This election, 1 NEWS looks at the top five issues New Zealanders care about the most. This week we take a look at what Kiwis want from the health system.
Covid-19 has thrust the issue of New Zealand's health system into the limelight this year.
Despite this, those working in health say it shouldn't take a global pandemic to highlight the lack of funding for public health and are seeking consistent funding, not just a quick fix.
In March, when Covid-19 was ramping up, the Government invested $500 million into strengthening New Zealand's health services to deal with the pandemic.
Dr Felicity Dumble, president of the New Zealand College of Public Health Medicine, told 1 NEWS the Government's cash injection into public health for the Covid-19 response shouldn't be a knee-jerk reaction to the pandemic.
Dumble said funding from the Government did allow the sector to increase staff numbers in public health units and train more public health doctors next year.
However, investment into public health has been stagnant, if not reducing, over a long period of time, Dumble said.
"That's really been brought to life with the response to Covid-19," she said.
"We certainly appreciate the fact that the Government has put quite a substantial amount of money into the health response and we believe that there will be long-term benefits from that, but we don't want it to be a knee-jerk reaction and a one-off.
"The Government needs to be investing in this.
"We need that investment to be long-term and sustained and protected, and that's across the public health workforce, not just the medical workforce," she said.
Out of date system
Since Covid-19 landed in New Zealand, the cracks in New Zealand's public health system have been exacerbated.
Dumble said the systems and legislation used in the sector are out of date.
"A lot of work at the coal-face in public health is based on legislation from 1956, the 1956 Health Act, so we're already somewhat stagnant based on the legislation that we work with.
"The lack of funding that had been over a long, long period of time meant that when [Covid-19] hit...it showed there were cracks in the seams because of the tools we were working with, the diminished workforce that we had.
"We've had to, with Covid, use tools that were old and used for other purposes and cobble things together in a great rush."
One of those outdated tools the system has been working with while trying to battle the virus was its "clunky" IT systems, Dumble said.
An updated IT system is crucial for public health staff - especially around contact tracing, data collecting and sharing.
The current system has made this process "quite difficult", said Dumble.
"It has been stressful, particularly during that peak time of the first wave - long hours, having to learn constantly and things were changing constantly.
"It was a brand new disease and we were still learning about it and how we best manage it."
Dumble, along with a group of health experts, wrote an open letter to the Government earlier this year calling for more support for the public health system.
"This is something we'd been calling for for years and years and years and finally something so tragic has happened that it's really shone the light on the fact that we'd been under invested in for years and that needs to be addressed and managed.
"Going forward, it's really important that the Government recognises public health verses publicly funded health. They're very, very different things. We need them to value the long-term investment in public health, because the benefits will be huge downstream."
'We are below critical mass'
Leading epidemiologist professor Dr Michael Baker agreed with Dumble and said there has been even more strain on the health system this year due to the pandemic.
He said investing in the underfunded system would financially be beneficial for the country in the long run.
"I think just recognising that investing in public health, it saves a huge amount of money and not having these capabilities is actually very expensive and dangerous.
"We are below critical mass at a national level now and it means we are very vulnerable to missing some important hazards and threats.
"Investing in public health doesn't just save lives and extend human life spans, extend the quality of life. It also saves the economy a fortune."
He said the Covid-19 response exhausted those on the frontline due to a lack of staff.
"You suddenly realise you don't have enough people and it takes years to train people, so you can't just suddenly generate a whole new workforce."
Baker is also calling for the incoming Government to invest in a dedicated national public health agency to continue managing the Covid-19 crisis.
He said it could then shift to looking at the other areas where there's potential for health gain in New Zealand, including reducing ethnic inequalities and getting a tough policy on tobacco.
"Not only is our system short-sighted in terms of not looking to the long-term threats on the horizon, but also it finds it very hard to, again, think more broadly about what makes people sick. And on the other side of it, what gives people a good, fulfilling life?"
Dumble also cited health concerns in broader issues, including climate change, poverty and the housing crisis.
"It sounds a bit cliche, but prevention is better than cure, so what we really need to do is keep our population as healthy as possible and that will be not just with the threats of communicable diseases, such as Covid or measles epidemics, whooping cough."
POLITICAL PARTY POLICIES FOR HEALTH
Labour: Make investment into hospitals and health services, boosting funding for Pharmac and increasing funding for planned care. Read the full policy plan here.
National: Establish a $50 million cancer fund within Pharmac, invest more in gynaecological cancer, create a rare disorders fund, improve access to dental care in schools, double the number of cochlear implants funded each year, and increase the level of post-natal care. Read the full policy plan here.
NZ First: Pledging $10 million to Gumboot Friday over three years, with money going towards the cost of providing free counselling and all administration costs for the programme. To fully fund St John, support alternatives to smoking affordable and widely available. Read their full policies here.
Green Party: Increase resources for wellness and preventative health measures, increase public health funding, ensure everyone can access healthcare services and incorporate mātauranga Māori into the health system. Read the full policy here.
ACT Party: More access and choice for healthcare, transform primary care, support NGOs. Read the full mental health policy here.
Māori Party: Establish a Māori health funding authority, implement a Māori health card, establish a comprehensive kaupapa Māori mental health service and drop Māori cancer screening by 10 years. Read the full policy here.
The Opportunities Party: Strengthen public health, tax sugar and junk food, create an accessible fruit and veggie scheme, make primary care affordable, increase investment in mental health prevention, improve access to dental care, investigate the best way to address period poverty and reinstall the independent Public Health Commission. Read the full policy here.
New Conservatives: Make private health insurance tax deductible, provide additional health support for rural communities, oppose euthanasia in any form, ensure vaccinations are not made mandatory and extend age-related, government funded, health checks. Read the full policy here.