• Health Reforms Long Overdue

    The Government’s (that is, Andrew Little’s) far-reaching health reforms have been – predictably and rightly – well received by most health professionals.

    I judge them – and welcome them – on the basis of my own experience in chairing a Primary Health Organisation over a period of some years. My experience led me to the conclusion that the problems of the health service were the consequence of flaws, not only in the organisational structure of health service delivery, but also in the funding arrangements.

    The decision to entrust the country’s health policy to a national body and to abolish District Health Boards is long overdue and gives us a chance to end the “postcode lottery” produced by the different standards and piecemeal levels of achievement in different parts of the country. It allows the possibility of a national policy, applied across the whole country, and one that does not depend on the vagaries implicit in having a range of district health boards, each one of which has its own local priorities, levels of expertise, and differing sensitivities to the presumed (and often widely varying) needs of their local communities.

    The variability created by having twenty District Health Boards was not, however, the only cause of difficulties. Problems also arose as a result of a confusing set of funding arrangements. Funding came originally, of course, from the government, that is the Ministry of Health. The total funding for the region, – that is, funding to cover both primary and secondary health care – was paid initially to the DHBs. They then had to allocate a proportion of the funding to primary care – that is, to general practitioners – and the remaining proportion they then retained for secondary care, – that is, for hospitals, the sector which they themselves administered.

    This unnecessarily complicated system of funding inevitably gave rise to uncertainty and suspicion. The primary sector would always suspect that they were being underfunded by the DHBs whose priority was, naturally enough, the funding of the hospitals for which they were responsible.

    But this was not the only cause of tension between the DHBs and the primary health organisations. Performance standards in primary health care were set by the Ministry, which looked to the DHBs, as the funder, to ensure that the standards were being met. The DHBs in turn would in turn monitor the performance of the primary health organisations, and would react strongly if they felt that the standards were not being met – and since they held the purse strings, this was a constant source of tension between the two sectors.

    The primary health organisations found themselves having to serve two masters – first, the Ministry, that set the standards, and secondly, the DHBs, who controlled the funding. The DHBs also found themselves in a difficult situation, having to account to the Ministry for meeting the required standards, but having to delegate to another body or bodies the practical responsibility for the work needed to meet the standards.

    The reforms seem likely to cut through these unnecessary and confusing complexities, so that funding will be provided directly to those bodies that will be responsible for delivery, and those bodies will have a direct line of accountability and reporting to the body that both sets the standards and holds the purse strings.

    The second major reform – the establishment of a Maori Health Authority – is also strongly to be welcomed. Anyone with any experience of health service delivery to a population containing a substantial proportion of Maori will have learnt that the take-up and effectiveness of health care provision is greatly improved if the delivery of that service is seen to be in Maori hands. The learning of that lesson is long overdue and should at long last lead to the improvement of shamefully bad Maori health statistics.

    Bryan Gould
    22 April 2021

  • The Government v. the People?

    We can all agree that a free press (and free media more generally) are important factors in a well-functioning democracy. But I am beginning to wonder if they provide us with an unalloyed benefit.

    I am an avid consumer of daily news – whether delivered by the press or by the broadcast media. And I have begun to notice what seems to be an increasing trend. What is regarded as “news” seems increasingly to fall within a particular category.

    Most news bulletins these days seem to comprise items of one particular kind. It seems that any individual or organisation can guarantee coverage as an item of “news” if they make a complaint – any complaint – to the effect that “the government” has somehow failed – has somehow done something that it should’t have, or has not done what it should have, or has acted, but “too little, too late”, or has listened to the wrong people, or has spent too little or too much, or has displeased them in some way.

    Complaints about the government seem to be manna from heaven to the news reporters. They require very little work – that can be left to, and has presumably already been done by, the complainant. All that is necessary is to offer the complainant a platform and – hey presto! – you have a news story.

    And there is always the even more welcome opportunity to put a government spokesperson on the spot, and to require them – whether or not the complaint has any substance – to account for themselves.

    I should make it clear that, although I am a supporter of the present government, the trend seems to have established itself over recent years, whatever colour the government of the day might be.

    But, you might say, isn’t that the role of the news media, to hold those who govern us to account?

    Yes, of course, but if it becomes the mainstay and staple diet of the news media, it can deliver an unwelcome injury to our democracy and convey a mischievous, damaging and inaccurate picture of its operation .

    It can offer, all too easily, a view of public affairs as, essentially, “the people” against, and the victims of, “the government” – and that would do no one any good. The proper functioning of democratic government is subject to quite enough challenges, not least from the social media, without concocting a false dichotomy between the popular will and the functions of government.

    The USA offers us an uncomfortable picture and warning of what happens when large numbers lose confidence, not just in a particular government, but in the whole concept of government in general. And that state of affairs dates back much further than Donald Trump – probably as far back as Ronald Reagan.

    It was “the Gipper”, after all, who famously said that “government is not the solution – government is the problem” and that “the most frightening phrase one can hear is “I’m from the government.”

    We (and our media) need to grasp that, in a democracy, government is the one actor we can rely on to protect and advance the general interest. There is all the difference in the world between holding government agents to account for failures on particular issues, and allowing an anti-government sentiment to take root. Without an effective government, we are all at the mercy of the powerful, the selfish and the ruthless.

    Bryan Gould
    16 April 2021

  • Minimum Wage? Property Investors? Don’t Touch Our Profits

    It has never ceased to surprise me that those who profit at the expense of others are so unaware of the harm suffered by those they exploit, and are so convinced that they have a right to do the exploiting and that their profit is a proper and justifiable reward for doing so.

    There have been two cases in point over recent days. The first was the introduction of measures to restrain the impact of property investors on the housing market. The government extended the “brightline”test for property investors, (so that their tax exemption in those cases where they made a quick profit by selling on was reduced), and the government removed the concession whereby investors could set interest costs against their tax liability. The squeals of protest that greeted these measures were matched only by the unlikely claims of investors that their activities in reality provided a social service and that their real concern was not for their own interests but for their tenants and for first-home buyers.

    Do they not realise that an investor could typically use the rules (as they previously existed) to walk into any auction room and effortlessly outbid a roomful of first-time buyers? Property investor could obtain virtually unlimited and cost-free credit from their banks, and use it to buy almost any property, secure in the expectation of a substantial and tax-free capital gain – which was virtually guaranteed as a result of their own activities – within a short time. Little wonder that first-time buyers stood little chance.

    The consequence was that first-time buyers were increasingly priced out of the market and that there was constant upward pressure on prices. When investors squeal about how hard done-by they have been, do they not realise that the government correctly recognised that there could be no relief for first-time buyers and no slowdown in property prices unless the advantages enjoyed by investors were limited?

    Their response shows instead that they believed that their “right” to go on making large tax-free profits at the expense of others should remain intact and take precedence over the distortion of the housing market that was inevitably the consequence. They were angry that a government elected to serve the needs and interests of the whole population should step in to alleviate a problem that was bringing misery and disappointment to many young families.

    The second instance was the raising of the minimum wage. The air was thick with warnings about the damage to the prospects, not just of small businesses, but also to employees themselves (whose jobs, it was said, would be lost) and to shoppers, who would have to pay higher prices – and all because employers would be obliged to pay their employees something approaching a wage that could support a family.

    As with investors, the response was one of outrage – how dare the government intercede in an attempt to mitigate the shocking child poverty that disfigures our society? The mindset – again – was one of entitlement – our ability to maintain our own living standards must be left untouched, even if the price of that is the impoverishment of others.

    In both cases, terms like “communism” were carelessly and inaccurately flung around. It is evidently hard for those with vested interests to understand the democratic concept of a government that is ready to act in the general interest. Differential privileges, arising from the ability to bid up house prices or to take profits from a business that cannot afford to pay its employees a living wage, must, it seems, be maintained at all costs.

    Bryan Gould
    3 April 2021

  • The Concentration of Media Ownership

    I was recently asked by the Fabian Society in the UK for an article about our Prime Minister. The piece I wrote and that has now been published can be found at https://bryangould.com/jacinda-for-a-british-readership/.

    I am satisfied that the piece is reasonably balanced, but – on reflection – I realise that I omitted to make an important point. I register in the piece that Jacinda is remarkably popular but I do not make the further point that she has achieved that level of support, despite having to face a constant barrage of sniping and criticism – not just from her political opponents – but also from New Zealand’s most powerful news organisation.

    NZME (New Zealand Media and Entertainment) are the owners of New Zealand’s most widely read daily newspaper – the Auckland-based New Zealand Herald. NZME also own a large number of provincial newspapers, as well as the most important commercial radio stations. They therefore have a virtually unassailable ability to dictate the news agenda.

    They make no bones about using that ability to produce a constant diet of anti-government coverage for their readers and listeners. Any daily edition of the Herald could be picked at random and found to feature a familiar range of news reports and opinion pieces from equally familiar authors, all writing from a shared viewpoint that is hostile to the government.

    Those authors are in some cases employed by the Herald as part of their ordinary journalistic staff, but others are “guest” columnists who – surprise, surprise – are also gainfully employed by NZME as hosts of the company’s commercial radio news programmes. In that capacity, they have built such reputation as they enjoy by virtue of their right-wing prejudices and willingness to criticise the government as a matter of course.

    The outcome is that the average (and non-political) reader or listener can find no refuge from a constant diet of anti-government news reporting – and worse, is likely to be unaware that their news (and opinion) consumption is so deliberately skewed. This unhappy trend has, if anything, intensified as a response to, and over, the period during which Jacinda Ardern’s leadership of the Labour Party has commended itself to the electorate.

    I should declare my own personal interest in the matter; over a period of some years, I wrote, on an unpaid basis, an occasional column for The Herald, and, for a shorter period, I was a paid weekly columnist for a range of NZME-owned daily papers. Both of those engagements were terminated by NZME as the New Zealand electorate swung in favour of Ardern and Labour.

    My purpose in bringing this (so far as I can) to the attention of the wider public is to alert them to the dangers confronting a working democracy when such a major part of our media is under single ownership – and an ownership that makes no bones about its willingness to be a player itself in the political debate.

    In most democracies, such a concentration of media ownership would be regarded as an unacceptable threat to the democratic principle – a threat that was recognised by New Zealand’s Commerce Commission when it recently refused to allow a merger of NZME and another (smaller) media group. That issue might need to be re-visited.

    Bryan Gould
    25 March 2021

  • Jacinda For A British Readership

    I was recently asked by the Fabian Society in the UK to write a piece about our Prime Minister for their annual publication. Here is the piece that has now been published.

    Jacinda Ardern is the most popular leader New Zealand has ever had. She established her domestic popularity and her international reputation by virtue of the calmness, decisiveness and empathy she brought to bear in enabling New Zealand to withstand and confront the coronavirus epidemic with more success than any other country.

    This success – remarkable for a young woman with no previous experience of government – came on the back of her similarly sure-footed handling of the murderous attack by an Australian terrorist on Christchurch mosques, and her empathetic reaction to the loss of life when a volcano erupted in the Bay of Plenty.

    She proved herself in each of these scenarios to be a leader who could be trusted, not least because she was a brilliant communicator. Her televised daily press conferences and grilling by the media in the early stages of the coronavirus outbreak were master classes in how to build public trust and understanding.

    Her “team of five million” were prepared to follow her to the ends of the earth (which is where most of the rest of the world would place her anyway). As the plaudits began to roll in from around the world, New Zealand enjoyed the experience of becoming – for once – the cynosure of all eyes.

    The reward for her efforts came in the general election in late 2020. An electorate that might have been expected to punish a government that had imposed on them all the economic disruption and uncertainty of successive lockdowns reacted instead with gratitude and affection. Ardern’s Labour government became the first to secure, under New Zealand’s proportional representation system, an outright majority in parliament without any need to seek coalition partners.

    During the campaign, I lost count of those whom I knew to be lifelong supporters of the right-wing opposition National party, who said no more to me than “she’s done a good job” and who then felt it unnecessary to elaborate further on their intention to vote for her.

    Her crushing victory undoubtedly owed much to her ability to unite the country and to render party differences beside the point. But that could prove to be far from an unalloyed benefit.

    Some of her critics on the left – and there are some – fear that her success in attracting support from the centre-right could mean that she has become their prisoner. New Zealand’s short three-year parliamentary term means that there is precious little time to enact a truly transformative programme and to carry the country with it. The critics fear that, rather than risk losing the support she has gained from those who would not normally vote Labour, she might soft-pedal on the need for change.

    It is not that Jacinda – she is one of those politicians who is best identified and widely known by her first name alone – lacks ambition for what her government might achieve. She has been clear in setting her goals – combatting climate change, reducing child poverty, solving the housing crisis by building more houses. Her critics doubt, however, her ability to achieve these goals, given that she has boxed herself in through her pledge, given under pressure from the opposition during the campaign, not to introduce a capital gains tax.

    The critics say, not without reason, that there is no solution to growing inequality without taxing the rich. Her defenders might respond by pointing to the unexpectedly positive performance by the New Zealand economy as it bounces back from lockdown – an outcome much helped by the quantitative easing put in place by the Finance Minister, Grant Robertson. As a result, the prospects for increased government spending are surprisingly bright.

    Time will tell – but it would be a brave person who would bet against an extended term in government for a leader who reads and represents the New Zealand psyche so well. Jacinda Ardern has discovered and demonstrated that politics is not just about “the economy, stupid”, but is also about emotion, empathy and personality; the key word in Ardern’s politics is “kindness”. She has created a new version of left-wing politics which distinguishes itself from its right-wing opponents not only through sheer competence and what it thinks, but through what it feels as well – its sympathy with, and regard and respect for, all of our fellow-citizens.

    Bryan Gould
    25 February 2021