Shane Reti loses health portfolio to Simeon Brown as PM "turbocharges" health

I am sad for him - it was a job he wanted but politics did him in

The demotion of health minister Shane Reti from the portfolio he so longed for was not a huge surprise for health sector folk with an eye on politics.

However, prime minister Christopher Luxon’s explanation for the move, as part of a Cabinet reshuffle which sees transport minister Simeon Brown selected to "turbocharge the delivery of health outcomes", may have raised a few eyebrows.

As Mr Luxon spoke of his Government’s “ruthless focus on execution in healthcare”, I was put in mind of the job cuts yet to be announced in response to Government demands for spending cuts.

Dr Reti’s own fate was sealed the day he announced the Government’s back-flip on Dunedin Hospital – he may as well have been standing on the executioner’s scaffold with infrastructure minister Chris Bishop alongside to ensure he did not bolt. Because where the back-flip on the ground-breaking smokefree legislation damaged Dr Reti’s reputation among health professionals, it was trampling on the hospital dreams of the electorate that most likely sealed his fate – hospitals are special in politics.

Case in point, the cancellation of the big Cook Strait ferry deal failed to damage finance minister Nicola Willis, even though it has left huge uncertainty over a significant chunk of infrastructure; indeed Mr Luxon showered Ms Willis with praises as he announced her additional role as minister of economic growth.

The South Island – fighting for hospital services and a reliable ferry service, got a minister.

2025 is all about a doubled-down focus on economic growth and – as part of that fresh focus – today I’ve announced a refreshed team to drive our economic growth plan.

In addition to her role as Minister of Finance, Nicola Willis will become Minister of Economic Growth. She will… pic.twitter.com/qKQrxTcuEF

— Christopher Luxon (@chrisluxonmp) January 19, 2025

But I digress. In announcing his Cabinet reshuffle today, Mr Luxon spoke as if the realisation that a significant number of New Zealanders now find it difficult to get a timely appointment with their GP, was a holiday epiphany for him, not a crisis the sector has raised repeatedly with politicians on both sides of the House for the last decade.

While praising Dr Reti as “a good man”, “a class act” and “a team player”, Mr Luxon seemed to imply that Dr Reti, being a doctor and all, would be better suited for his new portfolios – Universities and Science, Innovation and Technology.

Mr Brown, on the other hand “as a father, son and family guy will understand what is needed” to get regular New Zealanders timely access to their GP, emergency department, first specialist appointments, elective surgery and cancer drugs.

That need would be funding.

Because while Mr Luxon talked of his government’s record spending on health – an additional $17 billion, Budget 2024 saw the amount of day-to-day spend per person on health in the current year reduce by 3 per cent to $4686 per person: $143 per person less in real terms.

Mr Luxon talks of delivering on new cancer drugs but overlooks the fact that funding for these has been borrowed from next year’s Budget.

Granted, Mr Luxon probably mentioned “GP visits” in his announcement more often than you would read in your average Te Whatu Ora primary care document, but the reality is, if Mr Brown is going to make any headway on those desires of regular New Zealanders, then the current expectation of no more money for primary care until around 2027 will need to change.

Though it might have been helpful if Mr Luxon was clear on whether those visits are to be in-person and we are not going to see widespread telehealth introduced.

But I digress again.

To be honest, my political antennae are mostly focused on the health sector, and my appreciation of Mr Brown’s ministerial endeavours to date does not go much beyond removing road cones, but his boss talked him up to the point where one might be blushing, describing Mr Brown as “an outstanding and diligent worker” who brings the skills of “delivery and execution” to the health portfolio.

After getting his feet under the desk, Mr Luxon says, Mr Brown will be plotting his own course as to where he wants to go.

Oh, joy.

In the questions following the announcement, a reporter asked what impact the health portfolio change would have on Māori. Mr Luxon went broad saying, in essence, the economic growth the Government intends to deliver will be good for everyone, Māori and non-Māori.

Dr Reti is Māori. His demotion removes a Māori voice from high up the Cabinet hierarchy, whether it was being listened to or not. There will now be concern over the future of iwi Māori Partnership Boards in his absence and advisory committees like the Public Health Advisory Committee and the Hauora Māori Advisory Committee.

I am yet to read other reaction to today’s announcement and with more discussion and feedback over the coming days there will be time to think about Dr Reti's legacy and the early challenges for a new minister with no previous experience of the sector taking over.

The health portfolio is tough and for Dr Reti I think the creation of a coalition government and the agreements undertaken made it doubly so. As a “team player” he will put on a brave face but I am sad for him - it was a job he wanted but politics did him in.