The Royal Australasian College of Physicians' submission to the Finance and Expenditure Select Committee Budget Policy Statement 2021 - RACP
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
The Royal Australasian College of Physicians’ submission to the Finance and Expenditure Select Committee Budget Policy Statement 2021 Poutū-te-rangi 2021
Introduction
The Royal Australasian College of Physicians (RACP) welcomes the opportunity to submit feedback
to the Finance and Expenditure Select Committee on the Budget Policy Statement 2021.
The RACP works across more than 40 medical specialties to educate, innovate and advocate for
excellence in health and medical care. Working with our senior members, the RACP trains the next
generation of specialists, while playing a lead role in developing world best practice models of care.
We also draw on the skills of our members, to develop policies that promote a healthier society. By
working together, our members advance the interest of our profession, our patients and the broader
community.
Overall Position
The RACP believes that the Budget Policy Statement 2021 represents a cautious approach to
investment, which fails to address systemic and long-standing issues in our society. With the focus
on COVID-19, attention has been drawn away from societal problems and towards the preservation
of economic convention, and as such we believe a much bolder approach is required.
We acknowledge the importance, and the success of the COVID-19 response in keeping Aotearoa
NZ safe, however we challenge the extent to which it dominates the Statement and the direction of
the Government. Funds are available for investment in our people, with the Statement
acknowledging that both before the pandemic, and reaching into the future, Aotearoa NZ’s net debt
as a percent of GDP will remain lower than that of most other advanced economies based on
comparable measures1. Rebuilding from the COVID-19 pandemic represents a unique opportunity
to truly transform our society towards a more equitable future, and the RACP urges action.
This is particularly salient as we continue with the implementation of changes recommended in the
New Zealand Health and Disability System Review2. For these to create true change, resources are
required to properly implement its recommendations, and we hope that the Government will live up
to this challenge in Budget 2021.
COVID-19 Recovery, Unemployment Levels, and our Social Security Net
The Budget Policy Statement 2021 places immediate emphasis on unemployment levels, and the
general economic climate of Aotearoa NZ during the continuing impact of the COVID-19 pandemic.
In the foreword, unemployment is stated to be lower than expected at 4.9 per cent, in the context of
an economy which was larger in the September 2020 quarter than before COVID-19. While in
isolation these statistics are impressive, the later expanded impacts upon employment are
concerning for the RACP. Particularly, the 32 per cent rise in unemployment for women, in
comparison to only 18 per cent for men, alongside the continuation of historical trends in which
1 New Zealand Government. Budget Policy Statement 2021 [Internet]. Wellington: New Zealand Government;
2021. Accessed 11 March 2021. Available from:
2 New Zealand Health and Disability System Review. Final Report – Executive Overview [Internet]. New
Zealand Health and Disability System Review; 2020. Accessed 11 March 2021. Available from:
https://systemreview.health.govt.nz/assets/Uploads/hdsr/health-disability-system-review-final-report-
executive-overview.pdf.
The Royal Australasian College of Physicians 2
Submission to the Finance and Expenditure Select CommitteeMāori are inequitably impacted during recessions, will have significant impacts on our society in the
months and years to come3.
Māori unemployment has risen to 9 per cent and Pasifika unemployment to 9.6 per cent, in the
December 2020 quarter, while the overall unemployment rate decreased4. This shows that our
economy’s recovery from COVID-19 has exacerbated existing inequity within our labour market. The
status quo, in and of itself is not acceptable, and this further deterioration within the labour market is
of serious concern for the RACP. As noted later in the Budget Policy Statement, the average
material standard of living for Pasifika people is around a half lower, and for Māori a third lower than
average for the general population, which contributes to a proven inequity in health outcomes5.
Building back stronger from COVID-19, means that the Government must reject existing and
growing systemic inequity, and take strong, real moves which ensure Māori and Pasifika thrive in
our labour market in the years to come.
The Budget Policy Statement acknowledges systemic barriers in the education, health, housing and
social welfare systems, and that they do not address multifaceted, intergenerational disadvantage.
However, it fails to recognise that these systems are inimitably entangled with, and in fact
contributed significantly to, the intergenerational disadvantage of which the Budget Policy Statement
speaks. Systemic, institutional racism inherent in these institutions continue to perpetuate
disadvantage, and this is not addressed within the Statement, instead placing the focus on the
interaction between agencies.
While an increasing number of Māori and Pasifika continue to be locked out from the labour market,
a number which is growing due to the aforementioned impact of COVID-19, there is no signal in the
Statement that the Government will take action to increase benefit levels, which would immediately
improve the material standard of living for recipients. Due to low levels of income, living in a
household in which the main source of income is a benefit is a highly potent risk factor for persistent
poverty6. In addition, household costs are rapidly rising, driven by factors including rampant inflation
in the housing market, which continues to place undue stress on the finances of low-income
renters7. These problems were placed in the spotlight by the Welfare Expert Advisory Group’s
Whakamana Tāngata report, which was presented to Government in 20198. However, only
piecemeal changes have been made to address its recommendations. Although this report was
commissioned and released prior to the onset of the pandemic, the economic and social impacts of
COVID-19 have only exacerbated the inequities which were already so pronounced. We believe the
pandemic has underscored the critical need for benefits to reflect and enable a life with dignity.
3 Te Puni Kōkiri. Data & Analytics Summary - Economic Impact of COVID-19 July 2020 [Internet]. Wellington:
Te Puni Kōkiri; 2020. Accessed 11 March 2021. Available from: https://www.tpk.govt.nz/en/a-matou-
mohiotanga/employment-and-income/maori-employment-impact-of-covid19-july-2020.
4 Statistics New Zealand. Labour market statistics: December 2020 quarter [Internet]. Wellington: Statistics
New Zealand; 2021. Accessed 11 March 2021. Available from: https://www.stats.govt.nz/information-
releases/labour-market-statistics-december-2020-quarter.
5 Waitangi Tribunal. Hauora: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry.
[Internet] Wellington: Waitangi Tribunal; 2019. Accessed 11 March 2021. Available from
https://forms.justice.govt.nz/search/Documents/WT/wt_DOC_152801817/Hauora%20W.pdf.
6 Madden K. The Heart of Poverty Uncovering Pathways Into and Out Of Disadvantage in New Zealand
[Internet]. Auckland: Maxim Institute; 2016. Accessed 11 March 2021. Available from:
https://maxim.org.nz/wp-content/uploads/2017/02/3.Temp-Poverty-Pathways-Paper.pdf.
7 Fonseka D, Newton K. Rents soar after Covid-19 freeze ends [Internet]. Wellington: Stuff; 2021. Accessed
11 March 2021. Available from: https://www.stuff.co.nz/life-style/homed/renting/124052014/rents-soar-after-
covid19-freeze-ends.
8 Welfare Expert Advisory Group. Whakamana Tāngata – Restoring Dignity to Social Security in New Zealand
[Internet]. Welfare Expert Advisory Group; 2019. Accessed 11 March 2021. Available from:
http://www.weag.govt.nz/weag-report/whakamana-tangata/.
The Royal Australasian College of Physicians 3
Submission to the Finance and Expenditure Select CommitteeThe RACP urged action on benefit levels in its #MakeItTheNorm election statement campaign,
which recommended that Government implement the recommendations of Whakamana Tāngata
report with urgency. We remain committed to this goal, and advocate strongly that the Government
commit to implementation in Budget 2021. It is also important to note that this will have impact upon
many of the objectives, and capital areas identified in the Budget Policy Statement, such as those of
social capital, child wellbeing, and physical and mental wellbeing.
Action on Child Poverty
While child poverty statistics are generally trending down for the year ended June 2020, the RACP
wants to see much more action on this from the Government9. Over 125,000 children continue to
live in material hardship, in a country where this does not have to be the case. Children continue to
live in emergency housing, where the average stay has ballooned to 14 weeks, because there is
nowhere else to go10. This is acknowledged in the Budget Policy Statement, with access to warm,
dry and safe housing identified as key to child wellbeing. Now we need to see action on this, and the
apportioning of resources to comprehensively address this. Warm, dry and safe housing is a
foundational component to whānau wellbeing that supports improved physical and mental health
outcomes, educational achievement, and fosters a sense of connection to community.
Just Transition – Avoidance of the Worst Health Impacts of Climate
Change
The RACP supports strong action to meet Aotearoa NZ’s target of net zero emissions of long-lived
gases, and for reducing methane emissions by between 24-47 per cent by 2050. We agree with the
assessment in the Statement that significant further action is required to achieve this, and to deviate
from our current path of relative normality with regard to emissions. The possible impacts of climate
change upon our society, across a number of domains including those of health and of culture, are
catastrophic and must be avoided. Groups specifically at risk include those suffering from systemic
deprivation, children and the elderly, Māori, Pasifika, women, and people with disabilities, each with
their own unique interactions with the potential of climate change11. The status quo will not be
enough to achieve the change we need, and we hope to see the Government take bold action in
Budget 2021 to address this.
The Future of Work – The Place of Conditions in Budget Objectives
The RACP is disappointed that the Statement does not consider the importance of working
conditions and the direct future of wages in its objectives in this area. While expanding the provision
of technology infrastructure, and expanding the availability of training are undeniably important
aspects of work, which will allow us to become a more highly skilled and adaptable workforce, they
cover only a portion of what is important for good work in the future.
9 Statistics New Zealand. Child poverty statistics: Year ended June 2020 [Internet]. Wellington: Statistics New
Zealand; 2021. Accessed 11 March 2021. Available from: https://www.stats.govt.nz/information-releases/child-
poverty-statistics-year-ended-june-
2020#:~:text=In%20the%20year%20ended%20June%202020%2C%2018.2%20percent%20of%20children,rel
atively%20unchanged%20over%20the%20year.
10 Community Law Centres Aotearoa. Emergency Housing Standards Urgent [Internet]. Wellington: Scoop;
2020. Accessed 11 March 2021. Available from: https://www.scoop.co.nz/stories/PO2012/S00177/emergency-
housing-standards-urgent.htm.
11 Toogood C. Climate medicine: our changing climate and health inequity in New Zealand. New Zealand
Medical Student Journal [Internet]. 2019; 29: 25-28. Accessed 11 March 2021. Available from:
https://www.nzmsj.com/climate-medicine-our-changing-climate-and-health-inequity-in-new-zealand.html.
The Royal Australasian College of Physicians 4
Submission to the Finance and Expenditure Select CommitteeWe believe that every employee is entitled to a fair wage, which enables them to live with dignity, as
this is key to achieving wellbeing for all New Zealanders. This means ensuring a Living Wage for
workers now and into the future, across all sectors, alongside safeguarding and continuing to
improve the rights of workers. As such, it is important these objectives are considered alongside
those currently identified for investment in budget processes.
Good work means work that foster wellbeing, personal growth, fulfilment, autonomy and meaning.
We need to recognise that all forms of work (including unpaid work) are valuable, and form
irreplaceable parts of all of our lives. People deserve recognition and appreciation for the work that
they do, and they deserve to be safe when doing it. We would like to see Government support for an
updated time-use survey, and the backing in the budget to carry it out. It has been over a decade
since a time-use survey was previously carried out, and in that time, there have been big changes in
the way people spend and utilise time. This includes monumental recent shifts in flexible working
arrangements, alongside limited (although growing) recognition of the importance of female-
dominated care work, both paid and unpaid, including Paid Parental Leave and Pay Equity
legislation12. Societal recognition, and overall policy change using this data has the potential to have
significant wellbeing benefits for many in our society, including wāhine Māori, Pasifika women, sole
parents and women with disabilities, who have been consistently neglected and erased from
dominant narratives.
Physical and Mental Wellbeing
The RACP strongly agrees with the Government’s position that good physical and mental health,
and timely access to care and support when they are needed are fundamental to New Zealanders’
long-term wellbeing. As New Zealanders are continuing to cope with the repeated impacts of the
COVID-19 pandemic on their lives, including multiple level 3 lockdowns, the provision of mental
health support will be of particular importance. This has been recognised in the Ministry of Health’s
Kia Kaha, Kia Māia, Kia Ora Aotearoa: COVID-19 Psychosocial and Mental Wellbeing Plan, which
identifies the potential for this to exacerbate existing inequitable health, social, educational and
economic outcomes for Māori, Pasifika peoples and other groups13. We believe that in Budget 2021,
these factors should continue to be recognised, with further financial commitment to support Māori
and Pasifika peoples. This should take into account additional support which may be needed, due to
the reality that many communications have been poorly targeted to these groups, and that
generally, the recent environment surrounding COVID-19 lockdowns has become increasingly
hostile14. It is especially important that areas such as South Auckland are supported, due to the
undue vitriol these communities have faced during recent events.
12 The Royal Australasian College of Physicians. Something To Do: Make Good Work the Norm
Value Unpaid Work [Internet]. Wellington: The Royal Australasian College of Physicians; 2020. Accessed 11
March 2021. Available from: https://www.racp.edu.au/docs/default-source/policy-and-adv/aotearoa-new-
zealand/make-it-the-norm-good-work-unpaid-work.pdf?sfvrsn=e36cf51a_4.
13 Ministry of Health. Kia Kaha, Kia Māia, Kia Ora Aotearoa: COVID-19 Psychosocial and Mental Wellbeing
Plan [Internet]. Wellington: Ministry of Health; 2020. Accessed 11 March 2021. Available from:
https://www.health.govt.nz/publication/covid-19-psychosocial-and-mental-wellbeing-plan.
14 Weekes J. Covid 19 coronavirus: Anger at breach, fears about 'conspiracy theories' during lockdown
[Internet]. Auckland: The New Zealand Herald; 2021. Accessed 11 March 2021. Available from:
https://www.nzherald.co.nz/nz/covid-19-coronavirus-anger-at-breach-fears-about-conspiracy-theories-during-
lockdown/FD37KPUOA7AN3FVCCFMJMSJFHI/.
The Royal Australasian College of Physicians 5
Submission to the Finance and Expenditure Select CommitteeConclusion
The RACP thanks the Finance and Expenditure Select Committee for the opportunity to provide
feedback on this consultation. To discuss this submission further, please contact the NZ Policy and
Advocacy Unit at policy@racp.org.nz.
Nāku noa, nā
Dr George Laking
Aotearoa NZ President
The Royal Australasian College of Physicians
The Royal Australasian College of Physicians 6
Submission to the Finance and Expenditure Select CommitteeYou can also read
