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  • Writer's pictureZahra Shahtahmasebi

The role of lobbying within the health sector to affect change



In preparation for this piece, I searched Google with the words “lobbying” and “health” and the results provided a clear illustration to why lobbying is a concept so fraught with controversy.


With Google pulling up articles on alcohol and tobacco corporations leveraging their money to influence policy decisions that would restrict their products, it’s no wonder those images of shadowy conversations in deserted Parliament corridors come to the fore when the term lobbying is used.


And while the Government’s recent decision to repeal Aotearoa New Zealand’s world-leading smokefree laws came as a shock to us and the rest of the world, it also makes the power these corporations hold an important topic for discussion.


But there’s a side to this coin that isn’t captured in those Google search results.


The healthcare system in Aotearoa New Zealand is, for the most part, funded by general taxation. For people who are eligible, access to publicly-funded services or facilities, like hospitals, are free or subsidised. This means that policy decisions do affect our healthcare system, either directly or indirectly, but lobbying can also be used within that as a way to affect meaningful change.


Off the back of the Government’s announcement to repeal the smokefree laws, national public health agencies got to work, including Hāpai te Hauora setting up a petition to challenge this decision. Within a week the petition had the public of Aotearoa behind it, with over 30,000 signatures and people sharing it far and wide across social media.


Protestors opposing the repeal of smokefree laws. Photo: Hāpai te Hauora


While Aotearoa watches with bated breath to see what happens next, both the petition and the letter did their job of engaging with government officials as well as corralling the public to stand against the repeal.


A US researcher, Leonard Weber, wrote that one of the reasons lobbying has acquired a negative reputation is because of the view that people or groups only do it to serve, or protect, their own interests.


But, he goes on to say, that when it is done with the goal of improving the common good, lobbying is often the most appropriate path to take.


He suggests considering lobbying as advocacy – an effort to influence public policy for the benefit of those in our society whose voices are not heard.


It’s interesting what a difference those words make. An advocate connotes someone fighting the good fight, compared to a lobbyist who is typically characterised as nefarious and corrupt.


But when it comes to the definitions it's hard to see any real differences between these two terms.


A position statement written by charity Youthline back in 2006 refers to the World Health Organisation’s definition of advocacy for health as:


“A combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or programme”.


Which sounds awfully similar to how we defined lobbying in ‘A brief history of lobbying in Aotearoa New Zealand’. The Youthline paper then goes on to cite a Mexican ministerial statement, signed by New Zealand, which says advocacy is an important tool that includes lobbying, political organisation and activism.


Youthline adds that by developing its advocacy and lobbying activities, it would strengthen its national standing and ability to support its community of rangatahi.


In Aotearoa, this is something we’re good at. Like Youthline, there are many charities, organisations and individuals who will push the Government to make changes in healthcare that will benefit our society.


And petitions, like the one set up by Hāpai te Haoura, have been the catalyst of many positive changes in the health sector. Just this year, the previous Labour-led government announced our country’s first ever Women’s Health Strategy – a piece of policy over two decades in the making, thanks to the dedicated mahi of many but particularly Women’s Health Action and social change agency Project Gender.


Project Gender submitted a petition of 2,873 medical professionals, academics, and women asking for a gender lens to be applied to healthcare, and also made oral submissions on the need for a strategy at Parliament. A year later, the strategy was announced, with the vision of improving the health of our wāhine.


Carmen Shanks speaking at the handover of a petition to fund Trikafta. Photo: stuff.co.nz


A petition with over 9,000 signatures was also important in securing funding for cystic fibrosis drug Trikafta. National charity Cystic Fibrosis New Zealand (CFNZ) lobbied drug-buying agency Pharmac for two and a half years to get the drug fully funded here in Aotearoa, which came into effect in March this year.


Before that, patients were having to pay around $300,000 a year to self-fund Trikafta, or were travelling across the ditch to Australia to get a subsidised version there.


Lobbying right alongside CFNZ was Patient Voice Aotearoa, a collective of patients, caregivers, whānau, charities, and campaigners, led by chairperson Malcolm Mulholland, who lobby the Government and Pharmac for better access to medicines.


Prior to the election, Mulholland took his campaign, #MyLifeMatters, on the road, hosting local discussions from Whangārei to Dunedin, to demonstrate the impact a lack of access to medicines has on our community.


He finished in Auckland with a debate between the leading party’s health spokespeople, calling for Pharmac to be reformed. In the new coalition government, David Seymour has been named as an Associate Minister of Health, with responsibility for Pharmac, and has said the agency needs to listen more to patient voices.


Health professionals themselves, like our GPs, are in an ideal position to lobby, as both members of the community, and as workers on the front line, giving them a clear understanding of the health system.


In September, Aotearoa changed from using smears to using a HPV swab to check for cervical cancer – a change brought about by the work of many health professionals and academics, like Professor Beverley Lawton, who conducted research and pilot programmes which showed how effective this method was.


Party leaders Chris Hipkins and Christopher Luxon on the campaign trail in 2023. Photo: RNZ


We saw lobbying play out most effortlessly on the debating floor during the Election 2023 campaign trail. During the Newshub leaders’ debate, National’s Christopher Luxon and Labour’s Chris Hipkins were both asked point blank by host Paddy Gower about the minimum age of eligibility for bowel cancer screening. As he motioned to patient Aimee Rose Yates in the audience, Gower asked, “Will either of you lower the age of screening and save the lives of Kiwis?”


Both leaders committed to matching Australia’s screening age of 50, or 45 if asked for. It was policy made on the hoof - a commitment that had not been part of either party’s policy manifesto. But it’s safe to say the decisions of both leaders in that moment were influenced by the lobbying work in the months leading up to the election - patients sharing their stories in the media and a study published in the ANZ Journal of Surgery, as well as an editorial written by a group of doctors and researchers in the New Zealand Medical Journal. While the tobacco and alcohol corporations, and others continue to lobby within their own best interests, for many out there, lobbying remains an important tool we can all use to better the health of Aotearoa.


Zahra Shahtahmasebi is a rising young journalist currently working in the not-for-profit space. Based in Tāmaki Makaurau, she predominantly writes on health, and politics with personal interest in women’s health. She was awarded the nib Health Journalism Scholarship - junior at the Voyager Award in 2021 and was runner up for the Le Mana Pacific Award in 2023.

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