Lizzie Marvelly: I've found Joyce's $11.7 billion hole

Former Health Minister Jonathan Coleman. Photo / Mark Mitchell

I think we might've found Steven Joyce's $11.7 billion hole. It looks like it was in the consistently underfunded health budgets of the last National Government. With rot, mould and sewage in the walls at Middlemore Hospital, asbestos in the maternity unit, faulty power supplies and God knows what else, the National Party has some serious questions to answer.

The one at the top of my mind is this: How the hell could they have been considering tax cuts when the health system was in such a dire state? Allowing the health system to literally moulder and ooze while offering tax cuts in an election lolly scramble is certainly not a good look. The party says on its website that it, "aspires to a New Zealand where all New Zealanders can flourish". Perhaps it should come with the disclaimer "unless those New Zealanders are sick", because the only thing flourishing at Middlemore seems to be the fungal spores.

I find the situation at Middlemore outrageous. As a New Zealander, I've always been proud of our health system. It's a testament to our spirit as a nation that we care for those who are sick and injured free of charge. It's just part of who we are. Failing to appropriately invest in health means that New Zealanders suffer. No Kiwi should ever have to go into a New Zealand hospital and wonder whether there's raw sewage leaking into the walls.

What kind of Third World outfit are we running? If the situation is this bad at Middlemore, what's it like elsewhere? Are our other hospitals plagued by similar issues? Have patients around the country been put at risk because the "strong economic managers" in the National Party decided to cut costs and cut corners?

The Counties Manukau District Health Board acting chief executive Gloria Johnson told RNZ that the board hadn't asked the previous Government for funding to fix its beleaguered buildings because of pressure from the Government to stay in surplus. That "surplus" was, of course, false – given the huge liability the ageing and disintegrating infrastructure represented. It almost makes you wonder whether the previous Government turned a blind eye in order to register shallow victories.

The former chairwoman of the Counties Manukau DHB, Lee Mathias, told RNZ that the problems at Middlemore had been widely known for years. "The mental health [building – that had to be demolished because of severe leakage problems] ... that had to be signed off by the minister, so I think most people in Wellington knew of the situation that Middlemore was in." Yet former Health Minister Jonathan Coleman denied knowing about it. "I'm aware over time that they need injections of capital to continue to develop the site but I was not notified that there was any sort of problem along these lines," he told RNZ.

For someone in the position of Health Minister, I'm not sure what is worse; being "aware over time that [DHBs] need injections of capital" and not appropriately providing for them, or not knowing that there is sewage seeping into the walls of one of the country's biggest hospitals. If Coleman truly didn't know what was happening at Middlemore, what kind of ministry was he running?

In February 2017, Treasury published a report into the financial performance of the health system. In it, it referenced a 2016 report by the Office of the Auditor General that raised concerns that "many DHBs do not sufficiently monitor their asset condition, age, and performance… [and] there has been a significant pattern of under-budget capital spending indicating that DHBs might not be investing the capital needed to deliver their services in the future." One would've thought that the Health Minister at the time would've read the report and done something about the serious problems it raised…

I fear that what we're seeing at Middlemore may just be the tip of the iceberg. We already know that the mental health system is under extreme pressure. Mental health advocate Mike King described 2017's mental health budget as "reshuffling the deck chairs on the Titanic". The situation at Dunedin Hospital was described by senior medical staff as "a slow-motion train crash" in April 2017, and in June 2017, some DHB chairpersons anonymously told RNZ that "the relationship [between DHBs and Director General of Health Chai Chuah] was the most fragmented and disjointed it had been in 20 years of ministry leadership".

What all this adds up to is a very sick health system. And it certainly didn't get that way in the six months since the coalition Government took office. The problems that the public health sector is facing have taken root over a period of years. Like untreated cancer, they have spread and thrived. And now it's up to the new Government to take extraordinary measures to try to arrest the damage.

There's another factor that needs to be considered: whether, as current Health Minister David Clark told RNZ, "[The National Government] were concerned about private profit for that health industry so it could grow, and one way of achieving that would by squeezing the public delivery of health services."

The optics of former Health Minister Coleman – who held the portfolio for three years – scuttling across to the other side and taking up a position with private healthcare company Acurity aren't exactly rosy. His refusal to answer questions about Middlemore, hanging up on RNZ's Susie Ferguson during a live interview, looks similarly bad.

Mind you, if shit in the walls at Middlemore were my political legacy, perhaps I'd be cagey too.

After three years on Coleman's watch, and many more years of drastic-underfunding, New Zealand now has to clean up the mess. Thankfully, though maddeningly, the ambulance has finally arrived at the bottom of the cliff.

What's the prognosis?

Expensive.