’.

As Stuff political editor Tracy Watkins observed: ‘‘Whenever Ardern and English were given a chance, their exchanges were tetchier and far more personal than we have seen in any of their previous outings’’.

The leaders agreed the main parties are essentially neck and neck just days out from the election. But they disagreed on four main points: that fiscal hole, income tax, health spending and specialist referrals.

Health spending

Ardern asked English whether health spending had kept up with inflation and population. And as Finance Minister Steven Joyce did during last week’s finance debate, English pointed out National has put more money into health than previous governments.

Ardern repeated her question then added: ‘‘The answer is ‘No’.’’

In the finance debate, Labour’s Grant Robertson accused National’s health spending of being $2.3b short since 2010. And again, there’s no real answer to this disagreement. It’s speculative. But it’s worth providing context around where that $2.3b figure came from, considering it gets bandied around so much.

In May, the New Zealand Council of Trade Unions said health funding ‘‘has not kept up with total costs, including the increasing costs of technology, growing health need and, to some extent, personal costs, let alone total costs plus new initiatives’’.

One of its key points was that ‘‘for the Health vote to regain the spending power of the 2009-10 Health vote and pay for the initiatives and additional costs announced over that time, it would need to increase by $2.3b in the 2017 Budget to $17.6b’’.

Labour also commissioned an independent study, which came up with the same numbers: ‘‘The funding needed for health to be restored to the level it was seven years ago to keep pace with cost pressures has widened to a massive $2.3b’’.

When Labour’s health spokesman, David Clark, brought this up during an urgent debate in the House, Health Minister Jonathan Coleman called the $2.3b figure ‘‘complete fiction’’.

Professor Jacqueline Cumming, at Victoria University of Wellington, has done some work on this. In a paper last month published in Policy Quarterly, she reported an analysis of data by the New Zealand Institute of Economic Research and Victoria University found trends in real (inflationadjusted) health expenditure per capita showed steady increases during the 2000s, but a flatter profile since 2009-10.

She also pointed out funding is not moving to primary healthcare and that decisions continue to support hospital care. ‘‘Simply focusing on total expenditure levels, as governments currently do, does not tell the full picture of how far that spending will go.’’

Income tax

It didn’t take long for the most contentious point of the campaign of late to surface - income tax increases.

It was Ardern who brought it up, saying: ’’I acknowledge that Bill and his team have stoked up a debate on tax … which … I have found profoundly unfair given noone under Labour will pay more tax than they are paying today.’’

English responded that National were just ‘‘putting forward the plan for the next three years, which includes now legislated tax reductions, right across low- and middle-income New Zealanders’’.

The nub of this dispute is National’s claim - mostly via political ads - that Labour will increase income taxes if elected.

English didn’t back away from it, nor did he repeat the ‘‘income tax increase’’ line, instead explaining that, what they meant by ‘‘increase’’ was that promised tax cuts under National to take effect in April 2018 would be cancelled.

This is true, but is not decreasing something the same as raising it? No, it’s not. To suggest as much is misleading.

It is also worth noting that the cuts will go to high income New Zealanders as well as those on ‘‘low and middle’’ incomes - anyone on more than $52,000 a year will get the maximum $1000 a year.

Specialist referrals

Ardern went on to say 58,000 Kiwis sent by their GP to a specialist were ‘‘turned down for no other reason than there wasn’t capacity’’. English said he didn’t agree with that. So where did that figure come from?

On Tuesday, Glenn Barclay, Public Service Association national secretary, said in a media release: ‘‘The fact that 58,000 people were referred to specialists last year but didn’t get the treatment they needed is indicative of the fact that services cannot meet growing demand.’’

And where’s that from? Well, we’re not exactly sure, but the obvious source is a data set collected by the Ministry of Health relating to the outcome of referrals for first specialist assessments (FSAs).

(Patients who are referred by their doctor for medical assessment - an FSA - must first be accepted by their district health board for the assessment. This decides the level of need and whether it meets the individual DHB’s threshold for care. If accepted, the patient may go onto a waiting list for surgery or other treatment, if this can be delivered by the DHB within four months.)

Since July 2015, pretty consistently, between 10 and 11 per cent of referrals were declined. During 2016, this added up to almost 70,000 total declines. The data set gives four reasons for referrals being declined: they were below threshold, had insufficient information, were not eligible, or the service was not required.

‘‘Below threshold’’ is the key one here. It means the referral was appropriate and the patient would benefit from an assessment, but the DHB didn’t have the capacity. In this category, in 2016, there were 26,700 patients.

If you take the total number of declines and exclude only ‘‘insufficient information’’, then you end up with a total of 57,762. Much closer to the quoted figure of 58,000. But that’s including patients deemed ineligible for public healthcare, and also those deemed below the clinical threshold and who can be offered an equivalent or more suitable service in primary care.

Labour later clarified it actually used data from July 2015 to June 2016, and used only numbers relating to below threshold and service not required (so excluding those ineligible), which for that period added to around 58,000.

Fiscal hole

This one came up yet again with English still refusing to back away from the claim that there is a hole Labour’s Budget.

‘‘What Steven Joyce did and what Bill English supported was [to] completely fabricate a story [the $11.7b hole in Labour’s fiscal plan],’’ Ardern said.

As with the income tax dispute, English did not repeat National’s initial claim, but hammered away at the secondary criticism that Labour have not left enough money for new spending in their budget.

‘‘That is absolutely not true, there is a big hole. Everyone agrees there’s a hole in the Labour budget,’’ English said. He added: ‘‘They all agree there is a hole, you can argue how big it is’’.

Firstly, there is no $11.7b hole in Labour’s budget and no expert seems to agree that there is. However, English was careful to add that ‘‘you can argue how big it is’’ and went on to argue that Labour did not have enough money left over for inevitable cost increases.

Once you account for already allocated spending, Labour’s budget leaves $3.2b total over the next three Budgets for new initiatives, while National has $7.9b remaining.

National’s new accusation is mostly that Labour’s $800 million allowances for their first two Budgets are insufficient (most of their $3.2b over the first three years arrives in the 2020 Budget).

There may be something to this claim as new spending normally accumulates in the following year, but Labour’s allowance doesn’t increase between 2018 and 2019. They could spend about $400m on new initiatives over those two Budgets, in comparison National will have $1.7b of new spending each year.

However, Labour has included new spending on health and education elsewhere (essentially on a different line of their plan), so it doesn’t have to be accounted for in new spending allowances.