It’s hard to think of a minister who has inflicted more damage on their own government in its inaugural year than Associate Health Minister Casey Costello. With Labour still licking its wounds, the Greens obsessed with internal troubles and Te Pāti Māori under investigation for alleged misuse of census information and failure to file annual financial statements, the New Zealand First MP may constitute an entire opposition party of her own, managing to generate headlines containing the words “government”, “tobacco”, “industry” and “health” on a regular basis for almost the entire year.
In late January, RNZ reported that Costello had proposed a freeze on tobacco excise taxes. She claimed the suggestion came from officials; documents quickly emerged contradicting this. A month later, she ditched Labour’s Smokefree legislation. In July, she slashed the excise rate on heated tobacco products at an estimated cost of $216 million.
She has been in a state of open warfare with the Ministry of Health, and has struggled to explain the origin of a document she distributed to officials claiming that “nicotine is as harmful as caffeine”, and other arguments that seemed unusually friendly to the tobacco industry.
She has been forced to apologise for withholding information from public health researchers after the Chief Ombudsman found her office’s handling of Official Information Act requests was “unreasonable and contrary to law”. The Prime Minister is now being drawn into defending Costello’s antics in Parliament’s Question Time.
Reshuffle avoided
Under normal circumstances, she would have been reshuffled out of the portfolio so quickly there would have been scorch marks on her office carpet and a politician-shaped vacuum behind her desk. But Costello is a NZ First MP; she serves at the pleasure of her leader, Deputy Prime Minister Winston Peters, not the Prime Minister.
Peters lives by the premise that the best defence is a good offence, and even a bad offence will do in a pinch. Labour’s health spokesperson, Ayesha Verrall, has conducted a sustained prosecution of Costello, and Peters recently revealed in Parliament that Verrall’s sister-in-law was one of the ministry officials who had access to information about the tobacco taxes, implying she was the source of the leaks. The ministry said Verrall’s relative had notified the potential conflict of interest but it then failed to notify Costello.
Wellington is a disgustingly clannish city: everyone is either married to or divorced from everyone else, and this does create countless conflicts of interest. But Labour has hundreds of fellow travellers embedded throughout the public sector, gleefully leaking and briefing the opposition and media against the government they despise.
The government’s outrage about this is partially justified: it is the elected representative and it is supposed to be served by politically neutral officials, not covertly undermined by partisan activists. But public health officials who are asked to progress pro-tobacco legislation will always become whistleblowers, and the Ombudsman’s criticisms of Costello’s ministerial conduct validate their decision to defy their own minister.
To have an Associate Health Minister wreaking havoc on the scale of Costello is an existential threat to the government.
An infected wound
Peters will be pleased with the controversy he has created – once again, he has turned the tables on his enemies. National will be less thrilled that media attention remains on Costello. Health is this government’s greatest weakness, and Costello is a shocking liability: an open, infected wound bleeding dreadful media coverage.
The favourable treatment for tobacco companies contrasts with a constant stream of news stories about patients dying waiting for treatment in EDs, hospitals closing overnight, staff shortages, gigantic budget blow-outs. The failure to fund cancer drugs in the Budget – quickly reversed – and the broken promise to fully fund the rebuild of Dunedin Hospital were two of the government’s greatest unforced errors.
Health Minister Shane Reti is widely acknowledged as one of the most intelligent and decent politicians in Parliament but it’s not apparent that either of those qualities is an asset in the health portfolio, which often rewards politicians wielding a combination of high aggression and low cunning.
The dire state of the crown accounts, the government’s fiscal settings, the dysfunction at Health New Zealand Te Whatu Ora and the enormous liability of our ageing population make it impossible to continue funding the sector at its current capacity.
New Zealand’s health spending is high as a percentage of GDP relative to the rest of the OECD, but low in dollar terms, because our GDP per capita is lower than average. Reti has yet to indicate how he will address this.
Most of his fellow front-bench ministers – Chris Bishop, Erica Stanford, Nicola Willis, Simeon Brown – are activist ministers, driving rapid policy change. Prime Minister Christopher Luxon shows a keen interest in education and trade issues but seems indifferent to the health portfolio.
National’s de facto policy appears to be one of managed decline – a gradual and passive downgrade of the public health system. Perversely, even a slow deterioration will require enormous injections of new funding to stave off a more rapid collapse.
The public are unlikely to warm to this. Market research company Ipsos’s “Issues Monitor” ranks healthcare as the second-biggest concern among voters (and No 1 among the high-turnout older voting demographic).
Labour is significantly ahead of National as the most trusted party on healthcare. To have an Associate Health Minister wreaking havoc on the scale of Costello is an existential threat to the government.
But there she remains, sitting proudly on the front bench, smiling broadly as Reti and Luxon repeatedly stand to defend her.
