Tom Peters
New Zealand’s public health system faces a rapidly worsening crisis, with growing levels of unmet need and understaffing, as the National Party-led government ramps up its brutal austerity program. The ruling class is forcing workers to pay for the economic downturn with cuts to jobs, wages and vital public services.
In July, the government replaced the board of Health New Zealand with a commissioner, former private hospital chief executive Lester Levy, who is tasked with making $1.4 billion in “savings” across the health system.
This is to be achieved largely through job cuts. On August 28, Health NZ called for “expressions of interest in voluntary redundancy” from workers in non-clinical roles. Chief executive Margie Apa told workers in an email that this would likely be followed by “formal change consultation processes over the coming months,” i.e. mandatory cutbacks. Thousands of people could lose their jobs.
The reduction in so-called “back office” roles is accompanied by a hiring freeze in many hospitals, despite a desperate shortage of thousands of nurses and doctors.
Radio NZ (RNZ) reported on August 30 that more than 30 doctors at Gisborne Hospital had written to MPs and Health NZ calling for urgent action to address critical shortages. Senior doctor Alex Raines said the hospital had only a third of the number of anaesthetists it should have. The operating theatre was forced to run at half capacity some weeks as a result.
The Northern Advocate reported that since July night shifts at Dargaville Hospital have been run without a single doctor present. Nurses protested against the unsafe conditions, which meant critically ill patients had to be transferred to Whangarei, an hour’s drive away.
On August 30, more than 600 nurses and other workers held a 90-minute stop-work meeting to protest conditions at Waikato Hospital. Nurse Tracy Chisholm told RNZ that the emergency department alone had a shortage of 20 nurses and healthcare assistants. The New Zealand Nurses Organisation (NZNO) said there were about 600 unfilled nursing vacancies across the region.
Waikato Hospital was reportedly running with just 40 percent of the necessary medical registrars on August 24‒25. Doctor Natalie Quin told the Waikato Times she felt “morally impaired, because we are not practising medicine properly.” She had reported at least 10 “patient harm events” caused by understaffing. One person had waited around six weeks in hospital for coronary bypass surgery.
At Taranaki Hospital, the Resident Doctors’ Association told Stuff on August 20 that four out of the 14 medical registrar positions had been vacant for six months. The remaining 10 registrars were frequently working 60 hours a week as a result.
On August 12 the New Zealand Herald reported that patients in severe mental health crises were “waiting for up to 72 hours for care in the South Auckland region” because of a shortage of full-time doctors and nurses in the region’s 24-hour crisis response unit.
The situation in primary healthcare is equally dire, with an estimated shortage of 500 general practitioners nationwide. A recent survey by the General Practice Owners Association of 244 practices—one quarter of the total number in New Zealand—found that 89 percent had increased or were about to increase their fees and 41 percent had reduced services in the past six months.
For decades, government funding for GPs has not kept up with increased demand and cost pressures. This year’s increase was just 4 percent, which will force further cuts.
The New Zealand Herald reported this week that dozens of sick and elderly people in the working class Auckland suburb of Ōtara are regularly lining up outside Ōtara Local Doctors and Urgent Care from 6:00 a.m. The clinic is one of few that allows walk-ins and has relatively low fees. Booking an appointment elsewhere often means waiting for weeks.
Greg McIndoe, a 66-year-old who recently underwent knee surgery and has chronic pain, said the situation was “outrageous.” He had to wait for hours in the cold twice a week to see a doctor.
Healthcare workers are attempting to fight back. Earlier this year, about 2,500 junior doctors held several one-day strikes to demand a decent wage increase. Last month about 2,500 St John Ambulance workers took limited industrial action, opposing a pay freeze and calling for more government funding. The trade union bureaucracy, however, is keeping all these disputes divided from each other, preventing any effective campaign against the austerity regime.
The Public Service Association (PSA) issued a statement on August 28 calling Health NZ’s latest proposed staff cuts “unfocused,” “reckless” and “a prelude to privatisation.” The PSA, however, has worked with the government to implement more than 6,000 layoffs across multiple government departments.
Opposition Labour Party health spokesperson Ayesha Verrall also postured as an opponent of the cuts, saying “[Health Minister] Shane Reti needs to explain how a modern, efficient, patient-centred health system can function without non-clinical staff supporting the frontline.”
In fact, the National-led government is picking up where Labour left off. More than 500 “back office” job cuts were made during the 2020-2023 Labour Party-led government as part of the establishment of Health NZ through the amalgamation of the country’s district health boards.
The Labour government, led by Prime Minister Jacinda Ardern, starved the public health system of funding. The NZNO and other unions ensured that workers’ struggles were isolated and sold out.
Ardern ended the country’s zero-COVID policy in late 2021, adopting the criminal policy of mass infection that was demanded by big business. This was imposed with the crucial assistance of the trade unions, which did not lift a finger as mask mandates and other public health measures were removed.
So far more than 43,000 people have been hospitalised and over 4,100 have died due to COVID-19, placing an immense burden on the healthcare system and resulting in longer delays for thousands of patients. This avoidable disaster, alongside the cost of living crisis and increased poverty, was a major factor in Labour’s crushing defeat in the October 2023 election.
The demand for high-quality, free public healthcare, available to everyone who needs it, must be taken up by the working class in opposition to the entire capitalist political establishment including Labour and the union bureaucracy.
The government’s claim that there is “no money” to fully fund health services is a lie. What is required is the socialist reorganisation of society: The billions of dollars in the coffers of the financial elite, and the money wasted on military spending for war, must be redistributed to rebuild and expand hospitals, hire thousands more doctors and nurses and to eliminate COVID-19 and other preventable diseases.
