On 7 November 2026, New Zealand will once again decide on our next government.

That means every one of us who are enrolled to vote must take the opportunity to decide on our future (Enrol or update online | Vote NZ). During every election we hear promises from political parties. Now is the time to remind ourselves of what was promised and what was (not) delivered. 

Remember National’s promise to put more money in your back pocket? And what was never put on the table but done to us by sleight of hand. Remember the pay equity legislation changes that ripped hope from more than 180,000 women and their families overnight.

A report in 2025 explored the Mood of the Workforce 2025 results NZCTU and found, among others, that more than 75% of workers stated their wages were not keeping up with the cost of living. Nearly 62% of workers also said they felt they were not being paid fairly for their work and were being asked to do more with less. Nearly 70% of workers said that housing was less affordable and 90% said that access to affordable housing was an issue. Funding cuts leading to job losses have increased uncertainty, stress and impacted on mental health.

Only 34% of workers thought that the health care system was doing ok. Financial inequality has resulted in poor health outcomes. Lower income individuals and families reported that their health had deteriorated over the past year.

Most of the building blocks of our health and wellbeing come from outside health care itself: where we live, learn, what we earn, our housing and our social connections.

The NZCTU report shows that the foundations of good health are inequitably distributed in our society, and crumbling. This is reflected in a recent global assessment of health care quality and equity where New Zealand is now 21st compared to Australia’s ranking of three (Best Healthcare in the World 2026). The unnecessary, costly and preventable differences we see today in the determinants of health, and in health and wellbeing outcomes, are not inevitable or fixed. They can be modified through the policies and actions that we all have the power to implement through enrolling and voting for a government with policies that are for, not against, the people.

While the social determinants of health in relation to health and wellbeing outcomes are now widely understood, the drivers of social determinants of health – political determinants are not so well understood. The political determinants of health are influential in creating relationships between government and policy that result in inequitable outcomes (laws, rules, or regulations that oppress one or more populations), allowing for a few to remain in power and to determine which communities receive vital resources necessary for their well-being and optimal living. Dawes (2020) provided a roadmap for advancing health equity by focusing on three major aspects of the political determinants of health: voting, government, and policy. 

Voting affords all, at an individual level, a voice to engage in policy solutions for issues directly impacting not only themselves but their respective communities. It is known that voting rights are essential for creating and advancing health equity. As voter suppression occurs as it is under the Coalition Government, the individuals most impacted by inequities are the same individuals who find themselves locked out of the political system. It doesn’t have to be this way.

Recommendations made to the Ministry of Health by the Public Health Advisory Committee in 2025 (Determining our Future: Online version | Ministry of Health NZ ) demand long term thinking and action through cross political party policy agreements that see past the three-year political cycle and focus on realising better outcomes for all. Developing agreed multi-partisan, long term wellbeing goals is a critical step for government to achieving health equity and wellbeing. Cross-party long term goals can be agreed if there is a will to do so as recent cross party infrastructure agreements attest (Government backs 30-year Infrastructure Plan with cross-party support - NZ Herald).

Our power is in our vote and pinning down political parties to agree to develop cross-party long-term agreements on health and education infrastructure that will deliver on achieving health equity and well-being. Health care cannot be seen in isolation. It is a strategic asset that shapes global competitiveness, labour markets, and capital flows. As Taiwan, South Korea, and leading European nations demonstrate, investment in healthcare pays off not only in public health but also in economic resilience and geopolitical leverage, all of which will give us fairly paid jobs, homes AND health.

for tomorrow. We are 64,000 members and counting. We are a political force to be reckoned with. Together, we are the lead in health and healthcare. Our political power can influence the political determinants of health.

Maranga Mai!

The time to wield that power is NOW!