Political Sadism, Or Moral Inertia? Explaining David Clark

By   /   February 15, 2019  /   36 Comments

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David Clark does not appear to have a metric for moral force. The calculation of our health system’s ethical obligations seems beyond him. How, when all is said and done, does one measure a family’s sorrow, or calculate a young doctor’s dedication?

What is the market-price of kindness?

CLEARLY, DAVID CLARK never got the “Politics of Kindness” memo. In the face of the appalling behaviour of this country’s District Health Boards, the current Minister of Health’s deafening silence is proof of either political sadism or moral inertia. Neither option is acceptable in a government so loudly committed to the “well-being” of its citizens.

It is hard to believe that Clark could have gratuitously refrained from speaking out against the latest decision of the Waikato DHB. So egregious has been the Board’s treatment of Dave Macpherson, Jane Stevens and their family, that the thought of Clark personally endorsing its conduct is repellent.

That said, any decent Health Minister would have picked up the phone the moment he discovered what the DHB was trying to do, and instructed its CEO to cease and desist immediately. Dave and Jane, having been vindicated by the Coroner, deserved much better of the Waikato health bureaucracy than this reprehensible attempt to have the whole inquest re-staged. Not content with contributing to the death of Nicky Stevens, Dave and Jane’s deeply troubled son, the Board seems intent upon recommencing the slow torture of his parents.

So, if Clark isn’t a vicious political sadist, then what is he?

The answer, presumably, is that Clark is yet another of those all-too-familiar neoliberal heroes – the politician who has trained himself to see no evil, hear no evil, and speak only when advised that it is “appropriate” to do so. Like the hapless participants in Dr Stanley Milgram’s infamous experiment, Clark keeps dialling-up the pain. Never questioning the moral probity of those issuing the instructions. The Waikato DHB’s insurance company wants Dave and Jane put back on the rack? Well then, the Minister must not, under any circumstances, intervene.

It would be nice to think that Clark: an indisputably well-educated man; a member of the Labour Party; and – may God forgive him – a self-confessed Christian! might have demonstrated the moral courage of those participants in the Milgram Experiment who stood up to the men in the white coats. The ones who said “No.” Who flatly refused to participate in a process that, as far as they knew, was inflicting ever-more-dangerous electric shocks to the errant subjects screaming in an adjoining room.

Sadly, Clark’s refusal to address the bad behaviour of a single DHB, acting on its own, is more than matched by his failure to rein-in the Boards’ collective aggression towards their own staff.

There was a time when Labour Party ministers came from backgrounds where strike action, and the solidarity that makes striking possible, were the stuff of personal experience. A Health Minister with that sort of heritage would instantly recognise the DHBs’ negotiators’ current tactics vis-à-vis the Resident Doctors Association. He would see them for what they are: a deliberate attempt to run down the clock, so that the scab MECA (multi-employer collective agreement) negotiated by SToNZ will, on 1 March, become the only agreement available to junior doctors.

An “old school” Labour cabinet minister, one who’d held a union card, would have put a stop to such scabrous tactics. Clark’s behaviour, however, suggests that his most formative professional years were the ones he spent working for Treasury. Certainly, it’s the Treasury way to prioritise “fiscal responsibility” over anything as subjective as the young doctors’ commitment to offering the best possible care to their patients. Care that can only be compromised by being forced to work 12 days straight without a break.

Unfortunately, “fiscal responsibility” has been so fetishized by this government that Clark felt morally justified in telling the DHBs that they must operate strictly within the unrealistically tight budgets imposed on them by himself and Finance Minister Robertson. The Coalition’s “Budget Responsibility Rules” are not for breaking; which is clearly being interpreted by the DHBs’ negotiators to mean – the  junior doctors’ union is.

Is this the behaviour of a Minister of Health inspired by the “politics of kindness”? Are these budgetary constraints intended to foster the nation’s “well-being”? Not really. They are, however, entirely consistent with the neoliberal assumptions which continue to underpin the New Zealand Labour Party’s political behaviour.

The most important of these continues to be the assumption that only bad things can come from the “politicisation of economics”. Ministers must be directed by the numbers – and only the numbers. The human heart is a poor guide to rational administration. Patient care, and the care of patients, is to be defined by the data – nothing else.

David Clark does not appear to have a metric for moral force. The calculation of our health system’s ethical obligations seems beyond him. How, when all is said and done, does one measure a family’s sorrow, or calculate a young doctor’s dedication?

What is the market-price of kindness?

 

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36 Comments

  1. Ada says:

    Kindness does nothing to ensure there is enough money to pay the essentials of a health system – staff wages, the power bills, pharmaceuticals, etc.

    Kindness is, in fact, the very last guide someone running the health system can use.

    • That kindness has no place in our health system will come as distressing news to most New Zealanders!

      • Marc says:

        Chris, read the State Sector Act that rules what a CEO can and must do, only responsible directly to the Commissioner, who ultimately appoints a CEO in the public service. The Prime Minister and State Sector Minister may have some input in the appointment process, but NO Minister can directly interfere with a CEO in the public service:
        http://legislation.govt.nz/act/public/1988/0020/126.0/DLM129549.html

        “33 Duty to act independently

        (1) Despite section 32, in matters relating to decisions on individual employees (whether matters relating to the appointment, promotion, demotion, transfer, discipline, or the cessation of the employment of any employee, or other matters),—
        (a) the chief executive of a department is responsible for acting independently (and is not responsible to the appropriate Minister); and
        (b) the chief executive of a departmental agency is responsible for acting independently (and is not responsible to the appropriate Minister or to the chief executive of the host department).

        (2) The independence provided in subsection (1) is subject to—
        (a) the requirement in section 50(4) that a chief executive may only appoint an employee to a key position with the Commissioner’s agreement; and
        (b) the requirement in section 59(5) that a chief executive have regard to the wishes of the relevant Minister in relation to decisions on ministerial staff.”

        Stop dreaming about ‘morals’ and so forth, they NO longer exist in this God forsaken country!

        • That is certainly what the law says, Marc, no argument.

          But the thing about controlling the legislature is that it gives you the power to threaten to change the law – and, if the threat alone isn’t enough to secure compliance, then to go ahead and change it.

          One of the key features of neoliberalism is precisely this cutting out of the loop of politicians. CEOs in the health service – and everywhere else – should, therefore, be warned that while on most operational issues the Minister is happy to leave the decisions to the CEO, on matters like this one they best be doing what the Minister says.

          In the end, the House of Representatives is the biggest and meanest dog on the block. Annoy that pooch at your peril.

          It would only require one or two examples being made of fools who put their faith in laws that were made by politicians for political purposes – and which can just as easily be repealed by politicians for political purposes – and I think you’d find that a call from the Minister was very soon all that was needed to put an end to this shit.

          • Marc says:

            “But the thing about controlling the legislature is that it gives you the power to threaten to change the law – and, if the threat alone isn’t enough to secure compliance, then to go ahead and change it.”

            Yeah, right, Chris, just remind Jacinda of this, once you meet her again. Or is it already one of the priorities on this government’s to do list???

      • Ada says:

        A health system run by the average of ‘most New Zealanders’ would quickly descend into chaos.

        Kindness doesn’t help you decide between competing priorities; facts and measurable outcomes do. That is the reality.

        • Oh dear, oh dear, oh dear, Ada.

          How would you determine which facts should take priority over which measurements, if not by reference to a coherent set of ethical standards.

          Technocrats think they can supplant morality with mathematics. But that has never been true – and never will be.

          You need to read some philosophy – and soon.

          • Ada says:

            Chris,

            You said ‘kindness’ – not a coherent set of ethical standards which would be of use in determining priorities.

            Kindness is so undefined as to be meaningless.

            • Richard Christie says:

              Ada, kindness is a function of empathy, which is innate to humankind.

              In our everyday dealings we deny with peril the essentials of that which makes us human.

            • Marc says:

              Yes, you are right.

              Perhaps they should try this, if they have not already, but going down that way will present the same kind of BS problems, as we know:
              https://www.hdc.org.nz/your-rights/about-the-code/code-of-health-and-disability-services-consumers-rights/

              The HDC acts like a gatekeeper, and only if he finds a breach of the Code, and only in certain circumstances, may there be a way of taking a complaint further.

              Most complaints sent to the HDC are NOT even formally investigated!

              The HDC Act is another piece of legislation, same as the ACC Act, the Social Security Act and so forth, that require urgent attention, to be amended so to empower consumers, clients, customers and beneficiaries, and to give them ways and means to actually get their rights.

              I fear none of that is a priority for the government we have.

  2. Michelle says:

    oh what a load of bullocks you really are starting to grasp at straws mr trotter the Waikato dhb were well and truly in the shite before the new coalition government came in and the mess there all belongs those national dicks who cut the services to the bone but had their people at the top like the Canadian appointed boss taking his mistresses on tax paid trips and as for the insurance companies they have no money after chch and all the environmental issues so if course they gonna try and not pay out.

  3. Shona says:

    Valid questions Chris. However the hypocrisy of Clark as a self professed Christian comes as no surprise. Having been raised as a Christian by parents who were very hands on and committed to their community and supporting others I am now well and truly an atheist of some 20 years now. I feel fortunate to know the Bible and it’s many fine stories of moral endeavor and the Proverbs and Psalms. The bible is an important work of literature. But that is all it is.Just as those who claim to follow it’s teachings are just that. Saying you are a Christian and actually being a Christian are two very different things. Jacinda’s government has no spine.

  4. Andrea says:

    Only the name is ‘Labour’, Chris.

    We’ve seen this Moneygod behaviour from so many agencies (and governments) in the past several years: ACC, WINZ, Police, Corrections, DHBs (of which there are far too many).

    Just about any time the little guy gets a win the big blokes dig further into the public purse to pursue until the end and beyond of the little guy’s resources.

    Clearly the maxim “if you can’t do the time, don’t do the crime” only applies to plebs.

    The whole health ‘structure’ is dysfunctional beyond belief. The hours required of staff – both permanent and trainees. The costs of training. The state of the infrastructure. The ‘rationed’ expertise (think radiologists, for example). The excessive administration with its drive through gaps in cover. Poor project management and long delays. Very poor community health cover – restricted to people who can pay for both consultation AND medication. Insufficient ‘fences at the top of the cliff’ to improve the overall health of the population etc, and so forth and so on.

    Instead of Parker mucking about with DHBs – delegate that to someone with more skill (preferably NOT in the ultra-incompetent swarm at the Ministry of Health) and let him set about a massive overhaul of this antiquated structure to improve outcomes, reduce losses of staff and customers*, and actually get value for money for the stakeholders – the population of this country.

    We deserve it.

    *customers, not “patients”. it’s long overdue that we all stopped being “patient’ with this service.

  5. David Stone says:

    Unfortunately they are all professional politicians. They have chosen a path in life to reasonably good income and retirement security. Not to make life difficult for themselves by pushing against the flow. There are no statesmen or women among them, or visionaries , or rebels with the possible exception of Winston.
    If you want courage and honest integrity Chris, you will have to put your hand up yourself.
    D J S

  6. Geoff Lye says:

    Not to mention the blatant underfunding of medicines and the Ministers resfusal to intervene in Medicines funding. Only 5 new medicines have been funded off th4 108 medicines on the waiting list since june 2018.

    Need we say more.

  7. peterlepaysan says:

    Peter Sim
    85 Avenue North Road

  8. Marc says:

    Well Chris Trotter, you do not seem to understand the limitations the State Sector Act puts onto Ministers of the Crown.

    There is only so much he can do (David Clark).

    http://legislation.govt.nz/act/public/1988/0020/126.0/DLM129110.html

    http://legislation.govt.nz/act/public/1988/0020/126.0/DLM129592.html

    http://legislation.govt.nz/act/public/1988/0020/126.0/DLM129589.html

    http://legislation.govt.nz/act/public/1988/0020/126.0/DLM129560.html

    So much power lies in the hand of a CEO and for the rest in the State Services Commissioner, NOT so much in the hands of the Minister!

  9. Marc says:

    Read this Comrade Trotter:
    http://legislation.govt.nz/act/public/1988/0020/126.0/DLM129558.html

    “38 Conditions of employment of chief executives

    (1AA) The Commissioner has, except as expressly provided to the contrary in this Act, the rights, powers, and duties of an employer in relation to chief executives.

    (1) Every chief executive shall be appointed for a term of not more than 5 years.

    (2) Every chief executive shall be eligible for reappointment from time to time.

    (3) Except where specific conditions of employment for a chief executive are provided in this Act, the conditions of employment of a chief executive shall be determined in each case by agreement between the Commissioner and the chief executive, but the Commissioner must consult the Prime Minister and the Minister of State Services about the conditions of employment before finalising those conditions of employment with the chief executive.

    (4) In the case of the Government Statistician, the Commissioner shall not be required to obtain the agreement of the Prime Minister and the Minister of State Services before finalising the conditions of employment of the Government Statistician.”

    So the employer of the CEO is the Commissioner, not the Minister, and the Minister can only act within the law as we have it, he cannot directly interfere with the CEO and his decision-making.

    I may suspect also, the present CEO may be in charge since the previous government, then the terms may have been signed off by the last Minister, and this Minister is bound by whatever stands in the CEO’s contract and in the State Services Act anyway.

    This supposed ‘independence’ of the public service is so great, Ministers cannot simply pick up the phone and give CEOs an ear bashing or whatever. Misconduct or so must be proven, before a CEO can be removed, and it is the Commissioner who has to get that ball rolling, not the Minister.

  10. Marc says:

    “An “old school” Labour cabinet minister, one who’d held a union card, would have put a stop to such scabrous tactics. Clark’s behaviour, however, suggests that his most formative professional years were the ones he spent working for Treasury.”

    Maybe that was possible before the State Sector Act 1988 was put in place, guess by what kind of government?!

    It was newly neoliberal Labour with Roger Douglas, Prebble et al, who brought the ‘independence’ of the public service into its present form, result of the introduction of the State Sector Act!

    • Gramsci says:

      You are right of course Marc the SSA and a host of others that Douglas and co brought in embedded neoliberal practice, however it should not stop Clarke and the rest of them from pulling embedded neoliberalism apart from the seams and a strong voice could signal this. It is a worthy criticism from Chris and both points need to be exposed. We are still firmly in the grips of a neoliberal coalition. What ever happened to the cries from the Greens and NZ First to dismantle it. – Keep calling to account I say don’t settle for symbolic changes that reinforce the status quo. Revolutionary moves do dismantling market and financialsed capitailsim are needed.

  11. sumsuch says:

    Hearing about Norman Kirk on National Radio I can’t help feeling the destruction of the Labour party came with the disappearance of working class people from leadership. And I’m the son of a nurse and a teacher. Laughable that baronet Sir Basil Arthur was the most … in the 4th Labour Govt. Tincture of indictment, really.

    • CLEANGREEN says:

      Get rid of bureaucrats Labour like Iain Lees Galloway and David Clark because they cringe and act exactly like hard nosed bureaucrats and will drag Labour down.

  12. SPC says:

    Part of the problem is, as Marc has noted, that democratically elected governments have had their capacity diminished by neo-liberal reform, the other is that it is become accepted wisdom that the less the minister (Health in particular) is heard during the three year term the safer a pair of hands they are seen to be.

  13. Richard Christie says:

    “It would be nice to think that Clark: an indisputably well-educated man; a member of the Labour Party; and – may God forgive him – a self-confessed Christian!”

    Chris, why bring religion into this, apart from satisfying your own faithism.

    Christianity has no special or exclusive claim to any sort of moral high ground.

    • Louis says:

      +1 Richard.

    • sumsuch says:

      Richard , we’re all just so very glad the fundamentalists aren’t as prominent in our society as USA. Despite Jesus they deliver for the rich. I have 2 of these pricks among my sibs. Mental cases.

      • Richard Christie says:

        In addition to delivering for the rich they’ve turned USA into an international laughing stock with its corrupt presidency and they promote a creeping theocracy that attacks the very foundations of science and reason.


 
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