Govt kicks off controversial health changes

Tuesday, 27 February 2024

The Government has kicked off controversial changes to health, aiming to repeal the Māori Health Authority and the Smokefree legislation under urgency.

The repealing of the Smokefree law would reverse the previous Government’s plan to reduce nicotine in products, cut the number of tobacco retailers and stop the selling of tobacco to people born after 2008, while the new Māori Health Authority - Te Aka Whai Ora would be disestablished.

Te Aka Whai Ora - the Māori Health Authority

After debate was paused on Tuesday night, the third reading of the Pae Ora (Disestablishment of the Māori Health Authority) Amendment Bill will take place on Wednesday.

Health Minister Shane Reti said the disestablishment was “a reflection of an approach that failed to put health needs for all at its forefront and a reflection of an implementation plan that faced significant challenges from the beginning”.

“I want to paint a vision for Māori and all New Zealanders. My vision is that all New Zealanders will have timely access to quality healthcare.“

Green Party spokesperson for Māori health Hūhana Lyndon said it would have devastating and lasting impacts.

“Scrapping Te Aka Whai Ora represents a step back to a status quo that has failed generation upon generation of Māori,” Lyndon said.

“The institutional neglect of the past has resulted in Māori dying at four times the rate of non-Māori from preventable disease and illness.”

GP and associate professor of primary care Dr Rawiri Keenan said in a statement there had been talk that “Te Aka Whai Ora has not achieved anything, yet it's barely had twelve months and if fixing the decades of health inequity was so easy, it would have been done by now”.

'If you look at the health literature you target resources where there is most need and economically it makes sense to intervene there as inequity leads to greater costs on the health system.“

Keenan said many within the health system were deeply concerned about what the changes meant for Māori health equity and what the flow on effects were for the health system overall.

Smokefree

Parliament will debate the smokefree legislation on Wednesday morning from 9am.

On Tuesday, Te Pāti Māori made a last effort before the bills went to Parliament, asking the Speaker for a debate on the Government’s use of urgency.

“Urgency deprives both legislators and the public of adequate time for scrutiny and deliberation on significant legislative measures such as the disestablishment of the Māori Health Authority and abolishment of Smokefree legislation,“ Te Pāti Māori co-leader Debbie Ngarewa-Packer said.

Researchers at the University of Otago, Wellington, warned the repeal of smoking legislation “means thousands of New Zealanders will continue to die needlessly from smoking-related diseases”.

Centre co-directors Professor Janet Hoek said the repeal lacked evidence, logic and support, while Associate Professor Andrew Waa said New Zealand now was faced “with the prospect of thousands of unnecessary deaths every year”.

“Māori, in particular, will continue to be harmed,” Waa said.

On Tuesday, Associate Health Minister Casey Costello said they wanted to help smokers stop.

“We want to enable smokers to quit and that's what we're going to continue to do.

Costello said she was continuing to get advice “to achieve our Smokefree targets“.

On Wednesday morning, Costello told TVNZ Breakfast she was looking to tighten regulations about vaping, including a ban on disposable devices, saying it “got away on us”. The Government would consider rules about advertising, and the display of vapes in shops, she said.

She also wanted to bring back a “vape to quit” programme for smokers.

Costello said smoking rates had continued to trend downwards, with daily smoking rates down to 299,000 people or about 5.6%.

'The goal of smokefree has always been below 5%, its never been zero. I think we can target well below five,' she told the programme.

On Tuesday, ACT health spokesman Todd Stephenson said the changes would have delivered criminal groups “a near-monopoly over the cigarette trade”, describing it as a “dopey experiment in prohibition”.

Immigration woes

It followed a damning review released earlier on Tuesday into the visa scheme rolled out after Covid found inadequate risk assessments and a failure by leadership to pay adequate attention when staff raised concerns at Immigration New Zealand.

The Accredited Employer Work Visa (AEWV) was introduced mid-2022, as the country faced workforce shortages after the pandemic. The intention was to speed up the work visa system by inviting employers wanting to hire overseas staff to apply for accreditation.

The review found INZ did not adequately assess the risk and impact of speeding up processing times against the risk of abuse of the visa system, a focus on timeframes overrode risk considerations, and when staff raised concerns, leadership failed to pay adequate attention.

The scheme was exposed to an increased risk of exploitation by “unscrupulous” agents or employers between July 2022 and June 2023.

Almost 150 employers have had their accreditation revoked, and another 53 suspended as part of investigations into the work visa, as at February 16. There have been more than 2000 complaints against employers and another 174 active investigations underway.