NZ Listener, 5 April 2008; v213 #3543, p21-23
First off, new Minister of Health David Cunliffe doesn’t want to be Prime Minister. “No. it’s a bastard of a job and I have a young family. I don’t think the two would go together.”
There are many things about Cunliffe that don’t go together. He is a Labour Health Minister, yet has (through his wife) private health insurance. He’s in a Labour Government, yet has long advocated private-public partnerships for infrastructure works. He’s a West Auckland electorate politician living in a $2 million house near Ponsonby’s latte-land. He guards the privacy of his wife, Karen Price, although she is well known as one of New Zealand’s most prominent environmental lawyers.
He’s also clever, yet often manages to hit a grandiose or pompous note.
It happened just days after assuming the health portfolio. Under question from Opposition health spokesman Tony Ryall, Cunliffe, 44, leaned on his desk and drawled: “Mr Ryall, why don’t you stay in your box. I’m running this show.”
It inspired New Zealand Herald political columnist John Armstrong to lampoon Cunliffe as a “slow-talking, quick-shooting gunslinger”, missing only the “cowboy boots, a 10-gallon hat and the sheriff’s badge”. He was, wrote Armstrong, like “some latter-day Clint Eastwood-type character”, but without the “required degree of silent menace to make him really threatening”. Cunliffe gained that sense of menace when, after three months in the job, he fired the entire Hawke’s Bay District Health Board and was, indeed, “running this show”. The comment, he accepts, could have been better phrased.
“The sense I was trying to get across was, in the end, the Opposition is not responsible for making the hard decisions. I could have chosen better words, let’s face it, but there you go. Having said that, there’s a need for some strong leadership and that’s for the sake of the people of New Zealand.”
In his fifth-floor Beehive office, there remains a distinct scrape of rawhide when he tells the country that everything he does, well, he does it for you.
Just like with Hawke’s Bay. His frustration – near fury – with Hawke’s Bay Today‘s coverage of the health board sacking is palpable. “What’s really sad about it is that it appears that the public of Hawke’s Bay has not been properly informed on what has been going on,” in Cunliffe’s opinion. “The local newspaper, Hawke’s Bay Today, has been giving a very biased view of the world and has not sought to get both sides of the story … I think it’s very sad for journalism, frankly, and I just want to reassure them that the decisions I’ve made are actually for their sake.”
Saddle up and pass the ammunition. Cunliffe’s gonna hang him some rustlers so the good folk of Hawke’s Bay can sleep peacefully in their beds at night.
Those who deal with Health Minister Cunliffe describe him as an “action man”, imbued with “momentum”.
Ian Powell, executive director for the Association of Salaried Medical Specialists, sees him as someone who “wants to do things that leave a tangible mark”.
Says Powell: “I think Tony Ryall has been quite effective as a sort of yapping dog, scoring points. Now, I think Cunliffe has the measure of Tony Ryall and he’s blocking his attacks.”
Cunliffe will not allow himself to be battered easily. He has developed a combative style of politicking, but says he doesn’t seek to be a “street-fighter”. It’s not uncommon for him to hound Opposition MPs for proof about their statements, and he appears to mock Ryall for sheer fun.
Powell is optimistic about Cunliffe’s promise after the new minister stepped into a 20-month-long industrial spat between district health boards (DHBs)and the union, possibly staving off strike action. A meeting in Cunliffe’s office between the doctors and DHB representatives, chaired by the new minister, started at 7pm and didn’t finish until 4am. At the time Cunliffe quizzed both sides, offered possible solutions and injected “a really assertive form of pragmatism”.
Powell has been involved with the union since 1989 and says there has never been such ministerial involvement. Having five associate ministers of health may help.
Powell says Cunliffe’s approach offers hope that the 21-DHB system can be made to work, and he echoes Cunliffe: “What it needs,” he says, “is central leadership.”
Cunliffe is the new wave of “Third Way” Labour politicians: well-educated, wealthy and perhaps more comfortable among big business than in a working men’s club. His roots were traditional – father Reverend Bill Cunliffe was a Labour supporter and electorate activist in Timaru. “I have Labour in my DNA, to my back teeth. I bleed red, and occasionally have hair to match,” Cunliffe said in a 2004 party speech.
“As a vicarage kid, I knew what it was like to go without, and to see folks’ toughest problems at first hand. As a family, we depended on the things that Labour stands for – a state school, state healthcare, a Government that cares.”
At Otago University he studied economics, law and politics from 1983 to 1987, graduating with first-class honours in political studies. From there, it was straight to the Ministry of Foreign Affairs and Trade (MFAT) in Wellington for seven years, then Canberra and finally Washington DC with his wife, who also worked for MFAT. While there, he earned a Diploma in Social Science (Economics) with distinction at Massey University.
Cunliffe learnt his trade as a diplomat, yet showed some of the bumptious cheek that would later evolve into perceived arrogance. He later wrote about a White House press dinner he attended, along with then Deputy Prime Minister Don McKinnon. Cunliffe noticed McKinnon was lining up to shake hands with President Bill Clinton: “Spotting my chance, I accelerated down the aisle to follow him at a discreet distance. A solid Secret Service forearm barred my way. Thinking on the spot, I raised my left hand to my fictional earpiece and said: ‘Security for the Deputy Prime Minister, make way please.’ It worked. I had a nice chat with Mr Clinton.”
In his final years as a diplomat, Cunliffe clearly sought more. He later wrote: “Foreign Affairs had provided a great education in ‘how the world worked’. But it was a Government perspective – and I believe then, as I do now, that only in partnership with the business and community sectors can Government truly be effective.” He wrote that he needed time in business, new skills and an opportunity to learn. His wife also wanted to move from MFAT.
So Cunliffe went to Harvard as a Fulbright scholar. He and Price paid for it by selling their Washington home, getting grants and working as house servants for two “slightly eccentric” macrobiotic -vegetarian professors. While Cunliffe studied, Price worked with the Environmental Business Council in Boston.
He graduated in the top 10% of his class at Harvard. Being there was a revelation to him. He felt “oddly at home” and was so overcome by the experience that he wrote poems describing his time there.
In Seasons, he wrote: “Summer is as sweet and delicate as the butterfly’s touch or the skylark’s dance.”
Another poem, penned on the steps of the Harvard Business School library, was written from the university’s perspective:
For one short year or two
I suckled you
with potent milk
of truth and learning.
You know my strength
you know my weakness.
They are in you
for I am Harvard
And I am yours.
Cunliffe was distraught after initially being knocked back while looking for work in management consulting. “I even cried,” he wrote in a Fulbright address. Still, he got interviews with six firms, finally choosing Boston Consulting Group (BCG). The couple returned to New Zealand, where Cunliffe started work at BCG and Price, a year or so later, joined law firm Minter Ellison, where she went on to become partner.
With an eye on Parliament, Cunliffe was brought into the Auckland Central Labour electorate committee by MP Judith Tizard, and worked as chairman. By 1998 he was a member of the Auckland executive and the Labour Party’s Economic Policy Committee, and was selected to stand for Titirangi.
He won Titirangi in the 1999 election, retaining it under its new guise of New Lynn in 2002 and 2005, even though he had moved to a well-to-do inner suburb. He and Price have two sons, William and Cameron, and he says the shift eased matters – it was “not manageable for her to do the commute and her duties as a mum”.
Cunliffe’s political success filled him with a confidence that put colleagues off-side almost immediately. He was cast as arrogant, a tag he says was easy to “hang on someone who was young and enthusiastic”. But he hopes he has picked up “a few things along the way, including learning to keep my head down”.
On balance, the latter appears unresolved. Cunliffe drops some clangers. Many claims of arrogance probably stem from this tendency to intone lines as if underlining his latest sentence in history; a harmless, occasionally laughable, affectation. His maiden speech reflects that: “Where there is wrong, right it; where there is injustice, fight it; where there is hunger, feed it; where there are no jobs, find some; where our elderly sit shivering in shabby flats they cannot afford to heat, give them dignity.”
The apprentice-politician years included significant select committee work, but it was May 2003 before Cunliffe was given ministerial roles and some associate roles (communications, finance, information technology and revenue), before promotion to full ministerial portfolios (communications, immigration, information technology). Behind the scenes, he is a prime driver in Labour’s economic policy.
And now health.
When it’s pointed out that a jibe about his arrogance didn’t come from the Opposition, Cunliffe presumes the most likely fount of criticism: “I’m very confident that I’ve got good relationships with my caucus colleagues. We’ve got a really positive and empowered ministerial team in health, I’m enjoying my friendships in the caucus, and it’s a very united caucus. You always get the odd chip but nothing I would worry about.”
He is relatively young, bright and hard-working and, as a package, he may well create factions in a Labour Party wondering about its next leader, and its subsequent hierarchy. Those more kindly inclined describe Cunliffe as hugely self-confident, rather than arrogant.
Whatever his personal ambitions, Cunliffe has ruled out contention for the Prime Minister’s job: “I have my hands full with a big, grunty portfolio and I’m enjoying it very much. I am here to make a difference, not to get a particular job.”
There’s much work to be done in health. There is a belief that Annette King’s tenure as Health Minister was a success, establishing a framework and a broad strategy shift to primary health. But there was also a perception she would repress knottier problems. Her successor, Pete Hodgson, was also seen to have that trait.
Cunliffe seems determined to thrash the hell out of the problems others avoided.
The district health board system is in for a shake-up – DHBs can have little doubt they are being watched, with Cunliffe’s associate ministers assigned “liaison” roles with specific boards in late March. He is keen to speed up collaboration between DHBs at both regional and national level. That, he says, would help win “efficiencies” in staffing, staff retention, purchasing and in sharing services.
“That was part of the background of Whanganui’s problem with [rogue gynaecologist] Dr Hasil. And to give you an example, co-operation between Whanganui and MidCentral [health boards] would seem to be an obvious way forward.”
The boards recently reached a regional agreement for some services.
Auckland’s three DHBs and Northland are also co-operating on purchasing but he believes more can be done by transferring “learnings from the best players to the others”. That will involve introducing common computer systems between individual DHBs and the Ministry of Health.
“I’ve essentially got a fixed budget … literally anything we can save in terms of wastage or double purchasing can go straight into medicines or nursing or -primary health care.”
Cunliffe also intends to bring in financial penalties for poor hospital safety. “They don’t get a quarter percent of their budgets if they can’t prove they are implementing a set of nationwide standards on quality improvement practices.” For some DHBs, this safety could be the tipping point between being in the red – or black.
And then there are the workforce issues: “We need to look at recruitment and retention factors – both domestic and foreign – across a number of the key occupation groups … foreign doctors make a huge contribution and the health system has become, to some extent, reliant on them.”
He sees recent high-profile cases involving foreign doctors as exceptions, but adds: “I don’t want to see a situation where there is three-quarters foreign staff and one quarter Kiwi staff, so we need to stabilise it.”
Cunliffe also supports a needs-based approach to health, identifying links to racial groupings, an approach Labour backed away from when Don Brash got political capital highlighting perceived inequities. You live a shorter life if you’re Maori than if you’re Pakeha, he says. “There are no two ways around it. You are more likely to have cardiovascular disease, you are much more likely to have obesity or diabetes … We can actually fix a lot of that. We know how.”
Exactly how remains to be seen. Cunliffe’s centrist tendencies are at odds with Labour’s roots. He would be, for example, the first health minister to favour private health insurance. “My wife has private health insurance with her work. We have no intention of discontinuing that.”
Colin Espiner, political editor for the Press, wrote that the problems in Cunliffe’s communications and immigration portfolios were handled well, but health is not so simple. “The graveyard of politics is littered with the corpses of former health ministers who decided to shake up this most truculent of sectors.”
Cunliffe’s return is likely. He has a high spot on the Labour list, and a willing electorate. Now that he holds the health portfolio, his constituents might choose to remember Cunliffe’s maiden speech when he indignantly told Parliament: “167,000 West Aucklanders are forced to travel for an hour or more for emergency services at North Shore.” For a good chunk of the day, people in his electorate still have to go to North Shore Hospital for emergency treatment because of Waitakere’s limited hours.
As he says, the Opposition is not responsible for making the hard decisions.