Kerre Woodham: Labour makes big promises, but can they deliver?

Hundreds of the Labour Party faithful gathered over the weekend in Auckland to begin the march back to Parliament's government benches. Council of Trade Unions head Sandra Gray was preaching to the converted when she told the crowd that New Zealand's Pavlova paradise has been eaten up by the rich. She said Labour needed to give workers a reason to vote for them and to deliver fundamental and systemic change. Yay! Cue loud rapturous applause.

Barbara Edmonds, Labour's Finance Minister in waiting, stressed to the crowd, and the way the attendant media, that she would be a firm, fit and frugal Finance Minister. She and her husband have raised eight children. They have lived on one income. As a tax lawyer for small businesses, she knows, she said, how to manage money responsibly and make every dollar count. She repeated that ad nauseam throughout the day. Gone are the days of profligate spending. No, no, no. Not with Barbara at the helm. Not with Barbara in charge of the bank accounts. She knew how to be frugal. She knew the value of a dollar. She would make sure that money was spent wisely, judiciously, and not everybody who came knocking at the door with policies would get the money they wanted.

And yesterday, Labour Party leader Chris Hipkins announced a future Labour government would offer doctors and nurse practitioners low interest loans to set up new practices or buy into existing ones.

New Zealand, and this will come as no news to you, New Zealand currently has a GP shortage, which is expected to worsen. We have an aging GP workforce. GPs are looking to retire and they can't find anybody to take their place. A recent survey found two thirds of GPs are expected to retire in the next decade. Many in the sector have also warned of a an emerging duopoly, large primary healthcare providers buying up practices from the small family-owned GP practices.

So Labour has announced that initially it will offer up to 50 loans per year, prioritizing areas that have no GPs or practices with closed or partially closed books. They will only be available for owner and or community operated general practices. The loan will have to be repaid over 10 years. They will be interest-free for the first two years. Novel.

It aligns with Labour's messaging of health, jobs, homes, as it goes into next year's election.  But just as the three free GP visits per year, is a gift that a lot of people don't need or want, is this what GPs and practice nurses want? Do you actually want to own your own practice? I'm sure there are some that do. But just because you're a brilliant GP, does that make you a brilliant manager?

Running a business, a successful business, requires a very specific skill set. Times are tough for small businesses. And the problem for GPs practices doesn't appear to be having access to loans to buy into a business. It's that the business model doesn't seem to be working. You've got the very low cost access practices serving high needs populations. They face financial challenges, especially the community trust owned clinics that have been operating at a deficit. Increase costs for GPs, inabilities to raise fees, growing patient debt due to the cost of living. Those are the problems for GP practices, not necessarily the fact they haven't got the money to buy it.

They've also got the problem of trying to recruit and retain healthcare professionals. There's a shortage of locums and a high level of burnout because there aren't enough people to replace them. They're working longer than they wanted to. They've got more difficult healthcare problems presenting because people put off going to the doctor because they can't afford it.

Pay parity concerns are particularly severe for the very low cost access GP practices. They can't afford to pay the going rates in the employment market as they don't have the ability to increase fees. So is the ability to buy into a practice what's holding GPs back? I wouldn't have thought so.

That poor little targeted capital gains tax is going to be working overtime, isn't it? As more and more policies are heaped upon it onto its little fragile base. And good luck with to Barbara Edmonds, the want to be Finance Minister, when she says not everybody who comes knocking on the door is going to get money.

When you've got the Council of Trade Unions head Sandra Gray whipping everybody up in the front rows, you bet your bippy the firefighters and the police and the nurses and the teachers are going to be banging on the door saying, "Give me, we've been under a National-led coalition government for three years. Those bastards have screwed us down. We gave you support, we got you into power. Give us more".

You can you can say what you want to get into Parliament, to get into government but once you're there, there will be expectations and obligations.

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