7 minute read
DOCTORS IN THE HOUSE
ELIZABETH BROWN | SENIOR COMMUNCIATIONS ADVISOR
There are just two MPs in the New Zealand Parliament who are medical doctors – one in the red corner and one in the blue.
They both sit on Parliament’s Health Select Committee and both were on the Epidemic Response Committee, formed to assess the impact of the Covid-19 crisis. What leads a doctor into the bear pit of politics, and what contribution do they feel they can make?
DR SHANE RETI
Dr Shane Reti is in his second term as the National MP for Whāngārei. He is a GP and dermatologist and served three terms on the Northland District Health Board. He worked at Harvard University in the US, where he specialised in informatics, helping foreign governments fix their broken health systems.
It is his firm view that doctors and politics are inextricably linked.
“If politics is the ability to persuade towards a point of view, that’s what doctors do day in and day out with our patients. Medicine always has a political interface because we are the advocate for our patients, especially around funding and servicing.”
“I don’t think you can be a doctor without having political engagement,” he says.
Dr Shane Reti
On a personal level, his time on the Northland DHB, along with his work with overseas governments during his time at Harvard, consolidated a long-held interest in politics. When five-term Whāngārei MP Phil Heatley announced his retirement in 2014, Dr Reti was enticed home and successfully campaigned to retain the seat for National.
He says he often hears from voters that New Zealand needs more doctors than politicians. He has a ready response.
“In general practice I can service maybe 1500 to 2000 patients, but in this role I’m responsible for an electorate of 85,000, so I can reach and help more people.”
Dr Reti keeps up his medical registration, and during parliamentary recesses and the summer break he dons his stethoscope and sees patients. He also keeps in close contact with medical colleagues by running a Maintenance of Professional Standards (MOPS) group once a month.
He believes “staying on the tools” adds value to his role as an MP and as the Deputy Chair of the Health Select Committee.
“I bring technical expertise and I bring the coalface to Wellington. Officials will tell me about some great policy and great programme in one ear, and then I go and find the truth to that by speaking to patients and my doctor colleagues. I find out exactly what is and isn’t working.
“That’s not to diminish the advice and hard work that officials do, but there’s a difference between the blackboard and the patient bedside.”
Dr Reti says health systems everywhere are a challenge. He says there will always be unmet need, which New Zealanders need to accept. The solution he believes is to make the most of the resources we have and improve the system through better measurement and public service targets.
Fundamentally, he believes New Zealand boxes above its weight in terms of what we do with the resources available and in relation to the percentage of GDP spent. He adds however, there is room to do better and sitting on the Epidemic Response Committee to Covid-19 has brought some of that into sharp focus.
“Coronavirus has pushed and stretched our system and made more evident some of the holes we have, especially in public health. What I’m hoping we may get out of Covid-19 is greater resourcing and funding of public health and maybe even more people interested in it as a career specialty.”
He believes the beauty of the Epidemic Response Committee was that it allowed professionals to tell their stories and highlight the issues.
Dr Reti has no plans to quit politics at this stage. He is currently National’s associate spokesperson on health and would be up for a larger role, though he is quick to add “that would be up to the leadership.”
As to whether he’s a future health minister in the making, again he reiterates that would be the decision of the National Party leader, but says, “I keep my head down and work hard and my observation over several careers is that good things happen.”
DR LIZ CRAIG
Dr Liz Craig is a first-term Labour list MP from Invercargill – a job she likens to a first-year house surgeon.
She entered Parliament after a career as a public health physician.
Her interest in public health developed when, following two years as a house surgeon at Taranaki Base Hospital, she headed to Australia, first working in Canberra, where she earned a Diploma in Paediatrics, before spending four years training Aboriginal and Torres Strait Island health workers in Queensland. Returning to New Zealand she entered the public health training scheme, completed a PhD in epidemiology and went on to establish the New Zealand Child and Youth Epidemiology Service, monitoring and collating data on the health of the country’s children and young people.
The move to politics seemed like a logical step.
Dr Liz Craig
“I’d seen during the course of my work that we had high rates of children coming into hospital for poverty-related conditions. Tracking back, I could see child poverty rates surged in the early 90s, with the Mother of All Budgets, benefit cuts, market rates for state houses and the Employment Contracts Act.
“Children are looked after well in hospital but then they go home to damp, cold houses and I thought about how to make a bigger impact on that, so I joined the Labour Party in 2010 with a view to helping them write children’s policy.
“From there I got more involved in thinking through the broader social policies we might need and became a candidate in 2014 and then got into Parliament at the last election,” she says.
As a new MP her life is now split between Invercargill and Wellington. The hours are long, especially when Parliament is sitting and it is a travel day.
“There is no training manual, so you’re very much working from your own experience but liaising with senior colleagues. It just feels very like those first few years in medicine where the learning curve is steep, the hours are long, yet it’s really rewarding.”
A lot of Dr Craig’s time is taken up with select committee work. She sits on the Environment Committee, where she takes a keen interest in zero carbon initiatives and climate change. As a member of the Health Committee she likes the overview she gets of district health boards and the Ministry of Health, and her background helps her understand some of the complexities and policy interface.
She appreciated the opportunity to be part of the Epidemic Response Committee on the Covid crisis, hearing from the range of health professionals and groups which appeared before it.
For the long-time public health advocate, it was heartening to see the value of epidemiological modelling and public health advice recognised and incorporated in political decision making, not to mention the additional investment in the country’s public health units.
Dr Craig does not deny that parts of the health system are struggling but argues the Government has inherited a decade of underinvestment and realistically has only had two budgets to address it, with the first two focusing on primary care access, mental health, where there has been huge unmet need, and infrastructure development.
“This year the Government has moved to significantly expand our public health capacity in response to Covid-19, with this month’s budget also investing a record amount in DHBs to relieve basic cost pressures and help them catch up on the backlog created by Covid-19.
“But it’s not just about what’s in this year’s budget, you have to take a longer, strategic approach. You have to look over three, seven, ten years in terms of what is the broader investment strategy and asset management plan.”
Workforce training and retention also requires “some strategic thinking,” she adds.
What really spins Dr Craig’s MP wheels is that on any given day she can be looking at water issues, employment issues, community development, housing, employment, or health.
For now, politics is very much in her future. She has been selected again to stand as Labour’s candidate for the Invercargill electorate.
“It would be good to be able to continue. In the first term you focus on the basics of being an MP, and the next step is being available where you are needed. Given my background, the health sector is definitely where I’d like to make a bigger political contribution.”
