What Does a Healthy New Zealand Look Like?

Laura Barron looks at the issues facing Aotearoa’s health system today

“A huge, expensive, tragic and entirely preventable waste of lives.” Raf’s assessment of healthcare in Aotearoa comes after working in one of the country’s busiest hospitals for over 30 years.

Systemic racism, under-funding and policies that are geared towards a privileged few – this is all contributing to a system that, as Raf puts it, is “haemorrhaging money and getting nothing.”

Funding has become a massive issue in New Zealand healthcare.

The population is ageing – and with age comes disease. Total health expenditure currently stands at $24 billion.1 And yet hospitals continue to be under-staffed and under-resourced, with a review by the Treasury finding one in five government-owned health assets were in poor or very poor condition.2 As instances of cancer and other age-related diseases rise, we need to fund more treatments, and this all requires increasing amounts of government money.

Systemic racism means that age-related illnesses are occurring earlier in Māori and Pasifika. Life expectancy for Māori is seven years lower than a non-Māori/non-Pacific person, while 65 per cent of Pasifika in New Zealand are obese compared to 31 per cent of Non-Māori/NonPacific.3 Diabetes, high blood pressure and heart disease are strongly linked to obesity, while poor quality, leaky homes cause lung infections.

The real disease is poverty

These illnesses cost huge sums of money to treat, and yet as Raf points out, they are entirely preventable. In the play, Raf talks to the health minister about how healthy eating and improving housing standards are all ways to create a healthcare system that doesn’t just treat illnesses but stops them from ever happening in the first place.

Likewise, a healthcare system that understands the needs of the many different cultures that live in Aotearoa today is essential. We see many problems with cultural understanding throughout the play – culminating in the cremation of Seleni’s limb, which goes entirely against the world view of tagata Samoa. When stressed and underfunded healthcare professionals are many fast food joints are located in economically deprived areas, saying that “the real disease is poverty.”

Systemic racism means that more Māori and Pasifika live in economic deprivation in New Zealand, which in turn is causing significant health issues.

We can prevent these issues through stronger government policy. Laws to reduce sugar consumption and the number of fast-food outlets, increasing education in unable to understand their patients’ needs, it becomes even harder to overcome the health issues facing Aotearoa.

What does a healthy New Zealand look like? It’s a question Raf poses early in the play and throughout we are shown what a healthy New Zealand does not look like. A healthy New Zealand does not see certain groups over-represented in all the worst statistics, not just in healthcare but also poverty, housing, and imprisonment. It is not one where stressed and overwhelmed healthcare professionals must treat increasing rates of disease, instead of having policies that prevent those illnesses from happening to begin with.

The Simpson report, which Raf urges the Minister to read, was released in 2020, and set out its vision for a healthy New Zealand. It recommended sweeping changes to healthcare in Aotearoa, including increased emphasis on disease prevention and overcoming systemic racism through the creation of a Māori health board. The current government recently announced it would implement the Simpson report’s recommendations – could this be the first step towards creating a healthy New Zealand?

1 https://www2.deloitte.com/nz/en/ pages/2021-government-budget/ articles/health.html

2 https://www.stuff.co.nz/ national/115236249/healthcare-in-newzealand-a-victim-of-its-own-success

3 https://systemreview.health.govt.nz/ assets/Uploads/hdsr/health-disabilitysystem-review-final-report.pdf p.20