Public health expert Michael Baker. Photo:
Public health expert Michael Baker is sounding alarm bells about cuts to the health sector in the wake of the Royal Commission report on the Covid-19 response.
He says the government should act on the report's recommendations immediately, by appointing an accountable minister as a first step, and the government should be doing more to tackle the problems of Long Covid.
The report, released on Thursday, has 39 recommendations, and called for public health capacity to be built up to keep options open for decision-makers in future pandemics.
As the outgoing commission's chair Tony Blakely explained, the idea was to reduce the need to use lockdowns, mandates and border closures.
Given the need to build the health system up, Baker questioned the wisdom of the sweeping cuts announced at Health New Zealand on Wednesday.
He said probably the biggest weakness in the report was that it had arrived "at a time when we're seeing huge cutbacks in our public health system".
"Less than a week ago, Te Whatu Ora announced that it was reducing by 25 percent its positions in public health and by almost half its positions in its data and digital team, and these are critical competencies for managing a pandemic and preparing for future pandemics.
"So I think that's still the biggest limitation with this process, is who's going to do the work? Which agencies and do they have the staff and resources? At the moment we're seeing that's probably not the case.
"At the same time they're announcing these cuts, they've also announced a national pertussis epidemic ... we're also vulnerable to a measles epidemic, and we've got avian influenza on the horizon.
"Just these operational activities could take a lot of our critical resource at a time when we're actually reducing our competency, so I think that's actually the big question is how do we actually implement this really, I think, very well thought-out road map."
Internal Affairs Minister Brooke van Velden, in a statement accompanying the release, said the report marked "the conclusion of phase 1 of the Inquiry". The second phase - with consultation for the terms of reference alone costing $14m, about the same as the first phase's budget - begins on Friday.
Prime Minister Christopher Luxon, ahead of the report's release, said he would not comment until he had seen it and its recommendations.
He was already looking ahead to the second phase of the report, however, saying it would be an "independent assessment of what did we do well and what did we not do so well".
Van Velden gave no further details about when a response or actions on the recommendations might be expected.
Photo: RNZ / Nate McKinnon
Baker pinpointed the final, 39th recommendation - which includes the appointment of a responsible minister and the production of six-monthly progress reports - as essential for the government to work on.
"I hope they immediately follow recommendation 39 which is really a key one," he said.
"Some of these recommendations will require a lot of work. I mean, they're higher level, but the implementation will require a great deal of policy development and consultation.
"I would hope that we don't put it all on hold till we get the phase two report, because that is going to delay things by well over a year, right into 2026. I don't think we can afford to wait that long."
He said a similar report was done rapidly in Australia and the government there announced more than $250 million towards establishing a centre for disease control like the one in the United States. The United Kingdom has an inquiry with nine phases, and the UK prime minister has already announced plans to act immediately on the first one delivered in July.
"So I think we need to act now," Baker said. "We can't delay action on these critical recommendations."
Long Covid remains a concern
Baker also said the report had not touched on Long Covid as much as it could have - and it was an ongoing problem that would need to be dealt with.
"I think this would be possibly one area where this report was quite light on recommendations, and that was how we manage an ongoing threat like Long Covid.
"We can look at the cost of Long Covid to New Zealand in economic terms is estimated at about $2 billion a year in lost productivity, but even worse than that it's the misery and loss of wellbeing, and people having to give up work.
"It's quite a devastating chronic illness."
Reducing infection rates through masking and other infectious controls would help keep Long Covid cases down, he said.
Keeping immunity high through booster vaccines had also been shown to decrease the chances of getting Long Covid, he said, but Long Covid had been a major focus of Australia's report and needed more attention in New Zealand.
"Certainly, we do need a national strategy. At the moment, it seems to be a strategy of ignoring it, and I just don't think that's acceptable."
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