Why Dr Shane Reti didn't work as National’s health minister
Sunday, 19 January 2025
ANALYSIS: The Prime Minister wants “ruthless execution”, and it was a ruthless execution.
Dr Shane Reti spent a week of his summer break doing charity work at a clinic in the Cook Islands, in the middle of a tropical cyclone, only to come home and be sacked as health minister.
But in that lies Reti’s problem.
Luxon doesn’t want an empath, he wants delivery, à la minister of getting-stuff-done Simeon Brown.
Reti “worked hard” last year, Luxon told reporters on Sunday. Not hard enough, evidently, to be anywhere near the health portfolio.
On paper it was perfect. Reti is respected within the health sector, took every chance to stick it to Labour in the last term, and as a non-smoker-teetotaller, walks the talk on National’s bread and butter family values politics.
There was no question when National formed the coalition who would take on the health portfolio.
He set to work on his health targets ‒ back to his GP roots. He fronted a bungled cancer promise ‒ though it’s rumoured he was not the architect of that pre-election pledge, which would track given anyone with a shred of knowledge about Pharmac’s model would have seen it was never going to work.
He inserted the commissioner in July and Luxon started sitting in on their meetings.
Rumours have swirled during the months since that the PM was lining up a more politically minded replacement for health minister.
A doctor is programmed to do no harm, and in that comes a level of purist politics that ultimately made Reti likeable, yet ineffective in this Government.
And a minister of health won’t survive if they can’t win a few arguments with the minister of finance.
Nicola Willis is tightening the belt, so Reti gets no funding for his health targets. Primary care isn’t happy. Nurses aren’t happy. Patients aren’t happy. The entire South Island isn’t happy. Luxon needs a fall guy.
He could have blamed the board of Health New Zealand but no ‒ we sacked them. He could have blamed the chief executive of Health NZ who has somehow survived a financial mess that required a commissioner. But that wouldn’t show political leadership.
So Reti goes, sent to beaver away on science and universities portfolios until he inevitably returns to the clinical environment, inexplicably outlived by the associate health ministers ‒ Casey Costello with her tax rebates on tobacco products and David Seymour whose health legacy so far is telling Pharmac to no longer bother considering the Treaty of Waitangi.
Luxon needs a health minister who wasn’t afraid of making a few enemies.
The fact clinicians liked, respected and ‒ more often than not ‒ pitied Reti was likely his downfall. Brown on the other hand has no skin in the game, and knows full well who his master is.
Luxon made it clear Brown’s track record in transport is what got him the portfolio. He wants and backs Brown to “get the job done quickly”.
How you fix decades of systemic problems in the health system without spending money ‒ quickly ‒ while making hundreds of people working in it redundant is a fairly tall order.
Brown is already starting on the back foot too ‒ there are a number of health promises the Government hasn’t kept and how he handles Dunedin hospital from here could well prove to be the decider of the next election.
How Luxon will measure Brown on success remains to be seen, but there will be no hiding any missteps from long-suffering patients.