Grant Brookes, Fightback member, is standing for election to Capital and Coast District Health Board (DHB) at the upcoming 2013 local body elections. Brookes is standing on a Health First ticket, endorsed by the Nurses Organisation (NZNO) and the MANA Movement. Fightback writer Ian Anderson interviewed him.
FB: What are your goals in standing for election to the Capital and Coast District Health Board?
GB: Elections are a difficult arena for activists. They favour candidates with big budgets, high public profiles and easy access to mainstream media, who trade off conventional memes – in other words, the mouthpieces of the rich and powerful.
But contesting elections is an important part of building a mass movement for radical change.
Many goals can be served by standing. For example, standing in elections can help legitimise and popularise radical ideas, raise the profile of socialist groups and recruit new members, put pressure on political parties which claim to represent working class and oppressed groups, and so on.
I have stood in elections in the past in pursuit of some of these goals.
But I am standing for election to the Capital and Coast District Health Board this October with the aim of winning a seat. This different goal colours all aspects of my campaign.
FB: What is the nature of the role?
GB: The Board is made up of seven elected members, and up to four members appointed by the minister of health.
It provides “governance” for the DHB. So basically that means setting broad priorities for healthcare in the district, taking responsibility for outcomes, putting together a budget and annual plan and so on, under the auspices of the NZ Public Health & Disability Act 2000.
But it’s stunted governance, because the Act as passed by Labour made even the elected Board members accountable not to the electorate, but to the minister of health.
Recent amendments by National have given the health minister even more powers. He can now essentially veto board decisions, impose ministerial directives and replace an elected board with an appointed commissioner, like the education minister is doing in a growing number of schools.
In a presentation to the July meeting of the Nurses Organisation’s Regional Council, I said there is a danger that District Health Boards could become mere window dressing for government policy decisions, unless Board members are prepared to claim their democratic mandate to speak out.
FB: What has been your involvement in the Nurses Organisation, and what struggles has the organisation waged in the District Health Boards?
GB: For the last eleven years I have been a delegate for the Nurses Organisation, and have represented members at Capital & Coast DHB on our union’s National Delegates Committee since 2008. More recently, I have chaired the Greater Wellington Regional Council. I currently represent Greater Wellington on the NZNO Board of Directors and I’m the convenor of the National Delegates Committee.
What drew me (and many other others) into NZNO activity was the Fair Pay campaign of 2003-4. Delivering pay rises of 20-30 percent, this remains the biggest struggle waged by the union in the DHBs in a generation.
Since then, the main extended campaign in the Sector has been for Safe Staffing, Healthy Workplaces. The goal is to get sufficient staffing in every DHB to match the fluctuating healthcare demand. It’s a work in progress.
Although I am endorsed by the Nurses Organisation, I am not representing the union in this election. Rather, I aim to be a voice for the health of the disadvantaged majority of the population.
FB: What would you say are the main problems confronting nurses, and others in healthcare?
GB: The main problem confronting the health system is underfunding.
Council of Trade Unions economist Bill Rosenberg calculates that the health budget was $238 million short of the amount needed to meet costs this year. Health has been similarly underfunded for at least the last three years.
This is driving care rationing, in all sectors. People can wait weeks to see a GP. Dependent rest home residents are washed less often. Patients have to be sicker before they see a hospital specialist. Workloads for nurses and other healthworkers are rising.
Health is also being run increasingly according to bureaucratic directives. A handful of “health targets” are prioritised, at the expense of health in general – just as “national standards” in schools are reducing education to the acquisition of a very narrow range of skills.
And while the health system is being compromised in this way, inequality and other social determinants of health are making for a sicker population.
FB: What would a just health system look like?
GB: A just health system would create health equality, where health status is not shaped by ethnicity or income.
It would be democratically controlled by healthworkers and health service users, or patients.
It would be universally accessible and free – from primary health to tertiary care, including dental services, aged care and optometry – because health would be recognised as a human right.
It would see individual health as the product of social conditions, and work with other agencies to address social determinants of health such as housing, income, alienation and so on – similar to the original vision of Whānau Ora.
It would be part of a cooperative, egalitarian society where resources are democratically allocated and directed according to need.
Bits of it might like the community clinics, or Misiònes, established as part of Venezuela’s transition towards “socialism for the 21st century”.
In other words, it would be radically different from the health system we have now.
FB: How can others in the community support the struggle against cuts, against privatisation, and for public healthcare?
GB: Community “support” will never be enough – particularly given emasculation of the District Health Boards of real decision-making power. Cuts and privatisation will only be reversed by a mass struggle of, and by the community. And by community, I mean the working class majority, organised in unions, parties, clubs, marae, groups and so on.
The role of elected District Health Board member, as I see it, is to be a mouthpiece for this struggle to greatest extent possible under the law.
There is also an important role for the few health experts and academics willing to side completely with the disadvantaged majority.
Watch this space!