Feature

Kiwis’ big adventure

Britain isn’t the only country experimenting with the purchaser-provider split in health care. David Seedhouse reports from down under

After many years of Thatcherism the Labour Party has been swept back into power on a tide of national concern for the underprivileged, and has cocked a massive snub to opinion pollsters in the process. As the elated Labour leader forces his way through throngs of jubilant supporters, cameramen keep a respectful distance from the rostrum, and he launches into a passionate victory speech...

‘The polls put us 10% behind, but they were wrong. The smug PM thought he was home and dry, but it will be a long night for him. It will be a long cold night for the government. But it will be just a little warmer for the homeless, those without jobs, the sick who cannot afford the medicine they need...’

It was hard not to feel a lump in the throat. It was hard not to wish to have witnessed these scenes back home, with John Smith- rather than New Zealand Labour leader Mike Moore — welcoming a victory for socialism. It was hard not to be overwhelmed by the heady emotions of the moment. Hard, that is, until you remembered just one unfortunate fact: the Labour Party had not won. They had come close, but 49 seats to the incumbent government and 46 seats to Labour is impossible to describe as a victory even in New Zealand. And if you could not close your mind to this inconvenient truth then Mike Moore’s ‘victory speech’ was nothing short of bizarre.

Moore’s charade was surreally out of place on election night, but nonetheless offers an apt metaphor for 1990s New Zealand. On the fact of it people are confident, looking to a bright and prosperous future. But just like Mr Moore, their assurance comes from being part of an international crowd, travelling the same course as other nations. Uncharted waters no longer seem to appeal to the Kiwis.

New Zealand claims to be the first country in the world to have granted women the right to vote - in 1893 - and in the early part of this century the government introduced comprehensive social welfare systems. New Zealanders were among the first people in the world to enjoy the security of retirement pensions, low cost housing, universal education, unemployment benefits and a national health service paid for out of taxation.

The national concern for social justice has been seriously tested — and some say proved to be terminally brittle — by a financial crisis sparked when Britain joined the EC at the start of the 1970s, so shutting the door on New Zealand’s main market for agricultural products. The country had to borrow heavily to cope with the economic shock, and to pay for public spending, particularly on welfare, which rose in tandem with growing agricultural unemployment.

In 1984, with the country on the edge of bankruptcy, the new Labour government unreservedly embraced Thatcherism. With great speed the once highly protected economy was deregulated, state enterprises and utilities were sold off, farming subsidies were abolished, and welfare payments savagely cut.

The health care changes have been particularly controversial. The medical profession had fiercely resisted a salaried service when it was mooted in the 1930s, so New Zealanders have always been used to payimg a ‘fee for service’ charge to see their GPs. But they balked sharply when, in 1992, cash registers were introduced into public hospitals. Kiwis were told that they must pay ‘part-charges’ for hospital services: up to NZ $500 (£200) per stay, and NZ $50 a night. Because of their unpopularity these charges were dropped before the election but, whatever the shape of the new government (at present New Zealanders have a hung parliament) it is likely that they will resurface. A debt of the size New Zealand faces, coupled with the well-known pressures pushing up welfare costs worldwide, mean that the New Zealand public health service must, somehow, be restricted. The most likely course, if part-charges are not pursued, is a mixed private and public system, with individuals increasingly encouraged — or forced by circumstance — to take out private health insurance. Eventually, though there may well be a rump of public services left, these will most likely be thought of as second class (as in the US), and might conceivably dwindle away altogether. New Zealanders have been softened up for such a scenario over the past couple of years by the so-called ‘core services’ debate through which much publicity has been given to the idea that not all medical services can be paid for by the state, and that the public must decide which services it is reasonable to expect a government to provide and which it is not.

Although it is easy to understand that desperate measures were required to deal with New Zealand’s economic crisis, it is depressing to see so little imagination in a new country. While there has been a rapid increase in Kiwi millionaires, the last few years have also seen the advent of charitable soup kitchens — soup kitchens for hungry citizens in a land so naturally bountiful that it is nicknamed ‘God’s Own’. Mindless graffiti is now scrawled on many buildings, and crime is rising.

Life’s losers are being allowed to fall to the floor in today’s New Zealand, which was never acceptable in the past. New Zealand’s settlers have two traditions — one, understandably, harks back home, to an imagined land of parliamentary democracy, disciplined schooling, good manners, and everything in its place.

But modern Britain is alien to the uniquely Kiwi tradition. In reality there seems to be little left in the UK of the egalitarian ‘spirit of endeavour’; which inspired the colonists to establish a fairer land, without class barriers, where making an ‘honest fist’ of things is far more important than having the right connections — a tolerant nation where one’s neighbour actually matters. This tradition is still alive in New Zealand, but it is under great threat.

New Zealanders are at a crossroads in their history — and while they continue to ape the fashionable policies of other countries, the danger is that they will forget altogether their own pioneering heritage.