Comment to Fabian Society at the National Theatre Alive Film of ‘NYE’: 13 September, 2024

You will hear I have some voice limitations. It is the result of successful surgery on my larynx. When I reflect on what happened, I am struck at the quality and the expertise of the healthcare professionals who treated me with a caring respect.

I open this way, because the national habit is to report only failures. Yes, there is much to grumble about in the public healthcare system, but once you are inside, it is impressive. The challenge is that many people cannot access it in a timely manner or even at all. We do not know how many, because unlike most affluent democracies, we have never surveyed unmet healthcare needs.

The difficulty with only grumbling is that it leaves the system exposed to those who have a solution to a complex problem which is clear, simple and wrong – and probably makes things worse.

That is what happened in the early 1990s. There had been a long history of grumbling about the failures of our public healthcare system without a lot of analysis. The neoliberals arrived with their solution which was to privatise the public health system. Commonsense fought them off but the scars of the neoliberal attack remain and continue to distort not only the healthcare system but many other facets of New Zealand life.

The leader of the attempts to deal with those scars was Michael Cullen. If you haven’t read his memoir Labour Saving you must, for it is as close to a New Zealand Fabian manifesto as there is. But he was only partly successful. He did not have enough people supporting him who understood the fundamentals of neoliberalism. The vast majority of the country – perhaps more than 90 percent – dislike neoliberalism and grumble about it, but they haven’t done the hard grind of understanding it in order to provide a practical alternative. Indeed, the grumblers are prone to adopt unconsciously much of the neoliberal framework than they reject.

That Michael could make only limited progress because he didn’t have enough support is a reminder of the achievement of Nye Bevan in creating the British National Health Service. There was much support around him. A broad consensus saw the need for a comprehensive public healthcare service with, as we shall see, some powerful centres of bitter resistance. There had been a lot of preliminary work before Bevan set it up, especially the 1942 Beveridge Report, Social Insurance and Allied Services, which contributed greatly to building that consensus.

The main legislation – the National Insurance and National Health Service Acts – was passed in 1946. William Beveridge told Walter Nash that New Zealand was the only country ahead of Britain in social security. We used to boast that we were world leaders. We can no longer make such a boast, except in regard to ACC (despite the attempts of Bill Birch and Nic Smith to wreck that scheme).

Answering the question of how we fell from being a world leader to being at the back of the bunch belongs to another forum, as to whether we could get nearer the front of the bunch.

New Zealand’s public healthcare system is an integral part of the nation’s belief in itself. That is the reason why it was possible to fend off the neoliberal attack in the early 1990s. Instructively, Jim Bolger said that the health redisorganisation almost cost National the 1993 election.

What we are facing now is a creeping undermining of the public healthcare system by privatisations. We have never eradicated neoliberalism from our policy framework; it rusts away weakening strong structures until they collapse.

So we grumble, but we do not sufficiently cherish our public healthcare system. It probably means as much to us as the National Health System does to the British. But they may cherish it more. A 2013 opinion poll found that the NHS was more popular than at its creation, and more popular than the British armed forces, the BBC and even the monarchy.

That’s the point of the play we are to see. It is a British celebration of their public healthcare system by focusing on a key person in its founding. Forty-three years after he died, Nye Bevan was voted number one in poll of a 100 Welsh Heroes. (Rugby player Gareth Edwards was sixth.)

Most New Zealanders could not even name the founder of their public healthcare system. My choice would be Peter Fraser who was Labour’s first Minister of Health and who continued to drive the changes while he was Prime Minister. Yet twenty years after his death, a Labour Party Annual Conference did not even acknowledge him as a party leader.

His status has recovered. A recent consensus of three historians ranked him as only behind Seddon as our greatest prime minister. But ironically, the only solid biography of Fraser is by Michael Bassett, a neoliberal who tried to portray Fraser as a neoliberal rather than a progressive moderniser. The neoliberal rust never sleeps.

Nye Bevan would have agreed. He had better biographer, as you are going to see. Its final image is revealing. Not only is Nye being held high, but he is also being held high by medical staff supporting him in his time of need. So the play also celebrates the NHS. We should celebrate our public healthcare system.