Comment

Arthur Grimes: Bipartisan approach will get best of wellbeing

Arthur Grimes looks at how putting the former government and current Government's approaches together would achieve significant improvements in areas that are in dire need of improvement

The wellbeing budget has come and gone. As expected, it resulted in new, focused expenditures in the five key priority areas outlined by the Minister of Finance in December:

- transitioning to a sustainable and low-emissions economy;

- boosting innovation, and social and economic opportunities in a digital age;

- lifting Māori and Pacific incomes, skills and opportunities;

- reducing child poverty, improving child wellbeing and addressing family violence;

- supporting mental wellbeing, with a special focus on under 24-year-olds.

The last three of these five priority areas, in particular, saw significant initiatives addressing social issues for which New Zealand is a poor performer. We have high rates of child, family and sexual abuse, high rates of mental ill-health, high rates of child poverty, and large disparities in social and economic outcomes for Māori and Pacific communities relative to the rest of the population. 

Focusing on these priorities is clearly in keeping with the government’s wellbeing agenda. Furthermore, focusing new resources at the community level, as seen in the initiatives to place mental health workers in doctors’ surgeries, is consistent with early intervention at the top of the cliff rather than dealing with problems at the bottom. These moves – which have been coordinated across a range of government agencies and Ministers – are to be applauded.

What benefits can we expect?

Expenditures and new programmes are one thing – the other side of the coin are the benefits that are expected to result as a consequence of those initiatives. So what wellbeing targets have been set? The following is a list of key wellbeing targets that have been announced (in some cases with slight shortening in wording, and with dates removed):

- A target of 98 percent of children starting school having participated in quality early childhood education.

- A target infant immunisation rate of 95 percent.

- A target incidence rate for rheumatic fever initial hospitalisations of 1.4 cases per 100,000 people.

- A target reduction in the number of children experiencing physical abuse by 5 percent.

- A target to reduce long-term welfare dependence by 25 percent.

- A target of 85 percent of 18-year-olds having achieved NCEA Level 2. 

- A target of 60 percent of 25-34 year-olds holding a qualification of level 4 or above.

- Targets to reduce the violent crime rate by 20 percent; reduce the youth crime rate by 25 percent; and reduce the total crime rate by 20 percent.

- A target to reduce re-offending by 25 percent.

- A target to reduce the proportion of children living in households that are in poverty (measured as 50 percent of the median income before housing costs) to 5 percent (with target reductions also in two other measures of child poverty).

These 10 wellbeing targets all look eminently sensible. What may be surprising is that only the last of these was listed in the latest wellbeing budget. The other nine were amongst the Better Public Services Targets of the previous government. They were cancelled by the incoming government and not replaced with similar target wellbeing measures. Similarly, a separate set of health targets was cancelled by the incoming government, along with accountability for a range of educational outcomes.

It is reasonable to argue, on the back of these respective wellbeing targets, that the last administration had a broader wellbeing outcomes agenda than does the current government. With the (very major) exception of child poverty, the current government appears to be more focused on inputs that may contribute to greater wellbeing. 

It is admirable, as has occurred in the latest budget policy process, to ensure coordination across departments to deliver programmes that contribute to improved wellbeing. But without clear targets there is a substantial risk that the expenditures will be seen by agencies and ministers as ends in themselves, rather than as means to achieve actual improvements in the wellbeing of vulnerable groups. 

Government has rightly recognised the importance of establishing (and publishing) target outcomes to reduce child poverty. Having the child poverty targets will ensure a continued focus of policy-makers on the broad range of policies required to achieve these very desirable outcomes for children and their families.

It is imperative that similar targets are set also for: a range of social and economic outcomes for Māori and Pacific communities; for child abuse and sexual violence; and for mental health outcomes (e.g. for suicide numbers, and for waiting times for inpatient admittance and for outpatients who have mental health issues). That way, attention paid to these issues by policy-makers will not stop with the expenditures, but will be ongoing so that the expenditures achieve significant improvements in areas that are in dire need of improvement. 

Having clear targets also means that we can hold government to account (positively and negatively) for how well their programmes contribute to the improvements in wellbeing that we all seek. 

Perhaps we can get bipartisan agreement by putting the two administrations’ approaches together and establish a set of “Better Public Wellbeing Targets”!

Professor Arthur Grimes joins Professor Gregor Coster, Dean of Victoria University of Wellington’s Faculty of Health, to discuss the Wellbeing Budget on Thursday 27 June, 12.30pm–1.15pm, at Rutherford House Lecture Theatre 2, Pipitea Campus, as part of the University’s Spotlight Lecture Series.

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