The "Big C" of the health world right now is Covid, but cancer, construction and community provision of services were big issues before the pandemic began, and remain so.
Cancer was the big political issue in health during 2019, in no small part due to the superhuman efforts of Winton farmer Blair Vining.
Before his death from bowel cancer a year ago, Mr Vining generated such a groundswell of support for his campaign for better cancer treatment services that the Government was forced to act, drafting a national cancer strategy and forming a Cancer Control Agency.
However, that has by no means quelled the political disquiet over cancer, and issues such as funding new drug therapies and equity in provision of treatment services are still fraught with contention.
National, which threw its weight behind Mr Vining’s campaign, has continued to make cancer a focus of its health policy and has pledged to create a dedicated cancer drug fund worth $200 million over four years.
It has also promised to enhance and improve the Cancer Control Agency, accelerate the bowel screening programme, create local radiotherapy units and set a target for health boards to provide faster cancer treatment.
Labour defends its record on cancer control and has vowed to provide greater Pharmac funding for cancer drugs.
New Zealand First, in line with its focus on provincial growth, has pledged to keep funding linear accelerators and other cancer treatment technology for regional hospitals.
The Greens do not have a specific cancer policy, but in general terms want healthcare to be available at the earliest stage possible, in the hope of achieving the best outcome possible.
Act New Zealand has called for an independent review of Pharmac’s operation, particularly how it makes its decisions — a call National and Labour are also likely to heed.
Construction is a particular issue for southern health services, as the long-awaited and much needed construction of a new Dunedin Hospital inches forward.
All parties support the project, but National and Labour in particular have hotly debated whether it is being progressed with sufficient speed.
Dunedin Hospital is far from the only health construction issue facing the South; the district health board also has to manage facilities at Wakari Hospital regarded as not fit for purpose.
Labour, as part of its mental health strategy, has set aside several million dollars to build new mental health facilities, although the South has yet to see any progress in this area.
New Zealand First has also pledged support for greater investment in mental health, including more funding for counselling services.
The Greens support building new health services, but with an emphasis on planning, equity and sustainability.
Infrastructure is a key Act policy, and it has called for a centralised, planned approach to health infrastructure builds, and also for property management to be taken away from health boards.
Covid-19 lockdown restrictions forced hospitals and general practices to scale up new ways of providing community healthcare remotely.
Initiatives such as telehealth — remote consultation via telephone or the internet — are now much closer to being the norm rather than a novelty, and integrated primary healthcare along the lines of the healthcare homes model being rolled out in the southern region is now a much more accepted concept.
National has promised to expand the role of primary care providers, and plans to fully fund a "navigator" at each general practice to improve access to health services.
Labour’s health policy focuses on its record investment in health services, with the expectation of more to come if Labour is elected.
The Greens have also promised to boost primary health funding, as well as encourage "out of hours" provision of health services.
Act plans a dramatic overhaul of health administration, cutting DHBs from 20 to six, setting up a national IT platform for healthcare procurement and supply, and encouraging greater collaboration between public and private hospitals.
For most New Zealanders, what they want is an assurance of care, be that at a GP or a physiotherapist, in an emergency or access to elective surgery.
Most DHBs are dealing with a backlog of surgery due to Covid-19 delays, and Government parties made funding available through a Covid-19 recovery package to address that.
National has pledged that no-one will have to wait more than four months for elective surgery.
Mental health will also be a battleground on the election trail, the parties in the coalition Government having backed record investment in the area and commissioned an inquiry, but opposition parties believe not enough has been done, and what has been spent has been done so ineffectively.
