Why are our health system priorities so out of whack, and officials so obsessed with McDonald’s?

Dr Eric Crampton
NZ Herald
28 November, 2024

You can learn a lot about a household’s priorities, or an agency’s priorities, when budgets tighten.

For the past few months, we have heard a lot about how the health system has been cut to the bone. Radio New Zealand piously reports every document leaked from the National Public Health Service (NPHS) showing how terrible the NPHS thinks that any cuts to the NPHS might be.

This past week has been informative about the National Public Health Service’s priorities, about the magnitude of cutbacks it has already faced, and about how broken the country’s land use planning system is.

McDonald’s wants to open a franchise in Wānaka in a rural area by a traffic interchange. Because it’s in a rural area, rather than in town where it would be simpler, an extensive consenting process is required.

Queenstown-Lakes District Council asked the National Public Health Service to provide a submission on the proposal. The Council would not do that unless it wanted to block the McDonald’s development or otherwise raise the costs of building it.

With all the pressure the NPHS claims to be under, it should have seemed unlikely that the organisation could find the capacity to submit on a single McDonald’s in Wānaka.

We have been assured that the NPHS is at breaking point. Staff have told Radio New Zealand that they are working 11 hours a day to get through their critically important work.

One fast food restaurant could not possibly be a priority in a country with over 170 McDonald’s. And what competence could the health service even have in Resource Management processes?

I strongly urge every one of you to read the submission from NPHS Regional Director Vince Barry to the Queenstown-Lakes District Council about that single McDonald’s.

It tells us a lot about how the NPHS views the world, its role in policy, and its priorities.

The submission runs to eight pages of content, plus a reference list. It concludes with a letter from Health in All Policies Advisor Monica Theriault.

The submission covers a lot of ground, none of it good.

Sometimes, like a 1990s’ anti-globalisation protestor, Mr Barry opines on the evils of multinational (MNC) and transnational (TNC) corporations. The National Public Health Service, according to Mr Barry, is “concerned about the impacts of MNC and TNC, such as McDonald’s, on planetary health and the health of current and future generations.”

A local fish and chip shop’s offerings might be no healthier than McDonald’s. Still, Mr Barry warns that “there is argument that a transnational business will be competing with Wānaka’s local businesses.”

The submission shows a deep anti-corporate ethos and an utter lack of understanding of the Resource Management Act. Effects on trade competitors, like Wānaka’s local businesses, are not supposed to be considered in consenting applications. If Mr Barry were an RM lawyer skilled in couching anticompetitive preferences in terms a consenting panel might accept, he might have claimed that the McDonald’s would draw people away from downtown, hurting downtown’s amenity value.

It's hardly the only problem with the submission.

While the RMA does consider health effects, that consideration would only be about the effects of restaurant-type activities in that location. It does not and should not extend to what the restaurant serves. The country has a food safety regulation regime.

The submission urges further measures that seem aimed at increasing McDonald’s legal costs – like demanding a comprehensive health impact assessment and a cultural impact assessment. The NPHS also weighs in on other matters about which it has no competence – like the visual amenity of the proposed restaurant.

And it provides a remarkable chart asserting that “GDP as a measure of economic growth” contributes to ill-health and health inequalities.

This is not a one-off. This is how the NPHS sees its role. This is its baked-in ideology.  

Mr Barry had previously inserted himself into discussions of whether Invercargill’s food trucks’ offerings have sufficient nutritional merit.

The letter from Health in All Policies Advisor Monica Theriault, which concludes the submission, notes, “We are eager to enhance how the concepts of health promotion can be effectively applied within the RMA framework.”

They want to do more of this.

The NPHS has revealed what it considers a priority in a time of restraint.

I draw a few conclusions.

First, the government’s coming reforms to the land use planning system must prevent the weaponisation of consenting processes.

Second, the Commerce Commission needs to pay a lot more attention to the anticompetitive effects of the land use planning system.

Finally, Minister Reti has not gone far enough with proposed budget cuts. He might consider razing the NPHS to the ground and starting over with an agency sharply focused on infectious disease. It is hard to see what else could fix it.

To read the full article on the NZ Herald website, click here.

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