New health minister's unpromising track record

The recent track record of Simeon Brown, the former Minister of Transport and the new Minister of Health, is somewhat at odds with the Hippocratic Oath argues Kirsty Wild and Alistair Woodward.

The most important qualities for a minister of health are a deep and evident concern for the health and wellbeing of the population; a willingness to listen to and take seriously advice from all kinds of experts; and an ability to build coalitions. In his last job Simeon Brown [above] did not display these qualities,'
The most important qualities for a minister of health are a deep and evident concern for the health and wellbeing of the population; a willingness to listen to and take seriously advice from all kinds of experts. In his last job Simeon Brown did not display these qualities, says Kirsty Wild and Alistair Woodward.

Simeon Brown is the new minister of health. He has no formal qualifications and no professional experience in health. But he has a record that is relevant. In his last job, as Minister of Transport, he made many important decisions that affected the health of New Zealanders. On the whole, his actions were damaging.

Nearly two thirds (63 percent) of serious injury in New Zealand is caused by transport crashes. They keep our hospitals full to overflowing; and efforts to avoid these horrific and frequently life-changing injuries are necessary for the sustainability of the health system.

Officially, reducing transport injury is a health priority, yet Brown made a number of decisions, against health advice, that are likely to make the problem worse. The decision to reduce funding for pedestrian and cyclist safety infrastructure was inexplicable, given the high rates of severe injury per kilometre travelled among these groups.

Reducing the money available for councils to maintain footpaths was particularly harmful for elderly people, who are much more likely to fall when footpath quality declines. The decision to increase speeds, including around schools – perhaps the first time, internationally, safe speed measures have been reversed – increases chances of injury and avoidable deaths, especially for children, elderly and disabled people. These are the groups in our community who need more time to cross roads safely and are particularly at risk from high-speed traffic.

Health professionals and school leaders pleaded with the minister not to reverse speed restrictions outside schools. School leaders told him about the pain of having to bury students; emergency room doctors spoke of the suffering of their patients and their families. The minister was indifferent. When Auckland Transport won an international road safety prize for the soon-to-be-cancelled safe speeds programme, Brown mocked their efforts. In a TV interview on the honour he said “there’s lots of woke awards out there”.

Transport programmes influence on injury and levels of illness in the community as well. Adequate physical activity is one of the two key pillars of staying well (alongside good nutrition); and walking is by far our most popular form of exercise. Most people don’t use gyms or have elaborate exercise routines: they walk. Nearly sixty percent (57 percent) of New Zealanders get their exercise from walking – with most of us using transport infrastructure (footpaths) at some point during our trip.

Levels of physical activity in the community, and therefore health, depend strongly on safe vehicle speeds and high-quality footpaths. However, Brown deliberately and explicitly cut investments in walking and cycling.   

About 40 percent of our primary school children also still walk and bike to school, and kids who do this have been shown to have better physical and mental health, and better learning outcomes. Levels of physical activity in the community, and therefore health, depend strongly on safe vehicle speeds and high-quality footpaths. However, Brown deliberately and explicitly cut investments in walking and cycling.

The Warkworth roundabout, about 60km north of Auckland, is an example of the minister overriding local initiatives on the grounds that money should not be spent on speed restrictions and walking and cycling infrastructure. The Warkworth intersection is crowded, confusing and dangerous, and residents have been lobbying for improvements for more than a decade. After many years it seemed a decision had been made on what should be done, but Brown intervened and cancelled the work because it included “five new speed bumps and three sections of cycleway”.

Another example of bad health decisions taken by Brown are those related to air pollution. This is a major, preventable cause of illness in New Zealand. The Health and Air Pollution in New Zealand (HAPINZ) study estimated that 1 in 10 premature deaths in New Zealand are because of air pollution – two thirds of which comes from automobile exhausts. There are effects documented on the immune, neurological, reproductive, and respiratory systems. Long-term exposure contributes to asthma, heart disease, cancer and dementia.

The study estimated that each year air pollution causes more than 13,000 hospitalisations for asthma among children; about 8,500 hospitalisations for respiratory disease; and 4,600 hospitalisations for cardiovascular disease. Despite advice from scientists, doctors, and staff in the Ministry of Transport, Brown chose to weaken efforts to reduce air pollution. On his watch the clean car discount was scrapped, the tax on large polluting diesel vehicles was reduced, and scheduled improvements in air-quality standards for vehicles were recently halted.

What makes a good minister of health? In our view, the most important qualities are a deep and evident concern for the health and wellbeing of the population; a willingness to listen to and take seriously advice from all kinds of experts; and an ability to build coalitions. In his last job Simeon Brown did not display these qualities. We fear his talk of “driving change” in his new job, and “turbo-charging health” is out of touch.

The health system is complex. The most important decisions are made by clinicians not managers, and staff are allergic to direction from Wellington, especially if this is imposed without respect, or commitment to the evidence around how to do less harm.

Dr Kirsty Wild is a senior research fellow and a public health epidemiologist at the Faculty of Medical and Health Science.

Professor Alistair Woodward is a public health epidemiologist at the Faculty of Medical and Health Science.

This article reflects the opinion of the author and not necessarily the views of Waipapa Taumata Rau University of Auckland.

This article was first published on Newsroom, New minister’s track record doesn’t bode well for our health, 30 January, 2025

Media contact

Margo White I Research communications editor
Mob
021 926 408
Email margo.white@auckland.ac.nz