New Zealand’s new coalition government: What might it mean for paramedicine?

New Zealand’s 2017 general election on October 23 saw the incumbent National Party gain the largest bloc of support with 44% of the vote. However, it was a coalition arrangement between the Labour Party (37%), the New Zealand First Party (7%) and the Green Party (6%) gain the ultimate majority and sworn into power, led by Labour leader Jacinda Ardern.

So what might this mean for paramedicine and ambulance services in New Zealand? Paramedics Australasia New Zealand Chair and Chair of the New Zealand Paramedic Registration Working Group Sean Thompson, provides some initial analysis based on his observations and personal coimmunications.

Paramedics Australasia is proudly non-political. The New Zealand Chapter is in regular contact with all political parties and this has put us in a good position of influence with the new coalition government. Building relationships with politicians regardless of their perceived influence at the time is vital. They are aware of us as they look for issues to bring before the ruling parties when in opposition, and when they move into power we find ourselves as trusted and independent advisors.

Labour Party
Myself and PANZ Committee member, Hannah Latta, met with the incoming Minister of Health Dr David Clark in July this year. Our discussions included full funding for ambulance services, paramedicine’s role in primary health, paramedic registration, and health and safety of ambulance staff. Dr Clark took detailed notes throughout our meeting and was especially interested in the future role we could play in primary health, especially in rural areas. He was wellinformed on the issues we presented and he committed to continue to support and promote paramedic issues. The Labour Party under former Health Spokesperson Annette King has been vocal on the need for paramedic registration and she regularly stressed the need for paramedicine to have a more visible role within New Zealand’s health system. Labour’s Jenny Salesa will also take on an associate health role within Cabinet. Her specific portfolios within this are yet to be announced, but it is possible that responsibility for ambulance services are delegated to her.

New Zealand First Party
The New Zealand First Party has always been a strong advocate of paramedicine, especially under their former health spokesperson Barbara Stewart, who regularly raised questions in the House following our communications with her. It appears that New Zealand First will not have an associate health role in the current coalition government but leader Winston Peters has previously issued statements advocating for paramedic issues. Tracy Martin will become the Minister of Internal Affairs and as an emergency service, ambulance services have some crossover into this portfolio. New Zealand First previously advocated for a Ministry of Emergency Services. When PANZ first met with New Zealand First three years ago, we demonstrated paramedicines role as a core health service, rather than primarily an emergency service. We have not seen any indication that a Ministry of Emergency Services has been discussed during these coalition negotiations.

Green Party
The Green Party has historically been a proponent of paramedic registration, especially under former health spokesperson, Kevin Hague. His predecessor Sue Kedgley was arguably the first politician to bring paramedic issues to the political consciousness and in 2008 she initiated select committee inquiries into ambulance services and double crewing. Julie Anne Genter will now take on a role as Associate Minister of Health outside of Cabinet. I was in contact with her just before the election and we agreed to meet once the outcome of the election was finalised.

National Party
The National Party has been a strong proponent of paramedic issues and we saw this with their announcement earlier this year to fund the double-crewing of ambulances. PA New Zealand has written to thank both Associate Minister of Health Peter Dunne (United Future leader) and Minister of Health Dr Jonathan Coleman for their support over the past nine years. I received a letter from Mr Dunne on 1 September stating “I … hope the next government will proceed rapidly to regulate paramedicine as we have discussed”.

As the National Party is now such a sizeable opposition party we now look forward to engaging with them to promote and advocate for paramedic issues in parliament.

Registration
Health Workforce New Zealand, the arm of the Ministry of Health with oversight of health professions regulated under the Health Practitioners’ Competence Assurance Act (2003) are currently still collating the findings of this year’s targeted consultation process on registration. Once the findings are summarised they will be presented to Cabinet for approval or further discussion. I don’t currently foresee any negative effect on registration from the change in government. There may be a delay while the government addresses their new policy priorities in their first 100 days, however, registration may even ultimately be sped up if the pre-election support for registration from the three coalition partners is any indication.

In summary
We wait to hear who the new Minister or Associate Minister responsible for ambulance services will be. Paramedicine may be best served if responsibility for paramedicine and ambulance services comes directly under the Minister of Health’s portfolio. This should give us greater prominence and hopefully our good relationship with David Clark might assist with this. However, associate ministers are often better able to focus on specific portfolio responsibilities and speak to these before Cabinet.

My overall analysis is that there are very positive signs for paramedicine within the new coalition government. I look forward to the progression of regulation and professional registration. I also hope to see investigation of more appropriate funding models for ambulance services as was advocated by the coalition parties when in opposition. I temper this hope with a knowledge that the high intentions of opposition parties are frequently reprioritised once those parties face the realities of government.

As the professional body representing paramedics in Paramedics Australasia, and its New Zealand Chapter, will continue to independently advocate on the issues that affect New Zealand paramedics and ambulance staff, and in the interests of those we care for.

Sean Thompson
Chair, New Zealand Paramedic Registration Working Group