National Party leader Christopher Luxon made claims about health outcomes that were clearly false. Why was he left unchallenged?

In the TVNZ leaders’ debate last night, Luxon and Labour’s Chris Hipkins had a testy exchange over Māori healthcare.

Hipkins held firm on the creation of a Māori Health Authority, established last year, arguing strongly that the persistent gaps in health outcomes and care justified it.

Luxon was equally clear in opposition to it. He framed his critique of the authority around an alleged complete lack of progress on Māori health outcomes. He was very specific.

“Every single health outcome has gone backwards under Chris’s government,” Luxon said.

“Six years, not one has improved for Māori or for non-Māori.”

While sweeping in nature, Luxon’s claim did not get a direct response from Hipkins.

Luxon repeated a similar line later in the debate.

“Gone backwards. Chris, under your government, every single health outcome for Māori or non-Māori [has gone backwards]. You can’t have that.”

Hipkins did push back on this occasion, citing the ongoing reduction in rates of smoking.

Luxon’s claim was far from true — there are a number of areas where health outcomes for Māori and non-Māori have improved while Labour has been in charge.

But it is perhaps understandable that Hipkins was not quick to correct Luxon because the data — even though it’s better in many respects — is still grim. Maybe Hipkins did not wish to dwell on this.

Improved health outcomes
There are a number of health outcomes where, for Māori, statistics have improved.

Perhaps Labour’s biggest boast is their track record on bringing down lung cancer and smoking rates for Māori.

Lung cancer is the second leading cause of death for Māori in Aotearoa. But according to the Ministry of Health, rates of lung disease for Māori have come down.

In 2017, the rate per 100,000 people was 79.9 for Māori. By 2019, it was down to 68.4. This also aligns with smoking rates among Māori dropping.

Pre-colonisation, Māori did not smoke. However, when tobacco was introduced to Aotearoa in the 18th century that quickly changed.

Smoking has been particularly harmful for Māori who have higher smoking rates than non-Māori and experience greater rates of death and tobacco-related illness.

In 2017/18, the smoking rate for Māori adults was 35.3 percent. By 2021/22, it was down to 20.9 percent (approximately 127,000 people).

Rates were falling under National but they have continued to drop under Labour, which has rolled out a number of initiatives in an effort to reduce nation-wide smoking rates.

As part of the Smokefree 2025 Action Plan, historic and world-leading legislation mandated an annually rising smoking age that will mean that anyone born on or after 1 January, 2009, will never be able to purchase tobacco products.

Other cancers
Overall, cancer registrations rates among Māori fell from 416 per 100,000 people in 2017 to 405.7 in 2019.

Breast cancer registration rates for Māori women fell from 140.7 per 100,000 people in 2010 to 122.5 per 100,000 in 2019. Prostate cancer registration rates for Māori fell from 105.5 for Māori in 2017 to 103.5 in 2019.

For non-Māori, overall cancer registration rates increased slightly from 323.2 (2017) to 332.4 (2019).

Life expectancy
The life expectancy gap between Māori and non-Māori may be the most telling indicator of all when it comes to inequities.

According to the latest available data from 2019, life expectancy at birth for Māori men in 2017-2019 was 73.4 years, up 3.1 years from 2005-2007 data.

The life expectancy for non-Māori men is 80.9 years. For Māori women, it was 77.1 years, up 2 years from 2005-2007. Non-Māori women are expected to live to 84.4 years.

While Māori life expectancy has increased over time, the gap to non-Māori persists.

At the current rate of progress it will be more than a century before Māori and non-Māori have equal life expectancy, a study by the Association of Salaried Medical Specialists found in 2021.

Child immunisation
In the debate, after Hipkins raised smoking as an area of improvement, Luxon said child immunisation was a concern. On this, he was correct.

Over the past six years, child immunisation rates have steadily fallen.

In 2017, 86.2 percent of eligible Māori five year olds had completed all of their age-appropriate immunisations. As of last year, the rate had shrunk to only 71.8 percent. That is an alarming 16 point drop in the period Labour has been in power.

In April of this year a report commissioned by Te Whatu Ora’s Immunisation Taskforce found that immunisation failed to achieve “adequate on-time immunisation rates in young tamariki” and to immunise Māori, meaning those who were most susceptible to “vaccine-preventable disease” had the lowest immunisation coverage.

The report highlighted the worst rate in the country — just 34 percent of Māori children in South Auckland were fully vaccinated. It attributed part of the problem to vaccinators being diverted to the country’s covid-19 pandemic response.

“This caused childhood immunisation rates to plummet. These rates are now the lowest they have ever been and ethnic disparities have further expanded,” it said.

The report outlined 54 recommendations covering funding, delivery, technology, communications and governance across the programme.

In the debate, Hipkins suggested the anti-vaccine movement was part of the problem, which he sought to link with National.

National has proposed an immunisation incentive payment scheme. The plan would see GP clinics paid a lump sum for achieving immunisation targets, including full immunisation for two-year-olds, MMR vaccines for ages 1-17, and influenza vaccines for ages 65+.

The clinics would have to either achieve 95 percent coverage for their childhood patients, and 75 percent for the flu shots, or achieve a five percentage point increase for each of those target groups, by 30 June 2024 to receive the payment.

Labour’s Dr Ayesha Verrall said a similar scheme already existed.

Labour has also failed to halt type 2 diabetes, the country’s biggest and fastest growing health condition.

Ministry of Health figures show that in 2021 there were 302,778 people with diabetes, predominantly type 2. Since the Labour government came into power in 2017, the estimated rates of the number of Māori with diabetes per 1000 has risen from 66.4 to 70.1 in 2021.

The rates for non-Māori have also climbed from 27.8 in 2017 to 30.1 in 2021. It is also important to note that the rate of diabetes in Aotearoa has been steadily rising over the past 50 years.

Type 2 diabetes can also lead to devastating health conditions and complications, including heart failure, kidney failure, strokes and limb amputation.

According to Ministry of Health data obtained by RNZ under the Official Information Act, since 2011 there has been a 39 percent increase in diabetic limb amputations across the whole population.

For Māori, the number has more than doubled in the past decade from 130 in 2011 to 211 in 2021. Under Labour, the number of Māori diabetic limb amputations rose by 15 percent.

Māori are still 2.8 times more likely to have renal failure, another complication of diabetes.

Mental health
According to Te Whatu Ora, the rate of suspected suicide per 100,000 Māori population in 2021/22 was 16.1. This is not a statistically significant change from the average of the past 13 years.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

There is a definite gloominess among the public right now — with a perception that not only is the country broken in many ways, but the political system is too.

We see this most strongly in surveys that ask if the country is on the right track or not.

Generally, New Zealand has flipped in a few short years from having about two-thirds of the public saying the country is headed in the right direction, to now having two-thirds saying we’re going the wrong way.

Journalists and politicians report that out on the campaign trail they are discovering that the public is angrier than ever.

Mark Blackham reported last week that “MPs are encountering angry people — a general anger about the state of affairs and paucity of political choices.”

Stuff journalist Julie Jacobson summed up the political mood in the weekend as “Disillusioned, demoralised, disenchanted, disgruntled”. And she argues this has only increased during the campaign: “What was a low hum has become a sustained grumble.”

‘Out of love’
Jacobson reports that across the political spectrum people are “out of love with what’s currently on offer.”

Certainly, much of what the politicians are offering is extremely grim. For example, both Labour and National are promising to slash billions of dollars from public services.

This promised austerity drive reflects a reality that the government’s books are empty, with no room for additional new spending. Hence Prime Minister Chris Hipkins has openly said that this election can’t be one for big spending policies.

Hipkins has gone from promising “bread and butter” reforms to, as leftwing political commentator Chris Trotter points out, being committed “to less butter and thinner bread for at least the next three years.”

Trotter says, in general, there’s not much for the public to positively vote for, and instead people will vote negatively – choosing whoever they regard as the best of a bad bunch.

Hence, “This is not going to be a happy election.”

For traditional leftwing voters, Labour’s austerity programme is a major disappointment, as it goes hand in hand with opposition to any real tax reform that might collect more revenue for public services and infrastructure.

Strong suspicion
Likewise, on the right, there is a strong suspicion that National’s tax cuts are simply unaffordable. The policy is being called out by the likes of rightwing political commentator Matthew Hooton as being unprincipled and incompetent, and by the Taxpayers Union as foolhardy.

There is also growing scepticism that some of the bigger policy promises are electoral bribes that can’t be delivered. Hooton says that a “cynical electorate” sees many of these policies as empty promises — especially because voters have got used to being lied to or misled by politicians who don’t deliver their promises once in power.

He suggests that voters are right to be cynical because New Zealand has had “15 years of people hearing promises from politicians which are platitudes on the face of it and they haven’t even been delivered to that extent”.

Similarly, Stuff journalist Andrea Vance argued in the weekend that “Voters know when they are being used”, suggesting that the “bribes” being offered don’t compute for voters. Vance says politicians are promising to slash “public services and spending — in the name of savings and efficiencies — when they are already stretched and degraded.”

Voters shouldn’t have confidence, she suggests, that the next government will be able to meet the existing needs of public services, let alone start fixing the severe deficits in infrastructure and services. Fundamentally there is a credibility gap between politician promises to cut spending but to properly maintain all “front-line” services.

Politicians aren’t up to challenge
Voters are aware that we’re in something of a “polycrisis”, and the status quo is unsustainable.

Political pollster Peter Stahel wrote last week that there is “an unmistakable mood for change” based on a “strong undercurrent of dissatisfaction, driven by personal financial hardships and an uncertain economic outlook”.

His company’s polling show “only 29 percent of voters say the current options for prime minister appeal, with nearly half (46 percent) saying they don’t.”

There’s a cost of living crisis, failing public health and education systems, a housing crisis, a climate crisis — the list goes on. As Newstalk’s Mike Hosking says, “There is no shortage of serious, worryingly serious, issues to discuss this campaign”, but the politicians are largely missing in action.

Because the politicians haven’t risen to the challenge, the contrast between what is desperately needed and what is on offer has never been so great. The public is right to be disenchanted — parties are mostly just offering sniping and petty criticisms of their opponents.

As political commentator Josie Pagani has put it, “This is an election of parties wrestling on the ground, when we crave a new Jerusalem.”

Pagani says “We have gone from ‘Hope and Change’ to ‘Perhaps Just a Biscuit’.” Whereas in previous elections, parties ran on a programme of grand causes, this time around, issues like child poverty and the housing crisis are being ignored by politicians.

Former Labour leader David Cunliffe appears to agree — he went on Breakfast TV on Thursday to say that “voters are grumpy. They don’t think that either party is really hitting the nail on the head in terms of what’s worrying them.”

Similarly, business commentator Bruce Cotterill wrote in the Herald last week that the campaign has been highly disappointing so far because it’s more about attack ads and petty sniping than about illuminating the big issues and the policies that the parties have for fixing them.

He laments the lack of debate about the crises in the health and education systems, and says problems like housing waiting lists and child poverty have been virtually ignored.

Hooton also says this avoidance of the big issues is a tragedy, especially since we are now in what he argues is the worst economic crisis in decades.

An uninspiring election campaign
In lieu of being focused on the things that matter, the politicians are becoming more aggressive, threatening to turn this year’s campaign into the most negative in living memory.

Press gallery journalist Glenn McConnell reports that as we go into the last month of the campaign its “becoming more feral”. He says the politicians are largely to blame: “Nobody is running a wholesome forward-looking, solutions focused campaign. They are frothing to attack, attack, attack.”

The lacklustre nature of the parties is reflected in their campaign slogans according to Jacinda Ardern’s former chief of staff Mike Munro. He says none of them are original, because “every variation of wording around concepts like change, hope, aspiration, unity and the future have been previously used on party billboards”.

And he argues that the parties are incredibly risk-adverse this election, being determined to stage-manage every element of the campaign and the candidates, reducing any chance of life in the election.

Is this therefore the most uninspiring election ever? Writing on Sunday, journalist Andrea Vance asks: “Has there been a duller election campaign in recent memory?” She labels it “the election of The Great Uninterested” because people seem to be turning away in boredom or disgust.

Vance says: “It’s not just that voters are bored. They’ve stopped listening.”

Political commentator and former Cabinet Minister Peter Dunne is also amazed at the lacklustre performances of the politicians so far – especially Hipkins and Luxon who are in the fight for their political careers.

He says, given the big issues at stake, “Neither Hipkins nor Luxon has so far shown sufficient passion or boldness to convince New Zealanders they have what it takes to be an effective prime minister in the difficult years ahead.”

Election fatigue and low voter turnout
Do you wish the election was over already? You are probably in good company. This year there is no apparent enthusiasm for the campaign. You’ll notice that there aren’t many pictures or videos of politicians being swamped on the campaign trail, signing autographs or having mass selfies with fans — as occurred in recent elections.

Young people, in particular, seem unimpressed this time around. According to political scientist Richard Shaw, the students he teaches are losing faith in the New Zealand political system.

He says that they are part of a growing cohort who are now “over” politics. Shaw is also picking that voter turnout is going to be low this election.

So, could the most popular choice at the coming election be “none of the above”? Certainly, the number of eligible voters who choose not to vote in the upcoming election could surpass a million, effectively making it the most popular option in 2023.

Voter turnout has generally been trending down in recent decades, and it hit a low of only 69.6 percent at the 2011 election. That low turnout was generally because none of the parties were offering much that was inspiring, and no one expected the result to be close. Hence, one third of the electorate turned away in that election in disgust, apathy, or whatever.

The fact that the politicians and debate have become more aggressive and divisive puts people off. Other commentators are also now picking a decline too.

David Cunliffe says: “Expect a record low turnout, and expect a record low vote share for Labour and National combined, and the highest ever share for the [minor] parties on both sides of politics.”

Leftwing columnist Verity Johnson has also written recently about the political despair among the public, predicting an extremely low voter turnout: “I’ve lost count of the people I’ve spoken to this week (smart, articulate and historically politically engaged people) who aren’t planning on voting in October. What’s the point, they shrug, there’s no one to vote for.”

Johnson says that the rising fury in New Zealand society is very tangible: “if you go into the suburbs and listen closely, you can hear an ominous hiss of fury rising up like a gas leak.”

She suggests that this disenchantment is rational, and that there’s now little hope that politics can fix the problems of New Zealand: “Whatever happens on October 14, it feels like there’s just gonna be another 3 years of muddling, myopic, middle management politics where we have our head up our ass and our ecosystem on fire.”

Is politics in New Zealand broken?
Given the declining trust and participation in politics and the electoral process, this might signal that something is wrong in New Zealand’s democracy.

Of course, this is a problem all over the world at the moment, with rising dissatisfaction and a sense that elites and vested interests dominate. There is a huge mood of change everywhere.

Chris Trotter says that most politicians haven’t caught up with the new Zeitgeist. He reports on a new book exploring the decline of politics, written by former British Tory Cabinet Minister Rory Stewart, which reflects on how the political system has hollowed out.

Here’s the key quote that Trotter cites from the book, suggesting it could well come from a minister in the current New Zealand government: “I had discovered how grotesquely unqualified so many of us, including myself, were for the offices we were given… It was a culture that prized campaigning over careful governing, opinion polls over detailed policy debates, announcements over implementation.”

Similarly, writing about how dire the current election campaign is, Matthew Hooton says New Zealand’s political system is effectively broken because the parties simply aren’t serious vehicles for political change anymore.

He argues that they have been captured by careerists, consultants and lobbyists seeking power: “That is, they are not concerned with achieving power to make anything better. They are focussed merely on achieving office, to enjoy the status and perks.

“This is why they feel no need to do real work between elections, before which they release pseudo-policies, written the night before, often by external lobbyists or consultants, that they can’t and won’t deliver — and which they don’t care whether or not are delivered anyway.”

Dr Bryce Edwards is a political scientist and an independent analyst with The Democracy Project. He writes a regular column titled Political Roundup in Evening Report.

Article by AsiaPacificReport.nz

National Party leader Christopher Luxon made claims about health outcomes that were clearly false. Why was he left unchallenged?

In the TVNZ leaders’ debate last night, Luxon and Labour’s Chris Hipkins had a testy exchange over Māori healthcare.

Hipkins held firm on the creation of a Māori Health Authority, established last year, arguing strongly that the persistent gaps in health outcomes and care justified it.

Luxon was equally clear in opposition to it. He framed his critique of the authority around an alleged complete lack of progress on Māori health outcomes. He was very specific.

“Every single health outcome has gone backwards under Chris’s government,” Luxon said.

“Six years, not one has improved for Māori or for non-Māori.”

While sweeping in nature, Luxon’s claim did not get a direct response from Hipkins.

Luxon repeated a similar line later in the debate.

“Gone backwards. Chris, under your government, every single health outcome for Māori or non-Māori [has gone backwards]. You can’t have that.”

Hipkins did push back on this occasion, citing the ongoing reduction in rates of smoking.

Luxon’s claim was far from true — there are a number of areas where health outcomes for Māori and non-Māori have improved while Labour has been in charge.

But it is perhaps understandable that Hipkins was not quick to correct Luxon because the data — even though it’s better in many respects — is still grim. Maybe Hipkins did not wish to dwell on this.

Improved health outcomes
There are a number of health outcomes where, for Māori, statistics have improved.

Perhaps Labour’s biggest boast is their track record on bringing down lung cancer and smoking rates for Māori.

Lung cancer is the second leading cause of death for Māori in Aotearoa. But according to the Ministry of Health, rates of lung disease for Māori have come down.

In 2017, the rate per 100,000 people was 79.9 for Māori. By 2019, it was down to 68.4. This also aligns with smoking rates among Māori dropping.

Pre-colonisation, Māori did not smoke. However, when tobacco was introduced to Aotearoa in the 18th century that quickly changed.

Smoking has been particularly harmful for Māori who have higher smoking rates than non-Māori and experience greater rates of death and tobacco-related illness.

In 2017/18, the smoking rate for Māori adults was 35.3 percent. By 2021/22, it was down to 20.9 percent (approximately 127,000 people).

Rates were falling under National but they have continued to drop under Labour, which has rolled out a number of initiatives in an effort to reduce nation-wide smoking rates.

As part of the Smokefree 2025 Action Plan, historic and world-leading legislation mandated an annually rising smoking age that will mean that anyone born on or after 1 January, 2009, will never be able to purchase tobacco products.

Other cancers
Overall, cancer registrations rates among Māori fell from 416 per 100,000 people in 2017 to 405.7 in 2019.

Breast cancer registration rates for Māori women fell from 140.7 per 100,000 people in 2010 to 122.5 per 100,000 in 2019. Prostate cancer registration rates for Māori fell from 105.5 for Māori in 2017 to 103.5 in 2019.

For non-Māori, overall cancer registration rates increased slightly from 323.2 (2017) to 332.4 (2019).

Life expectancy
The life expectancy gap between Māori and non-Māori may be the most telling indicator of all when it comes to inequities.

According to the latest available data from 2019, life expectancy at birth for Māori men in 2017-2019 was 73.4 years, up 3.1 years from 2005-2007 data.

The life expectancy for non-Māori men is 80.9 years. For Māori women, it was 77.1 years, up 2 years from 2005-2007. Non-Māori women are expected to live to 84.4 years.

While Māori life expectancy has increased over time, the gap to non-Māori persists.

At the current rate of progress it will be more than a century before Māori and non-Māori have equal life expectancy, a study by the Association of Salaried Medical Specialists found in 2021.

Child immunisation
In the debate, after Hipkins raised smoking as an area of improvement, Luxon said child immunisation was a concern. On this, he was correct.

Over the past six years, child immunisation rates have steadily fallen.

In 2017, 86.2 percent of eligible Māori five year olds had completed all of their age-appropriate immunisations. As of last year, the rate had shrunk to only 71.8 percent. That is an alarming 16 point drop in the period Labour has been in power.

In April of this year a report commissioned by Te Whatu Ora’s Immunisation Taskforce found that immunisation failed to achieve “adequate on-time immunisation rates in young tamariki” and to immunise Māori, meaning those who were most susceptible to “vaccine-preventable disease” had the lowest immunisation coverage.

The report highlighted the worst rate in the country — just 34 percent of Māori children in South Auckland were fully vaccinated. It attributed part of the problem to vaccinators being diverted to the country’s covid-19 pandemic response.

“This caused childhood immunisation rates to plummet. These rates are now the lowest they have ever been and ethnic disparities have further expanded,” it said.

The report outlined 54 recommendations covering funding, delivery, technology, communications and governance across the programme.

In the debate, Hipkins suggested the anti-vaccine movement was part of the problem, which he sought to link with National.

National has proposed an immunisation incentive payment scheme. The plan would see GP clinics paid a lump sum for achieving immunisation targets, including full immunisation for two-year-olds, MMR vaccines for ages 1-17, and influenza vaccines for ages 65+.

The clinics would have to either achieve 95 percent coverage for their childhood patients, and 75 percent for the flu shots, or achieve a five percentage point increase for each of those target groups, by 30 June 2024 to receive the payment.

Labour’s Dr Ayesha Verrall said a similar scheme already existed.

Labour has also failed to halt type 2 diabetes, the country’s biggest and fastest growing health condition.

Ministry of Health figures show that in 2021 there were 302,778 people with diabetes, predominantly type 2. Since the Labour government came into power in 2017, the estimated rates of the number of Māori with diabetes per 1000 has risen from 66.4 to 70.1 in 2021.

The rates for non-Māori have also climbed from 27.8 in 2017 to 30.1 in 2021. It is also important to note that the rate of diabetes in Aotearoa has been steadily rising over the past 50 years.

Type 2 diabetes can also lead to devastating health conditions and complications, including heart failure, kidney failure, strokes and limb amputation.

According to Ministry of Health data obtained by RNZ under the Official Information Act, since 2011 there has been a 39 percent increase in diabetic limb amputations across the whole population.

For Māori, the number has more than doubled in the past decade from 130 in 2011 to 211 in 2021. Under Labour, the number of Māori diabetic limb amputations rose by 15 percent.

Māori are still 2.8 times more likely to have renal failure, another complication of diabetes.

Mental health
According to Te Whatu Ora, the rate of suspected suicide per 100,000 Māori population in 2021/22 was 16.1. This is not a statistically significant change from the average of the past 13 years.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz