During the election campaign, Jacinda Ardern announced her Government would fund Very Low-Cost Access (VLCA) GP practices. Adult patients would pay only $8 for a doctor’s visit, 13-18 year-olds would pay $2 and there would be no charge for children under 13.
These new maximum charges would be extended to people with a community services card who are with a non-VLCA practice but whose GP opts into the scheme. All other patients would enjoy a $10 reduction in GP charges.
There were also commitments to free mental health services, re-establishing the Mental Health Commission, pay equity for community mental health support workers, and extra funding for youth mental health counselling services.
While the health agenda is a bold one, Winston Peters did not mention health directly when he announced he was joining the Government.
He said that “capitalism” (read “neo-liberal capitalism”) was failing New Zealanders and it was time to reshape capitalism with a human face.
Peters was referring to the clear divide in New Zealand between the haves and the have-nots, between those who feel good about where they are at and those who feel the “system” is not working for them.
There is no better example of this than Fonterra. CEO Theo Spierings has an $8 million-plus salary package while the company’s contract cleaners, catering assistants and security guards earn just over $16 an hour.
We have known for a very long time that income inequality is a major factor in poor health outcomes. New Zealand researchers have done some outstanding work in this area and the NZ Medical Association, in its 2011 paper on health equity, reinforced this point.
Even with access to high-quality care, people’s income is a key factor in determining how healthy people are. There is a strong correlation between low income and a long list of health issues, including shorter life expectancy and poorer self-reported health status.
Low pay puts stress on workers and their families because of the need to work incredibly long hours to make ends meet, as well as a lack of adequate sick leave. The many people now in insecure work also face an increased risk of elevated and on-going stress and exhaustion, cardiovascular disease, lower life expectancy and obesity.
The Government is targeting low pay as a health investment, on a par with its planned investment in housing, tertiary education fees, public transport and cleaning up our rivers.
It quickly announced a big lift in the minimum wage, will increase paid parental leave to 26 weeks and introduce legislation to give workers more power to negotiate with their employer for higher wages.
The Government will also consult with employer and union representatives about a system of Fair Pay Agreements. Regulated by the Employment Relations Authority, negotiations will set minimum pay rates, hours of work, overtime and leave arrangements across industries where reliance on the market has led to a race to the bottom for workers’ employment conditions.
In addition to these measures the Government is committed to implementing the Living Wage for all core public sector workers and to extend this to workers employed by contractors to the core public sector, such as parliamentary cleaners and WINZ security guards.
Every one of these changes will be opposed by those who received the benefits of the current system. But this huge investment in housing, education, public transport and a liveable wage is probably a far better long-term investment in improving health outcomes for most New Zealanders than building more hospitals to care for the growing numbers of poor people who need medical treatment.
John Ryall is assistant national secretary for E tū, New Zealand’s largest private sector union with 50,000 members.
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