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Covid-19 crisis shows flawed NZ health system ‘not fit for purpose’


Local governments, agencies and communities must be given more power to reduce inequalities, says lecturer

The coronavirus crisis has exposed “significant” inequalities in New Zealand’s health system, including a continuing lack of access to basic medical services for people living in poverty, a leading New Zealand health academic has said.

Anna Matheson, a health policy lecturer at Victoria University of Wellington, argues that NZ’s health system is outdated and “no longer fit for purpose”.

She says more power needs to be given to local governments, health agencies and Māori communities to drive change.

“Understanding health inequalities are reproduced through our social systems is important,” she writes in an editorial published by Newsroom, an independent NZ media outlet.

“Currently, our systems flow away from the local—away from the intimacy that drives empathy and compels action. Part of this flow is determined by history and its impact on power, knowledge and resources. Part of it is about what is valued and what is not.”

Matheson said that NZ policymakers were “good at gathering data, evidence and information to define and understand problems, but less good at acting to implement effective solutions”.

“It is against this background of inequality, inherent in our underlying systems, that the Covid-19 pandemic is happening. Despite the very necessary ‘first aid’ the government is attempting to provide, we can predict which social groups will be most affected,” she writes.

“We know the consequences of the pandemic will be substantial and long-lasting, similar to those we saw through the 1980s and 1990s with economic restructuring. Profound health and social consequences will once again fall heavily on those in already difficult and precarious circumstances.”

Matheson said that recent reviews of NZ’s health, disability, mental health and primary healthcare systems “all theorised that dominant western models of health are not entirely fit for purpose”. The Covid-19 crisis is also showing that these systems must change.

“We have known for more than 40 years that socioeconomic position determines how sick you will be and how long you will live. Put simply, if you are poor, your life expectancy is lower than someone with wealth—six years for men and five for women. If you are also Māori or of Pacific Island descent, you can expect to be sicker and die even sooner.”