Labour gets chance to give health a boost

David Clark. Photo: NZ Herald
David Clark. Photo: NZ Herald
While all the Budget day attention will be on Finance Minister Grant Robertson, arguably it is Health Minister David Clark who has the more difficult job.

In Opposition, Labour consistently claimed health was being underfunded, a line it has maintained since taking office.

That means a sizeable amount of money will need to be allocated to health for the Government to be able to claim it is addressing the problem - or at the very least argue it is doing more in the sector than the previous administration.

However, where do you start?

There are 20 District Health Boards, which receive about three-quarters of the $16billion the Government allocated for health in the last Budget.

Just two expect to trade in surplus this financial year and another two aim to break even.

The rest will rack up a combined deficit of $190million if all goes well. With the nurses' employment contract dispute awaiting settlement, any payout ensuing from that will see the deficit figure soar past $200million.

That is an issue the Government needs to be settled - and quickly.

A nurses' strike - quite apart from being hugely disruptive for patients - would be a terrible look for the Government after Dr Clark, Mr Robertson and Prime Minister Jacinda Ardern met their union last week, and Ms Ardern signed its open letter calling for sustainable health funding.

DHBs and nurses are not the only ones who have had their expectations raised by the new Government's health pledges.

Health is voracious: it takes up about 20% of Government expenditure and, as those DHB deficit numbers show, it is almost impossible to keep up with demand - let alone outpace it.

The mental health sector will expect greater emphasis in the wake of the ongoing Government inquiry into the sector, maternity services are under strain, disability groups have been vocal about their needs ... the list goes on.

The CTU yesterday estimated health's share of the Budget has to grow between $805million and $1billion - which may be more than the Government can spare.

With so many demands, some will be left disappointed.

Labour has already made a strategic retreat from its election promise to drop GP visit fees by $10, saying that will be phased in as it cannot achieve everything it wants in one Budget.

In addition to demands on operational expenditure, health's needs are about to eat into the $42billion set aside by the Government for capital expenditure. A new hospital for Dunedin has just been announced, the state of buildings at Middlemore Hospital demand attention, and Whangarei is the latest hospital to reveal issues with buildings.

Quite likely, there will be more to come.

It has been said that the most important health minister is the Minister of Finance.

In that case, Dr Clark should be well placed - a former Treasury staffer, he is also an associate finance minister and Mr Robertson delegated the running of the Budget process to him.

Sating the appetites of both Dr Clark's ministerial colleagues and his own sector is a delicate balancing act few would fancy - but it is one the perception of Grant Robertson's first Budget will rely upon.


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