Results of network survey: 100 day action plan and smokefree repeal

We received 40 responses to our survey on the new government’s 100-day action plan, and the repeal of SERPA and Smokefree 2025 legislation. Thank you to everyone who took time to respond. While 40 is not a large amount given the number of general practice staff across the network, the feedback does align with what we are hearing directly from practices, and gives us a good understanding of where our advocacy efforts need to be.

Repeal of the Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Act (SERPA) and the Smokefree Aotearoa Action Plan

The feedback on the repeal of smokefree legislation in Aotearoa New Zealand is overwhelmingly negative. Respondents expressed disappointment and concern, noting the potential increase in health risks, especially among Māori and other vulnerable groups. Many view the repeal as a backward step that undermines public health progress.

There's a sense that prioritising tax revenue over health is “morally reprehensible”, and the decision is seen as short-sighted and potentially influenced by tobacco industry lobbying. Concerns about increased strain on the healthcare system, rising rates of smoking-related illnesses, and negative impacts on youth and low socio-economic populations are prevalent.

Three of the 40 respondents support the repeal, arguing for individual freedom and questioning the effectiveness of the legislation. Overall, however, the sentiment is predominantly against the repeal, seeing it as harmful to public health and equity.

Other comments on the 100-day plan health actions

The feedback on the 100-day health action plan indicates a mix of scepticism, disappointment, and a few areas of approval. Two respondents said there wasn’t enough detail in the question and preamble, so voted ‘middle of the road’.

The responses can be divided into themes:

Promises and funding: Many responses express doubt that the government's promises will lead to meaningful changes, citing a lack of additional funding and practical support. There's a concern that without significant investment, especially in primary care, the system will continue to struggle.

Performance-based funding: The feedback criticises the use of KPIs linked to funding, arguing that it places undue pressure on already overburdened healthcare workers. Some also mention targets are not new; and previously resulted in pushing more work back on primary care as patients fell below the threshold.

Immigration and primary care: The impact of immigration on primary care is highlighted as a major issue, with some noting that it's currently under-supported and overburdened.

Workforce challenges: The feedback points to concerns about retaining and supporting healthcare workers. There's a sense that current policies might lead to an exodus of doctors and nurses, worsening the situation.

Education and incentives: There's criticism of the approach to education incentives, especially for nurses. The suggestion is to provide more support during study rather than post-graduation, and to address issues like pay equity and safe staffing.

There is a general sense of support for the establishment of a new medical school but also concerns about its cost-effectiveness and the assurance that graduates will remain in general practice or rural areas. Respondents would like to see detailed information about the school's operational and strategic plans.

Health equity and Māori health: There's worry that the progress in Māori health outcomes might be reversed, and that more needs to be done to address health inequities.

Specific policies: The disestablishment of Te Aka Whai Ora and potential removal of Te Reo names are particularly disappointing for many, seen as disrespectful and a loss for the healthcare system.

Voting regrets and frustrations: Some express regret over their voting choices, feeling that the new government's policies are not addressing the core issues in healthcare.

General dissatisfaction with the plan: Many feel the plan’s health actions lack thorough consideration and risks making the situation worse for vulnerable and health-illiterate patients. There's a call for more cultural appreciation and tailored approaches to health care. One respondent says,“It will disengage, affect, let down our most vulnerable and health illiterate patients. Everyone is NOT the same, these changes show a real lack of cultural appreciation. This is what separates us from the rest of the world, we should be embracing our culture and be proud!"

In summary, while there are a few positive notes about education initiatives, the overall sentiment is one of deep concern and disappointment, with calls for more substantive, equitable, and well-thought-out changes in the healthcare system.

*While we have completed gathering survey results, this is not the end of our advocacy on behalf of the network and primary care. We will keep you informed about our ongoing mahi/work in this area.