The National government is looking at reforming New Zealand’s health care system in a way that would bring back health structures similar to the ones the party brought in during the 1990s. Doing so would be breaking an election promise, but it wouldn’t be the first one. The Herald reports that a cost-cutting committee appointed by Health Minister Tony Ryall is understood to have recommended setting up a National Health Board to fund, monitor and direct the country’s 21 district health boards. The ministerial review was led by Murray Horn, former Secretary of the Treasury and banking executive.

The committees’ report, leaked to The Dominion Post, includes calls for much stronger links between the Government’s health and economic objectives, a background discussion paper states “Spending health dollars on improving life expectancy is a worthy objective in itself but it will only be an ‘investment’ in growth if people also work longer” This is the kind of policy advice we might expect from Horn, who’s resume also includes positions at the World Bank and the International Monetary Fund. The report also contemplates targeting health spending to those in the workforce best placed to help the economy grow. Age Concern chief executive Ann Martin commenting on the effect this policy would have on the retired said she was “appalled by any implication that people are only worth investing health dollars in if they’re working”.

New Zealand has been like a patient undergoing a series of experimental treatments over the past two decades, Labour reformed public health in 1989 at the tail end of the ‘Rogernomics‘ era, and National restructured again in 1993. The current model was brought in by Labour in 2000. As Ian Powell of The Association of Salaried Medical Specialists put it, the prospect of another restructuring of the health sector carries a “serious risk of destabilisation and paralysis”.