David Clark accused of cronyism after appointing another ex-Labour MP

Minister of Health David Clark has been accused of cronyism after he appointed former Labour MP Steve Maharey as new chair of Pharmac, against the advice of officials, and without following State Services Guidelines in considering a pool of applicants.

Clark’s history shows he has been appointed to a number of positions as he has worked his way into politics and up the ladder, and once he became a Minister (in Cabinet) he has made more than one appointment that involves political connections.

Clark is an ordained Presbyterian minister and practiced as one from 1997 to 2000 (he is still a celebrant and performed a civil union for Grant Robertson and his partner in January 2009).

He started his political involvement while working as an analyst for Treasury from 2003 to 2006, and was also appointed to a number of community positions:

  • Campaign hoardings assistance, Wellington 2005
  • Advisor to Hon David Parker 2006 – 2007
  • Dunedin North Campaign Committee member and activist 2008
  • Head of College, Selwyn College, University of Otago 2008 – 2011
  • Member, Finance and Audit Committee Otago Community Trust 2008 – 2012
  • Trustee, Otago Community Trust 2008 – 2012
  • Leith Branch Membership Secretary 2009 – 2011
  • Member, Otago Forward economic development forum 2009 – 2011
  • Dunedin North LEC Deputy Chair 2009 – 2010
  • Dunedin North LEC Chair 2010
  • Member, University of Otago Vice-Chancellor’s Alcohol Advisory Task Force 2010 – 2011
  • Deputy Chair, Otago Community Trust 2011 – 2012
  • Member of Parliament for Dunedin North 2011 – current

After working his way up the Dunedin North Labour Party administration he was selected to replace the retiring Pete Hodgson and won the safe-ish electorate in 2011.

He was appointed Minister of Health when Labour took over Government in October 2017. he made a controversial appointment soon after:

ODT (8 December 2017): Hospital rebuild chairman sacked; Hodgson given job

Health Minister David Clark has sacked the Dunedin Hospital rebuild chairman and appointed former Labour cabinet minister Pete Hodgson to lead the project.

When contacted, Hawke’s Bay consultant Andrew Blair said his role as Southern Partnership Group chairman was “terminated” this week. Dr Clark told the Otago Daily Times the rebuild needed to be led by a local person.

Mr Hodgson, Dr Clark’s predecessor in Dunedin North, served as MP from 1990 to 2011, and held numerous ministerial portfolios in the fifth Labour government.

“As a former minister of health, he understands the complexity of the issues involved,” Dr Clark said.

“He is indisputably a local champion, and  . . . is well connected into health.

Dr Clark’s other move is appointing University of Otago chief operating officer Stephen Willis to the group now led by Mr Hodgson.

So Clark’s university and political connections coming into play there. This left Clark open to criticism, which he got – War of words over Dunedin Hospital rebuild

Former Health Minister Jonathan Coleman says the Government has made the “wrong move for progressing the rebuild” of Dunedin Hospital.

“The announcement of the ultimate Dunedin Labour Party political insider and former Health Minister Pete Hodgson as chair of the Southern Partnership Group is exactly the wrong move for progressing the rebuild.”

Hodgson is probably a good person for the job, but there is a risk of it being seen as cronyism.

Now this week (Newsroom) Clark accused of cronyism over Pharmac appointment:

Steve Maharey, former Labour MP and ex-Education Minister was appointed Pharmac chair on August 1 to little fanfare.

But questions are now being raised about his appointment after it emerged Health Minister David Clark went against the advice of officials in appointing Maharey.

Documents released under the Official Information Act show the Ministry of Health advised reappointing existing chair Stuart McLauchlan for a fourth term.

A report from 3 May 2018 advised Clark, “the Ministry considers sound reasons exist that support the reappointment of Mr McLauchlan”.

“Pharmac is taking on new roles that will have a significant impact on the health sector… They will require Pharmac to develop new capabilities to carry out these new roles,” the briefing said.

It went on to say: “Mr McLauchlan has performed well as the chair and it is advisable to provide for continuity during this period of expansion of Pharmac’s role. This is particularly so, given that a new chief executive has recently been appointed”.

It went on to recommend McLauchlan be reappointed for a further term of three years or, if Clark wished to change the chair, to reappoint him for just one year, while a replacement chair was sourced.

But Clark overrode that advice.

Instead, he informed McLauchlan that he would not be reappointed, and elevated Maharey to the board.

Opposition health spokesperson Michael Woodhouse said the move was “appalling,” and raised questions about the process involved.

While Clark had the right to appoint Maharey, he went against guidelines from the State Services Commission, which advises a position description be filled out and a wide-pool of applicants be sought before appointing board members.

A workflow for appointment processes from the Department of Prime Minister and Cabinet shows that the general procedure is to identify required skills and “call for nominations”.

Instead, a statement from Clark said the position “was not publicly advertised, which is within the Board Appointments and Induction Guidelines from the State Services Commission”.

Clark told Newsroom the appointment “followed the standard process for Board chairs and was signed off by the Cabinet”.

But Woodhouse said the process raised issues of cronyism.

“David Clark’s appalling move to remove the previous chair and appoint a former Labour MP to the role, all with no position description, no application process, interview, or any other input into the decision is cronyism at its worst,” Woodhouse said.

Making uncontested appointments, especially when close political affiliations are involved, are risky.

Maharey may chair Pharmac competently and without controversy, but questions could be asked about his credentials. He has been Vice-Chancellor of Massey University since he left Parliament.

He doesn’t seem to have done health as an MP. His responsibilities:

  • 1990-1994 spokesperson of broadcasting and education
  • 1994-1997 spokesperson for labour
  • 1996-1999 spokesperson on social welfare, employment, and tertiary education
  • 1999-2007 he ha\d various portfolios:
    Minister of Social Services and Employment
    Associate Minister of Education holding special responsibility for tertiary education
    Minister of Broadcasting
    Minister for Education
    Minister for Research, Science and Technology
    Minister for Crown Research Institutes
    Minister for Youth Affairs

Nothing health related – but Clark didn’t have much of a background in health either.

If there are no controversies over Pharmac (or the Dunedin Hospital rebuild) this may not be an issue for Clark, but he should take care avoiding too many accusations of cronyism.


UPDATE: more appointments with political connections from Clark – More DHB chair turnover but Health Minister says it’s not political

On Sunday David Clark announced three new board chairs for Auckland DHBs – Pat Snedden will lead Auckland DHB from June 1, Judy McGregor at Waitemata DHB from June 10 and Vui Mark Gosche at Counties-Manukau DHB from Thursday.

At least two of the appointments appear to be politically motivated with Gosche coming into the role having previously been a Minister under the former Labour-led Government.

Gosche was a Labour MP from 1996-2008.

McGregor served as the first Equal Employment Opportunities Commissioner for the New Zealand Human Rights Commission between 2003 and 2013 (two terms), appointed by Minister Margaret Wilson and replaced in the role by politician Jackie Blue (a National political appointment).

Pat Snedden was previously also a Labour appointee who says he was politically pushed by National’s Health Minister in 2010 – see Minister pushes health chief out

Significant pay settlement for mental health workers

Community and institutional mental health care has been deficient ever since mental hospitals were mostly emptied several decades ago.

Last year when 55,000  aged and disability residential care, and home and community support services workers, were awarded a long overdue pay increase (from the bare minimum to something relatively reasonable) there was a notable exclusion of 5,000 mental health care workers.

Yesterday the Minister of Health David Clark announced that this would be rectified.


Pay equity settlement for mental health and addiction support workers

Health Minister Dr David Clark is pleased to announce an estimated 5,000 mental health and addiction support workers will soon receive the same pay rates as care and support workers.

In an agreement with unions and employers, the Government will extend the Care and Support Workers (Pay Equity) Settlement Act to include mental health and addiction support workers.

Nearly half will get an increase of more than $3 per hour which means full-time workers will be paid approximately an extra $120 a week before tax.  One-in-five workers will get an increase of more than $5 per hour or around an extra $200 for a 40-hour week.

The new pay scale reflects workers’ qualifications and experience. It will be back-dated to 1 July 2017.

“This agreement puts right a problem created by the previous Government, which deliberately excluded mental health and addiction workers from the Care and Support Workers settlement. These workers often support New Zealanders when they are most vulnerable and they deserve a fair go. This Government has delivered that,” says Dr Clark.

“Ensuring our mental health and addiction workers are paid what they deserve will help deliver a robust workforce,” says Dr Clark.

The $173.5 million settlement extension will be implemented over a five-year term and funded through an increase to Vote Health.


This will go some way towards improving mental health care in institutions, community houses and the community generally.

Mental health issues impact on many things, including general health, education, workplace productivity, crime, prison overcrowding and rehabilitation.

Paying workers more will help get more and better care for people with mental health issues and their families.

This costs a bit but it should be money well spent.

Suggestions Health Minister tried to gag hospital staff

A week that began with Prime Minister Jacinda Ardern announced she would be staying away from Parliament as the birth of her child nears has become very messy for the Government, with Winston Peters and Shane Jones throwing bombs into the political fray, Minister Eugenie Sage under fire from Green members for doing her job, and a run of bad looks from labour ministers.

And here’s another, from Newshub: David Clark accused of silencing DHB staff over Middlemore

Newshub has obtained a voicemail and emails which suggest the Health Minister tried to gag senior staff talking publicly about the state of embattled Middlemore Hospital.

In one case he even appeared to promise a board member, who he’d sacked, another job if they shut up.

“I notice more and more getting reported that is really not helping at all, and I’m hopeful that there won’t be much more commentary,” Health Minister David Clark said in a voicemail to District Health Board chair Rabin Rabindran.

“My fear is that if you and I keep commenting, the story keeps ticking along. I’d rather not have distraction about who said what when.”

However Mr Clark denies this, saying he was “absolutely not” trying to stop board members from speaking out.

“There were a lot of conversations happening through the media and that meant there wasn’t clear communication about what was going on, and that’s unhelpful,” he told Newshub.

The voicemail was left on April 18th, two weeks after he sacked Mr Rabindran. In the same voicemail, Mr Clark offered him a new job.

“I would consider you for further appointments because I think that sends a message.”

If Clark and other Ministers under fire survive the term voters may consider sending them a message.

There is a growing impression that the Government is either out of it’s depth, or over the top arrogant. Possible both.

Nation: Health Minister David Clark

On Newshub Nation this morning: Budget 2018 pledged around $4 billion to fix the ailing health system. We ask Health Minister David Clark if that’s enough, and what areas are going to take priority.

Unusually Newshub hasn’t tweeted an excerpts of the interview as it happened.

Clark came across ok. he acknowledged that past Governments had dome their best to provide good health services, and New Zealand had one of the best and in some ways cheapest health services in the world, but was due a comprehensive review to try to determine the most cost effective ways of delivering.

Hence the Government are doing a review. And Clark deferred most questions to be being subject to the review. And he repeated several times that he wouldn’t say what might happen in pay negotiations (he is not directly involved) nor with future budgets.

So he competently didn’t really say much about what might change in providing health services.

There was little of value in this interview. Maybe next year, or the year after, Clark will be able to explain how he will improve health services.

More from Minister of Health on GP fees promise

Minister of Health David Clark was pushed again today on the apparent decision to not fulfil an election promise to reduce GP fees by 1 July this year.

5. Hon MICHAEL WOODHOUSE (National) to the Minister of Health: Is it his intention to reduce GP fees for all New Zealanders by $10 per visit by 1 July 2018?

Hon Dr DAVID CLARK (Minister of Health): Last year, more than half a million New Zealanders couldn’t afford to visit the GP to get the care they needed. I’m not about to announce Budget details today, but what I can say is that the Government is committed to increasing the number of people that can afford to visit the doctor in the upcoming Budget.

Hon Michael Woodhouse: I raise a point of order, Mr Speaker. Largely thanks to the curtailment of the question, it was very specific—it specified a reduction and a date—and I don’t think the question was addressed.

Mr SPEAKER: And the question was addressed.

Hon Michael Woodhouse: Does he stand by his comments that Labour having to prioritise coalition commitments with the New Zealand First and Green parties is the reason the policy cannot be implemented from 1 July?

Hon Dr DAVID CLARK: Coalition priorities will be delivered, and I’m not going to comment further on what will be announced on Budget day.

Hon Michael Woodhouse: Why, then, did he answer an oral question seeking assurance on Labour’s GP fees policy on 16 November, nearly a month after coalition agreements were signed, “That member refers to specific aspects of our policy as announced, and we intend to deliver on it.”?

Hon Dr DAVID CLARK: We do intend to deliver more affordable care at the level of GP visits. Under the last Government, GP visits went up 44 percent and there was underfunding in the health sector. We are determined to make access to primary care more affordable.

Hon Michael Woodhouse: When he told Morning Report, yesterday, that the Government “needed to prioritise the things that had been promised.”, was he telling New Zealanders the Government saw free tertiary fees for rich families and winter heating payments for retired millionaires as a higher priority than reducing the financial burden of GP visits on low-income households?

Hon Dr DAVID CLARK: No.

Hon Michael Woodhouse: Well, then, in that case, isn’t the Minister really telling New Zealanders that despite the strong and improving economy the Government inherited, he overpromised, can’t count, and therefore can’t deliver on the pledges he made in Opposition.

Hon Dr DAVID CLARK: No.

The transcript referred to from 16 November 2017 is:

Dr Shane Reti: When he said at question time on Tuesday that more people would be able to access affordable primary healthcare, what specific health outcomes will that access deliver?

Hon Dr DAVID CLARK: We know that when people can access primary care we have more prevention in the system, and that lowers their personal experience of sickness but also lowers cost in the health system.

Dr Shane Reti: What assurances can he give that by 1 July next year he will deliver GP visits that will cost the patient no more than $2 and $8 within the $250 million he promised in Labour’s election policy?

Hon Dr DAVID CLARK: That member refers to specific aspects of our policy as announced, and we intend to deliver on it.

Jacinda Ardern promised on this policy before the election, and Labour now claim they have had to take into account demands of other parties in Government with them. But Clark repeated the commitment as Minister of Health after the coalition and confidence and supply agreements had been made.

Mental health crisis talk, but no urgency walk

There have been claims that our health system is in crisis. I guess it depends on what constitutes a crisis.

Speaking out of one side of his mouth Minister of Health David Clark says that parts of the health system are in crisis due to chronic ‘underfunding’, but out of the other side of his mouth he praises the state of Health.

And even though he sees a crisis in Mental Health he is happy to wait for a committee to investigate before taking action. He has justifiably been criticised for this contradiction.

On Q&A yesterday:

Corin Dann: The other criticism is that you’re manufacturing a crisis. Is there a crisis in health, for a start?

David Clark: There are some areas where there is a crisis. I think mental health – people will acknowledge is at a crisis level. But the reason our health system is holding together so well, and it is, is because of the dedicated staff. We have doctors and nurses and allied health workers who have turned up every day in an underfunded environment for years, and they deliver an amazing service, and New Zealanders know that.

There is a crisis, but the health system is holding up well?

Later the interview addresses mental health.

Corin Dann: We’re going to talk mental health now. Talking again to people in the health sector this week, one of the things that came up with mental health was actually an ED nurse, who said they are just seeing a massive increase in the number of presentations at emergency departments from people suffering from mental illness. What are you going to do about that?

David Clark: We know that we have an aging demographic, which includes dementia, and we have a growing population. As more people get weeded out for care in primary care, we have more acute demand at the emergency level. We’re going to need new approaches, new ideas to tackling these issues. And we’re going to need increased capacity in some areas.

No indication of what Clark intends to do, just “we’re going to need increased capacity in some areas”.

Corin Dann: Okay, I know you’ve got an inquiry looking at this issue and presumably that’s going to come up with some big, challenging recommendations for you on mental health, and you’ll deal with that. How quickly can you implement those?

David Clark: Yeah. I’m imaging we won’t be able to implement them all at once. We’ll take it budget by budget, step by step. But the purpose of making that inquiry independent is that it will bring forward hard recommendations. It will bring forward challenging recommendations. And we as a government will then have to wrestle with them. But I don’t want to get some watered-down version as minister. My job is to manage the prioritisation and the politics, and I’ll do that. 

Corin Dann: Sure. Big picture here, because I know you’ve got an inquiry, what is your feeling about the balance in terms of our mental health? Are we keeping people in the community too much? Are we not putting people in care enough? Where is the balance?

David Clark: My gut feeling is we’ve devolved care to the community without putting resource after it. And sometimes it’s been used as a cost-cutting measure. We need to change community attitudes. We need to change the way we’re delivering primary services to some extent. And we need to just make sure that mental health is afforded the priority that it should have. It shouldn’t be possible to cut corners for our most vulnerable.

Corin Dann: You’ve got other promises in mental health, in particular in schools and those sorts of things. Are you going to be able to deliver on those, having nurses or mental health care workers in those sorts of facilities?

David Clark: There are some things that have strong evidence behind them. Nurses in schools is one of those things. We will continue to roll out that programme. The cheaper doctor visits is another way of ensuring that those services are more accessible to people. So we will do some things in the interim. I’m not going to announce the budget detail today, Corin.

Labour rushed in an expensive tertiary fees-free policy, without claiming there was a crisis in education.

The did claim there was a mental health crisis in their Taking action in our first 100 days:

  • Set up a Ministerial Inquiry in order to fix our mental health crisis

One could think that a crisis would be treated a bit more urgently than deferring to a committee.

Labour’s post-100 day brag sheet includes this, but it is well down the list of priorities – 100 days. Here’s what we’ve done.

We’ve announced a ministerial inquiry into our mental health system. It’s time to do better by New Zealanders.

But this isn’t the time to do it apparently.

More details: Inquiry to improve mental health services

The Government has taken a major step towards improving mental health and addiction services with Prime Minister Jacinda Ardern announcing details of a ministerial inquiry.

The Inquiry into Mental Health and Addiction will be chaired by former Health and Disability Commissioner, Professor Ron Paterson, and will report back to the Government by the end of October.

Then any spending to address the so-called crisis will have to wait until the budget in May 2019, unless things get deferred further.

“Nothing is off the table. We all know we have a problem with mental health in this country and our suicide rate is shameful. It is well past time for us to do something about it.”

That was in January. Perhaps something will be done about it in this year’s budget, but even then one could suggest ‘it is well past time for us to do something about it’.

In the meantime: Funding uncertainty for Dunedin rehab service

A Dunedin rehab centre with a waiting list of 142 people, most addicted to methamphetamine, will run out of money in two months.

Addiction treatment services say the public funding model they operate under is creating stress, fostering competition between providers and, worst of all, detracting from the work of rehabilitating addicts.

With only 62 days left in the financial year Ms Aitken still had not been able to secure funding – which comes from a mix of government departments – to continue to run past July.

Perhaps they could go and talk to the mental health crisis working group. Drug addiction is a symptom of mental health problems.

Claims of crisis are not new. from may 2018:  New Zealand’s mental health system is in crisis

The Auditor-General’s new report on discharge planning for mental health patients shows more than ever that the system is in crisis.

The report by Greg Schollum, Deputy Controller and Auditor-General, diagnoses several acute ailments in the system – a lack of planning and liaison between DHBs and community services, limited bed numbers available in inpatient units, and rushed discharges into the community because DHBs cannot cope with growing demand.

“This report provides some alarming insights into the slow decay of the mental health system under this Government, particularly in terms of supporting severely vulnerable patients to re-enter their communities after time in DHB inpatient units,” says Erin Polaczuk, PSA national secretary.

“It’s clear that empty rhetoric and the hollow promises of prioritisation by this Government aren’t enough,” says Ms Polaczuk.

See also (Stuff, 3 February 2018): A growing emergency: Why are cops looking after mental health patients in crisis?

If things go according to current plans another report will be released in October. Perhaps that will call it a crisis too.

Then what?


David Clark has been asked (on RNZ) about the Moana House funding crisis and says it is something that needs to be worked out over time. And pushed on whether urgent funding would be provided he said he won’t be announcing the budget in advance and again said solutions would be forthcoming “over time”.

No apparent urgency given the claims of a crisis.

It is a very difficult situation for Clark (as the portfolio is for any Minister of Health).  But if the Government talks the crisis talk surely they should walk the urgency walk.

 

 

Health Minister: “we won’t be able to afford everything straight away”

Minister of Health David Clark has conceded on Q&A that there is not enough money available to pay for all Labour’s election promises, like reduced doctors fees and pay equity for nurses. He blames it on the competing demands of other parties in Government, and ‘underfunding’ by the last Government – Health is always underfunded in that it is never possible to afford all the needs and demands.

Corin Dann: It’s interesting talking to people in the health sector this week. One in the nursing sector said to me they voted National because even though they were sympathetic to many of the things you’re doing, because they didn’t believe you would have enough money left after making all your promises for the nurses, for their pay settlement. And that’s the reality, isn’t it? The nurses aren’t going to be able to get what they want because you’ve got so many other things to pay for.

David Clark: We’ve set aside money across health. We’ve said that we want to spend more money, and we did say we wanted to spend more money than our opponents. But we won’t be able to afford everything straight away. Nobody pretends we can. We won’t be able to afford everything in our first Budget. We’ve got to do it step by step. And there is a backlog of underfunding. We’re going to take steps to address that.
Corin Dann: You went into the election campaign making it clear you would deliver all this money and you would deliver all these promises.

David Clark: We will deliver the promises we make.

Corin Dann: In the first term?

David Clark: In the first term.

Corin Dann: All of them?

David Clark: Corin, all of them, subject to any new information that comes to hand.

The ‘new information that has come to hand’ since Clark became Minister is that the Government has already committed a large amount to things like the benefit increases, fee-free tertiary education and the Provincial Development Fund, and there isn’t going to be enough available for everything promised for Health.

Corin Dann: So new hospitals, what about—Let’s just stay back on the nurses’ pay very quickly. Because the issue here seems to be pay equity, isn’t it? That’s the big problem you’ve got looming. Are nurses going to get pay equity this term?

David Clark: Pay equity is further down. It was in the negotiated offer that went forward previously, pay equity – a shift towards that. It is huge. Let’s not pretend it’s not. It’s a serious issue, but it does need to be tackled.

Corin Dann: But why shouldn’t they get pay equity when other parts of the health sector are and we’re hearing stories of nurses who feel like they’re earning less than caregivers when they’re 20 years experienced or whatever. Why shouldn’t they be getting pay equity now?

David Clark: Well, they should be getting pay equity, but there is a process to work through to work out how we do that.

Corin Dann: It’s money, isn’t it? Because according to the advice given to the Labour Party during the coalition negotiations, the estimated cost from collective bargaining and pay equity, if you join them together, for the health sector over three years is $750 million. You don’t have it, do you?

David Clark: Yeah, these are big sums. Of course we have the money. We have budgeted really carefully. Labour Governments and coalitions with Labour in them are held to a higher standard. We know that.

I’ve heard this claimed before, as far as I know it is subjective and unsubstantiated, and I call bollocks on it.

David Clark: And that’s why we did our sums very carefully when we were in opposition, and the promises that have been made in the coalition agreements and the confidence and supply agreements will be kept. We have accounted for them and we will deliver on them.

But when?

Corin Dann: Let’s look at primary healthcare. Is that going to be the big focus for you in many ways? Because that’s what’s going to make the big cost savings, isn’t it?

David Clark: Absolutely. Longer-term, it will. In the short term, we’ve got so much unmet need. Last year over 500,000 New Zealanders couldn’t afford to go to their GP. One in four adults in New Zealand now cannot afford to go to their GP in any given year for reasons of cost.

Corin Dann: So will we see in the Budget you deliver on your promises to bring GPs visit down by, what, $10 on average? From $40 to $30?

David Clark: We’re going to have to phase some of these initiatives. There’s no doubt about that. I’m not going to skate around that, and I’m not going to make the Budget announcement today, you understand that, Corin.

Corin Dann: But you are signalling that that’s not coming all at once?

David Clark: We will make healthcare more affordable, and that includes primary care.

Corin Dann: So when can someone expect to see the average get down to 30? 

David Clark: Corin, I can’t announce that today. We are phasing our priorities, but we are absolutely committed to the principle of making sure New Zealanders can afford to visit their GP.

So a policy promise has become a principle that may be phased in at some time, perhaps.

Corin Dann: And you’ve got a national cancer agency you’ve got to do?

David Clark: Yep, we’ve got lots of things we’ve announced– 

Corin Dann: Will we see that this term?

David Clark: We will see some progress in that regard. I’m having policy work done now to tell me what the best way is of delivering those things. We’re in government now, and that’s different. I do have access to a lot of researches, to the best international evidence, and I want to make sure that every dollar I spend goes as far as it can possibly go as Minister of Health and of course as Associate Minister of Finance.

Being in Government is different to being in an election campaign, and being Minister of Health is different to being Opposition spokesperson on Health. You don’t need the best international evidence to know that it is very difficult to meet all the demands of the Health portfolio.

There will never be enough money to afford everything that is wanted, especially with substantial spending commitments for other things like education, social welfare, housing, transport etc etc.

Clark has since confirmed that the Government won’t be able to meet all their promises ‘straight away’.

NZ Herald: Health Minister David Clark says coalition funding pressures have delayed cheaper doctors’ visits for all

Labour’s promise to cut the cost of going to the doctor by $10 from July 1 this year will now have to be phased in over time, Health Minister David Clark has said.

He points to Labour having had to meet the cost of new priorities from agreements with the New Zealand First and Green parties, Labour’s partners in Government, as the reason the full policy cannot be implemented from July 1 as promised.

Clark’s admission is the first time a minister has conceded that an election promise may have to be delayed.

Labour promised that from July 1 this year, the cap on doctor’s visits for very low-cost access practices would be lowered from $12 to $2 for those aged 13 to 17, and from $18 to $8 for patients age 18 and over (it is already free for 0 to 12 year olds).

For visits to other GPs it promised, from July 1, to reduce the average cost from $30 to $20 for teenagers and from $42 to $32 for adults, and to cap the maximum fee at $59 from $69.

The policy was estimated to cost $213 million a year.

Clark made it clear today the policy will now have to be phased in but has given no hint as to how.

“I am pursuing the principle that we get more affordable access to primary care in this country,” he told the Herald. “And what happens when you form a coalition Government is that you agree priorities and we are responding to the priorities as they are outlined in the confidence and supply and coalition agreements.

“I am pursuing cheaper doctors’ visit but I am signalling that that will be phased over time.”

Perhaps there will be a clearer signal of what sort of phasing in over what time in the budget.

I don’t recall Clark or Jacinda Ardern or Grant Robertson saying “we won’t be able to afford everything straight away” during the campaign. A lot of criticisms were directed at Steven Joyce when he pointed out a large difference between spending promises and available funds – the infamous fiscal hole.

Health can be a particularly emotive issue on a personal level, people’s health and lives are at stake.

We know a perfect ‘fully funded’ health system is impossible, but what we should expect from our politicians and our Government is honesty that not everything can be delivered due to competing demands.

Q+A: Minister of Health David Clark

On Q+A this morning Corin Dann will be interviewing Health Minister David Clark.

I hope there are things of substance to answer questions on. Some health issues have been deferred to committees, like the Mental Health Inquiry.

And while key spending decisions have probably been made they won’t be revealed until the budget in mid-May, unless Clark has been allowed to feed some information in advance (National used to pre-release a lot of budget information).

Clark will likely be asked about conflicting claims from Clark on the condition of Middlemore Hospital buildings, but is likely to be prepared with explanations, evasions or diversions.


The first segment was on general health delivery and funding. Apart from the announcement of new DHB board chairs replacing people moved on bt Clark it was all vague ‘wait-and-see’ as has become the norm for ministers pre-budget, with gentle indications that all promises may not be delivered on.

An a lot of parroted slogans.

Middlemore was glossed over.

The second segment is on mental health. When asked ‘when?’ he talks in generalities again. Wait for the inquiry to report back, again.

Asked if they can deliver on policies – “we will continue to roll out that policy” but more “that will be revealed in the budget”.

A lot of comments like “grappling with issues” and “seeking good advice” and “working through a process”.

Dunedin Hospital rebuild? An announcement is pending.  Perhaps it is imminent this time, but there has been quite a few deferred announcements on this. I’ve heard that something is indeed imminent, but until it goes public we will just have to remain sceptical.

Medicinal cannabis bill passes first reading, doesn’t pass the compassionate test

The Government Misuse of Drugs (Medicinal Cannabis) Amendment Bill passed it’s first reading in Parliament yesterday, but it has failed to pass muster as a decent, compassionate bill.

Minister of Health, David Clark, introduced the bill.

This bill makes three key changes: it provides people who have a terminal illness a statutory defence to the charge of possessing and using cannabis, it will allow us to make regulations to set quality standards for medicinal cannabis products, and it removes cannabidiol from the Misuse of Drugs Act so that it is no longer a controlled drug. This bill does not make any changes to the recreational use of cannabis.

Making regulations to set quality standards for medicinal cannabis products will in time be worthwhile.

The last Government effectively already removed cannabidiol from the Misuse of Drugs Act so that it is no longer a controlled drug – it can now be supplied on prescription.

And the first change is a crock. It will remain illegal for cannabis to be grown or supplied, so people who are terminally ill will have to rely on someone breaking the law.

This bill will make medicinal cannabis more readily available and will help bring relief to people suffering a terminal illness or those in chronic pain.

That is very poorly worded (Clark read from a prepared speech).

The bill will do little to make medicinal cannabis more readily available (in the main it will be illegal to make it available).

And it provides no legal or medical relief for those in chronic pain or suffering from a debilitating illness if they are not certified as dying (within 12 months).

A major part of this bill is the development of a medicinal cannabis scheme. This will include an advisory committee to review the current requirements for prescribing medicinal cannabis, setting minimum product quality standards to improve patient safety and give medical practitioners confidence, and allow for the domestic cultivation and manufacture of medicinal cannabis products. In time, this scheme will lead to a greater supply of quality medicinal cannabis products worldwide, including products made here in New Zealand. The bill will allow for quality standards to be set for all medicinal cannabis products, whether produced domestically or imported.

Sounds ok, but this will take time to implement. Years probably.

We know, however, that in the interim there will be people with a terminal illness using illicit cannabis. That is why this bill establishes a defence to the charge of using and possessing cannabis or a cannabis utensil for people who have been diagnosed with a terminal illness. Giving the terminally ill a statutory defence for the possession and use of illicit cannabis will mean they are not criminalized in their final days. This is the compassionate thing to do while the medicinal cannabis scheme is established.

Someone who is dying probably won’t like being criminalized “in their final days” but it will be of little real consequence. It is unlikely the police would try to prosecute them now anyway, and they would probably die before the court process completed.

This is the compassionate thing to do while the medicinal cannabis scheme is established.

Terminally ill people are likely to rely on family, whānau, and friends to source illicit cannabis for them. We do not propose extending the statutory defence to cover the range of people who could supply cannabis to terminally ill people.

It is not ‘compassionate’ to force family, whānau, and friends to act illegally to supply cannabis. This is an awful aspect of the bill.

This legislation will not please all of the campaigners for medicinal cannabis…

An admission of it’s inadequacies.

…but it goes further than any previous Parliament has gone. It represents real progress in making these products more widely available. This bill is a real step forward that all Government support parties are pleased to sign up to.

In some ways it is a real step forward, or it will be, eventually. But in other ways it is abominable.

If Parliament wants to go further, it has the opportunity when it considers a member’s bill in Chlöe Swarbrick’s name.

When Clark said that he will have known, or at least should have known, that the Swarbrick bill is likely to fail at it’s first vote in Parliament today, so to suggest that as a solution to the inadequacies of his Government bill is embarrassing for him and for Labour.

This bill does offer some progress (in the future) on supply and use of some medical cannabis products, but it is a slap in the face of family and friends of those who are dying and might want some relief, and it ignores the needs and wants of the many people suffering from chronic pain and debilitating illness but not at imminent risk of dying.

Medical cannabis: Terminal vs Severe and Debilitating?

Medical Cannabis Awareness NZ wants the Government’s medical cannabis bill to be expanded to cover people suffering from ‘severe and debilitating’ illness. It currently only allows an exemption from prosecution for using cannabis for people certified to have less than a year to live (but growing is still illegal, as is the supplying of cannabis to them).


Terminal vs Severe and Debilitating?

The exemptions outlined for the terminally ill by Labour’s Medical Cannabis bill do not go far enough, and have been universally panned by patient advocates and policy experts.

MCANZ Coordinator Shane Le Brun:

“David Clark’s excuse for failing to deliver on Labour’s election promise is that there is a high portion of New Zealanders with chronic pain, many of those however would not be severe such as those who suffer from comparatively mild conditions such as osteoarthritis”.

“The Ministry of Health’s Non-pharmaceutical application guidelines have a terminology of  “severe or debilitating condition” using that definition instead of terminal would be a far more effective way of protecting patients. If such terminology is good enough for prescribers it should be good enough for police and the courts.”

“If such a change creates any extra administrative load for the courts to determine ‘severe or debilitating’ it would be short term only, as police would be on the receiving end of an attitude adjustment, the cost in administration pales into comparison against the significance of what it offers a very ill and vulnerable cohort of New Zealanders”

MCANZ Feels that the best solution to the criminalization of patients is to disrupt police prosecution
habits directly, before they get to court.

“The Solicitor General’s prosecution guidelines could be easily reviewed and updated to include a specific clause in the public interest test section. Such a clause counting against prosecution could be worded along the lines of ‘where the Misuse of Drugs Act has been breached for a significant therapeutic benefit”.

“Intervention before prosecution is critical to the safety and wellbeing of patients, most of whom are on benefits who can ill afford costly legal battles, and the seizure of what for many is an essential medicine”.

MCANZ Spokesperson Dr Huhana Hickey MNZM”

“The contradictions in allowing terminally ill to access but not providing them with a way of doing it, is as bad as denying all with pain the chance of taking a medicine that works. We need to educate society over the benefits of medicinal and how it can change lives.”

“To deny Medical Cannabis any longer is to show a disregard for people in chronic pain and who are in effect suffering at the hands of government policy. Change it now, it’s need not be complex, it can be simple, but they need to work with those of us who can no longer take opioids and other strong drugs who want our quality of life back.”