“Surely that is not the future we want” - Dr David Galler and Gail Duncan speak to the Finance and Expenditure Committee
Kaitiaki Hauora spokesperson Dr David Galler and Founding member Gail Duncan appeared before the Finance and Expenditure Select Committee to speak to the economic imperative of investing in public health and healthcare.
In their submission, Dr Galler set out a clear argument. The economic success of Aotearoa New Zealand depends on the health of our people. Under current settings, however, we are moving in the wrong direction.
Referencing recent analysis by health economist Andrea Black, he noted projections that by 2035 only 6.6% of adults in New Zealand may meet the WHO definition of being in good health. “Surely that is not the future we want,” he told the Committee.
Dr Galler argued that persistent underinvestment, workforce strain, infrastructure neglect and creeping privatisation are placing increasing pressure on the public health system. He emphasised that investment in public provision is more than a social good - it is economically rational and essential for long-term growth.
In response to questioning from the Chair about the Minister of Finance’s indication that $1.4 billion of the new operating allowance may go to health, Kaitiaki Hauora Founding member Gail Duncan added that while this may sustain current expenditure, it does not allow for meaningful improvement or address years of accumulated underinvestment. Maintaining the status quo, she said, will not meet the growing population's needs.
Kaitiaki Hauora is calling for Budget 2026 to prioritise substantial public investment in health infrastructure, workforce, pay equity, primary and community services, and long-term funding certainty for Iwi-Māori Partnership Boards.
As Dr Galler concluded, “Investment in health is essential for economic growth and must be prioritised.”
Watch the video or read the full submission below.
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Kaitiaki Hauora Speech on BPS to FE Committee Monday 23 rd February 4:05pm – 4-15pm by ZOOM
My name is David Galler
I am the spokesperson for Kaitiaki Hauora and this afternoon I will briefly speak to the economic imperative to invest in health and healthcare.
Kaitiaki Hauora is a recently formed coalition working to protect and strengthen Aotearoa New Zealand’s public health system by uniting communities, health workers, iwi Māori Partnership Boards, unions, and advocacy groups asguardians of public health.
We campaign for a well-resourced, Te Tiriti-honouring publicly provided health system that delivers equitable, culturally safe care for all.
Right now, we are a long way from that and sliding backwards, in large part due to inadequate funding, a failure to honour Te Tiriti o Waitangi, our failure to invest in necessary infrastructure and workforce, and because of the ongoing privatisation of services; all this set in a context of a persistent unwillingness to address the escalating social and commercial drivers of demand.
In her recent paper Managed Decline, the health economist Andrea Black projects that under current settings, by 2035 only 6.6% of adults in NZ will meet the WHO definition of being in good health.
Surely that is not the future we want.
Members of the Finance and Expenditure Committee, you of all people must know that the economic success of our nation is dependent on the health of our people and it is our view that privatisation will not fix New Zealand’s health system.
Budget 2026 must:
Address the commercial and social determinants of health, fund our public health system to deliver the services New Zealanders need across primary and community care, mental health and hospital-based servic
Include a dedicated funding package for Iwi-Māori Partnership Boards and long term funding certainty.
Invest in public workforce recruitment and development,
Fully fund pay equity settlements for nursing, midwifery and allied health
Boldly fund new public health infrastructure developments to upgrade and replace hospitals including regional facilities.
Te Kāhui Tika Tangata, our Human Rights Commission states “The right to health encompasses not just the absence of disease or infirmity but “complete physical, mental and social well being”. It includes access to both timely and appropriate healthcare, as well as the underlying social and economic determinants of health, such as conditions of work and adequate food and shelter”.
It is clear to us that our approach to the funding of health services is inadequate and limited by a siloed, short-term cost containment mindset and a lack of appropriate long term planning.
Put simply, NZ cannot afford to have so many of its people in poor health and we say it is an economic imperative for us as a nation to invest in health and healthcare services for all New Zealanders.
That is only possible through public provision and cannot be done through privatisation of services for profit. The link between investing in public health provision to achieve universal coverage and economic growth is well proved (reference the NHS research,)
Kaitiaki Hauora echoes the call from the head of Treasury and the Infrastructure Commission that “there is a case that the Government should increase Crown debt to fund long term infrastructure”.
They have recommended a doubling of the spend on hospital construction as a proportion of GDP over the next 20 years to factor in growth in the economy which will also account for population growth and any increases in productivity.
Kaitiaki Hauora is pleased with this development but wishes to point out that New Zealand’s approach to kick the can down the road and not invest in the future is not unique to infrastructure, it applies to the investments in health and healthcare more generally.
Iain Rennie’s rare warning earlier this month over the state of New Zealand hospitals, emphasising the scale of the rebuild, is a wake up call we must heed.
In the next budget and those that follow, Kaitiaki Hauora is calling for much more than a normal increase in health investment to account for the same factors. Investment in health is essential for economic growth and must be prioritised in the 2026 Budget Policy Statement, reflecting the 2026 National Infrastructure Plan priorities.
References:
1. https://www.nhsconfed.org/system/files/2022-10/Health-investing-and-economic-growth-analysis.pdf
2. https://asms.org.nz/wp-content/uploads/2025/10/Managed-Decline-Final.pdf
3. Treasury head issues rare warning over state of NZ hospitals - Watch on TVNZ+
4. New Zealand's first national infrastructure plan unveiled | RNZ News
5. Ten priorities for the decade ahead | National Infrastructure Plan | Te Waihanga