The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the New Zealand College of Midwives (NZCOM) commend Health New Zealand | Te Whatu Ora and the Hon. Simeon Brown, Minister of Health, for implementing interim measures to reduce unaffordable copayments for maternity ultrasounds, as well as committing to developing longer-term, sustainable funding arrangements.

Late last year, as a significant increase in maternity ultrasound copayments loomed, NZCOM and RANZCOG wrote to the Minister of Health urgently requesting an interim solution to address copayments, as well as a full review of maternity ultrasound funding.

Todayā€™s announcement of a $12.9 million funding boost for community-delivered maternity ultrasounds services, introduces arrangements with private providers – who deliver the majority of maternity ultrasound scans in New Zealand – to cap copayments at $30 dollars for those with a community services card (CSC) and $90 for non-CSC holders. This is a reduction from the previously proposed increases to $75 and $150 respectively.

The $92 fee currently paid by Te Whatu Ora to community-based ultrasound providers has not changed since 1997 and is substantially lower than public funding for other types of ultrasound scans, despite maternity ultrasounds often being more complex and requiring more time to complete. Providers have needed to charge women increasing co-payments to help cover their costs.

Now, Health New Zealand is finally boosting the funding it pays to community providers. Under the new approach:

• Co-payments must be capped at $30 for Community Service Card holders and $90 for non-CSC holders(includingGST).
• Hospital maternity ultrasound servicesremainfully funded, with no user charges.
• Existing regional subsidies, including those funded through hospitaland specialist services,regional commissioning or primary health,are toremain in place to ensure no woman is worse off during the transition.
• Providers who optinto the short-term contractwill continue to claim under the existing Notice and be eligible for a top-up payment, so that total funding including any co-paymentis up to $225.50 (incl GST) per scan for patients with aCSC, and $216.50 (incl. GST) for a non-CSC holder.

NZCOM Chief Executive, Alison Eddy cautions that $90 copayments for non-community services card holders will still be unaffordable for some women on low incomes, especially those with high-risk pregnancies requiring multiple scans.

During the course of a straightforward pregnancy, two routine ultrasound scans are recommended, however when there are concerns about the wellbeing of the baby, as many as eight scans may be required. At $90 copayment per scan, itā€™s easy to see how this can still amount to a very significant cost burden for families.

ā€“ NZCOM Chief Executive, Alison Eddy

Both RANZCOG and NZCOM have raised concerns about outdated maternity ultrasound funding and ever-increasing copayments for many years, highlighting the risks that families are unable to access clinically necessary maternity ultrasound scans because of cost, and that this will result in avoidable tragic consequences for mothers and babies.

°µĶųTV New Zealand Vice President, Dr Emma Jackson says, ā€œItā€™s great to see that for the first time in years funding has been put in place nationally to assist in reducing maternity ultrasound copayments, but most importantly it is a relief to see commitment to addressing maternity ultrasound funding properly, so that women can access the essential ultrasound scans they need for the safety of their pregnancy without cost being a barrier.ā€

°µĶųTV and NZCOM are committed to working with the Ministry of Health and Te Whatu Ora on a full review of maternity ultrasound funding and we hope to see copayments for clinically necessary maternity ultrasound scans become a thing of past soon.

ā€“ RANZCOG New Zealand Vice President, Dr Emma Jackson

For more information, please refer to .

Media enquiries

Bec McPhee
Head of Advocacy & Communications, RANZCOG
bmcphee@ranzcog.edu.au
+61 413 258 166

Alison Eddy
Chief Executive, NZCOM
(03) 372 9736

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), is concerned about the impact of the New Zealand Governmentā€™s recently announced ban on new prescribing of GnRH analogues (puberty blockers) for young people who are seeking gender affirming healthcare. Dr Emma Jackson, New Zealand Vice President says ā€œThis decision appears to be made based on ideology not evidence and could have a devastating impact on the wellbeing of vulnerable young people.ā€

Puberty blockers temporarily suppress the hormones that cause pubertal development, giving young people and their families time to make informed decisions about wellbeing, without the pressure of irreversible bodily changes. Under the changes announced puberty blockers will remain available for those who are already receiving them for gender affirming care and the changes do not impact prescribing of puberty blockers for children with early onset puberty. But those seeking care for gender dysphoria will no longer have access to puberty blockers.

In November 2024 the Ministry of Health released an evidence brief which identified some limitations in the quality of evidence regarding the risks and benefits of GnRH analogues. Dr Emma Jackson comments that ā€œlimitations in evidence quality are common across a number of areas of medicine, and donā€™t warrant a ban on access, especially when the consequences of a ban are significant.ā€

°µĶųTV responded to Ministry of Health consultation in December 2024 with a clear statement:

°µĶųTV supports the current practice of prescribing puberty blocker medication for gender affirming care of rangatahi/young people, and does not support any restrictions in prescribing, nor does RANZCOG see any need for ā€œsafeguardingā€ of prescribing.

°µĶųTV restates this position. Health care should be based on best available evidence and decisions should remain between clinicians, patients and their whānau. RANZCOG urges the Government to remove the ban on potentially lifesaving health care for young people requiring gender affirming healthcare.

Media enquiries

Catherine Coooper
°µĶųTV Executive Director Aotearoa New Zealand
±Ź³ó“Ē²Ō±š:Ģż+64 21 137 0748
·”³¾²¹¾±±ō:Ģżccooper@ranzcog.org.nz

Positive to see intention to support new mothers, but resourcing and implementation planning must follow.

In response to the of support for three day postnatal stays, three leading organisations in womenā€™s health and maternity care, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the New Zealand College of Midwives (NZCOM), and the National Council of Women of New Zealand (NCWNZ), emphasise the need for the resourcing and planning required to safely implement the Pae Ora (Healthy Futures) (3-Day Postnatal Stay) Amendment Bill.

Our three organisations share a commitment to improving outcomes for mothers, babies, and whānau across Aotearoa New Zealand. We appreciate the Government’s recognition that the critical postnatal period requires enhanced support, and we acknowledge the positive intent behind this initiative to give women genuine choice about their postnatal care.

No women and baby should be sent home before they are ready. The system currently allows for this, but in reality, a highly strained maternity system does not always make it possible. There are already shortages of maternity beds, and the midwives and obstetricians required to care for women and their babies.

The risk is that if good intentions are not backed up by resources to deliver service, that there will be unintended consequences as resources are diverted to deliver three day stays for all.

– Dr Gillian Gibson, RANZCOG President

There is much to be considered in implementing the Bill to ensure it achieves its objectives without unintended consequences.

In a highly resource constrained environment, when decisions are no longer based on clinical need inequities in care are likely to increase.

– Alison Eddy, CE of the New Zealand College of Midwives

ā€œWe do not want to see a ‘postcode lottery’ determining who can access extended postnatal stays under the new legislation”, said Raewyn Stone, NCWNZ Health Action Hub Convenor. “We would like to see the Government invest in strengthening the maternity workforce as a matter of priority, to ensure that existing disparities are not worsened.ā€

The three-day postnatal stay can be a positive step forward, but only if it is properly resourced, thoughtfully implemented, and forms part of a broader strategy to strengthen maternity services across Aotearoa New Zealand. We look forward to working with the Ministry of Health and Health New Zealand on implementation planning.

Media enquiries

Catherine Coooper
°µĶųTV Executive Director Aotearoa New Zealand
Phone: +64 21 137 0748
Email: ccooper@ranzcog.org.nz

°µĶųTV has issued a formal apology to Māori trainees and Fellows who have experienced culturally unsafe, racist, and inequitable conditions during their training.

This follows the findings of RANZCOG and Allen+Clarkeā€™s Māori Trainee Recruitment and Retention Research, which highlighted the systemic barriers, racism, and isolation faced by Māori trainees.

In Aotearoa New Zealand, this apology marks an important part of Te Tiriti o Waitangi obligations and RANZCOGā€™s responsibility to support Māori trainees and Fellows in safe and respectful training environments.

Discussions are also underway about conducting similar research into the experiences of First Nations trainees in Australia, which may be alongside other medical colleges. While still in development, this work represents a broader commitment to equity and cultural safety across the College.

Tēnā koutou katoa,

To all Māori trainees and Fellows who have trained or are currently training in obstetrics and gynaecology, and to Māori whānau and communities. We acknowledge and deeply regret that Māori trainees and Fellows have experienced culturally unsafe, racist, and inequitable environments within the FRANZCOG training programme.

Research commissioned by RANZCOG and conducted by Allen + Clarke, into the experiences of Māori in the FRANZCOG training programme, confirmed what Māori have voiced for years:

• That systemic racism, stereotyping, and cultural dismissal have caused harm
• That unsafe training environments have isolated and undermined Māori trainees
• That RANZCOG has failed to provide consistent cultural safety and support
• And, that this harm has extended beyond individuals to whānau, hapÅ«, iwi, and Māori communities

We acknowledge the findings of this research and on behalf of RANZCOG, we take responsibility for these failures.

We recognise that they reflect not only individual behaviours but also the structures, policies, and cultures of the College and hospitals where training is delivered.To Māori trainees, Fellows, and whānau, we apologise unreservedly for the hurt, loss of trust, and additional cultural burden you have carried.

This apology is part of our ongoing commitment to honouring Te Tiriti o Waitangi and to upholding our vision of excellence and equity in womenā€™s health.

But words alone are not enough. The goal of the research was to identify ways to improve the recruitment and retention of Māori in the FRANZCOG training programme. And the research provided clear evidence of where we need to improve.

This apology is underpinned by clear commitment to action outlined in RANZCOGā€™s Te Rautaki Māori me te Ara Whakamua (Māori Strategy and Action Plan). Actions include:

• Develop recommendations on providing a culturally safe environment in hospital placements for Māori trainees, that can be incorporated into hospital accreditation standards and used as a guide for placing trainees
• Review the RANZCOG complaints process to identify and recommend improvements for responding to those relating to cultural safety, racism, and discrimination
• Consider developing a proposal for a kaiāwhina role to provide dedicated support for Māori trainees and assist them with navigating the challenges of cultural loading and culturally unsafe workplace environments
• Continue to work on alleviating cultural load for Māori Fellows and trainees, including considering insights from Te ORA research in this area
• Investigate ways to provide greater flexibility in training, including flexibility in training timing to support parenting, whānau and iwi commitments, or those who wish to study te reo Māori or tikanga Māori

With the stewardship of He Hono Wāhine, RANZCOG continues to monitor closely progress against Te Rautaki Māori me Te Ara Whakamua and will be providing updates at hui-ā-tau. In addition to the actions in Te Rautaki Māori me te Ara Whakamua, we plan to take a hard look at our own organisation. Te Kāhui Oranga ō Nuku has agreed to explore a racism audit.

We know that we cannot undo the harm caused, but we are committed to learning, listening, and transforming the College so that current and future Māori trainees are safe, supported, and valued.

If you are currently experiencing racism, an unsafe environment, or the research and this apology have raised past experiences that are troubling you, we encourage you to reach out now.

°µĶųTV firmly believes that growing the Māori O&G workforce is vital to better meeting the needs of the wāhine and whānau of Aotearoa.

We are committed to working to ensure the FRANZCOG training experience supports this by valuing and nourishing Māori trainees.

Dr Gillian Gibson
°µĶųTV President
On behalf of the RANZCOG Board

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG, The College) has written to the Health Select Committee expressing strong opposition to

Background

In June, Minister of Health, Simeon Brown, announced the governmentā€™s intention to introduce legislation to ā€œimprove the effectiveness of health services delivery to patientsā€ and Cabinet has approved a suite of amendments to the Pae Ora (Healthy Futures) Act 2022.

However, in RANZCOGā€™s view, this legislation represents a fundamental shift away from evidence-based, clinically informed healthcare policy toward politically driven metrics that will compromise patient outcomes and exacerbate health inequities. While RANZCOG strongly supports improving patient care, outcomes and timely access, this Bill will actively undermine these goals.

Summary of concerns

Some of RANZCOGā€™s significant concerns about the implications of the bill are summarised below. For a more comprehensive overview, read the Collegeā€™s full submission.

Repeal of health sector principles

The Bill repeals the health sector principles, which include a focus on equity and self-determination for Māori, health promotion and prevention, and a broader approach to determinants of health. Removing these principles risks poorer health outcomes, particularly for Māori. Shifting the system away from evidence-based, best-practice care toward a less effective one-size-fits-all approach.

Reduced role for IMPBs

The Bill significantly reduces Health New Zealand Te Whatu Ora’s obligations under Te Tiriti o Waitangi and diminishes the role of Iwi-Māori Partnership Boards (IMPBs). The changes ignore compelling clinical evidence demonstrating Māori currently experience poorer health outcomes, remove structures designed to address inequities, and represent a step backwards in addressing health outcomes and equity for Māori.

Removal of Health Charter

The removal of the New Zealand Health Charter would eliminate a key document that sets minimum standards for Health New Zealand as a good employer and workplace. Research by RANZCOG highlights the ongoing prevalence of discrimination, bullying, sexual harassment, and harassment (DBSH) in obstetrics and gynaecology and collaboration across the sector is crucial in addressing this.

At a time when retaining and expanding the health workforce is paramount, it is essential that Health New Zealand Te Whatu Ora is held accountable in leading workforce wellbeing.

Political neutrality

The proposed requirement for Te Whatu Ora employees to be politically neutral and adhere to public service principles creates an irreconcilable conflict between professional medical ethics and employment law, designed to limit doctorsā€™ ability to advocate in a move that could compromise patient safety and public health advocacy.

Removal of specific expertise requirements

The removal of specific expertise requirements for appointments to the Health New Zealand Board and other advisory committees, particularly in areas such as Te Tiriti o Waitangi as well as medical and health knowledge, would undermine the quality of governance and hinder improvement of health outcomes.

Expansion of Health New Zealandā€™s role

Clauses 13 and 14 expand Health New Zealandā€™s role to include planning and providing infrastructure, but without a parallel emphasis on workforce development. This is an equally vital component of effective service delivery. The Bill also explicitly incorporates private healthcare providers into Te Whatu Oraā€™s functions, marking a shift in focus for the public health system.

Whilst RANZCOG recognises private outsourcing as a short-term fix to address gynaecological surgical wait times, this shift risks undermining public healthcare in the long term. The College advocates for sustained investment in building public system capacity.

Fixed targets

Embedding fixed targets in legislation risks compromising patient care and encouraging ā€˜gamingā€™, shifting the focus away from overall health outcomes toward narrow, process-driven metrics that ignore health complexity, and capture only a limited part of the care provided.

Conclusion

This Bill threatens to deepen Aotearoa New Zealandā€™s health workforce crisis by removing workplace safety protections, constraining professional advocacy, and prioritising narrow performance targets over comprehensive care. These factors are likely to drive clinicians overseas to jurisdictions with better working conditions. The resulting exodus of highly trained specialists represents a multi-million-dollar investment loss, compounded by the broader costs of worsening health inequities through preventable admissions, reduced productivity, and shorter lifespans.

The Healthy Futures (Pae Ora) Amendment Bill signals a troubling departure away from evidence-based healthcare policy. RANZCOG strongly urges the Health Select Committee to reject the Bill in its entirety.

Addressing Aotearoa New Zealandā€™s current health system challenges demands solutions grounded in evidence and shaped through genuine consultation with clinical experts and affected communities, not politically-driven changes that disregard professional expertise and documented health inequities.

Media enquiries

Catherine Cooper
Executive Director, Aotearoa New Zealand
ccooper@ranzcog.org.nz
+64 21 137 0748

Ahead of the Second Reading of the Pae Ora (Healthy Futures) (3-Day Postnatal Stay) Amendment Bill, three leading organisations in womenā€™s health and maternity care ā€” the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the New Zealand College of Midwives (NZCOM), and the National Council of Women of New Zealand (NCWNZ) ā€” have issued a joint statement calling for careful consideration of the Billā€™s broader implications.

While the group supports the principle that all women should have access to appropriate care after giving birth, they caution that the Bill, despite its good intentions, could entrench existing inequities and place further strain on Aotearoa New Zealandā€™s overburdened maternity system.

Instead, the group recommends prioritising investment in other chronically underfunded aspects of maternity care, such as maternal mental health care services and pregnancy ultrasounds. To be successful in improving outcomes from maternity care, ideally a post-birth extended in-patient stay should be part of an integrated and flexible package of postnatal support including improved access to maternal mental health support, and wider aspects of homebased postnatal support as required.

It is vital to address systemic capacity challenges across the maternity sector before legislating a fixed three-day postnatal stay.

– Dr Gillian Gibson, RANZCOG President

The proposed Bill guarantees a minimum three-day postnatal stay for all mothers and babies. While this may seem like a positive step towards enhanced care, the groups warn that if implemented without adequate expansion of resourcing and facilities to deliver services, the Bill could have serious unintended consequences.

There is a risk that the policy could shift the provision of postnatal care from a model based on clinical need to one driven by entitlement. In such a scenario and under current capacity constraints, there is a risk that some women may be discharged before they are ready, to accommodate those who may not need an additional stay but are entitled to it.

ā€œNo woman or newborn should be discharged before they are ready. Yet in reality, some are currently being sent home due to a lack of available beds,ā€ states Alison Eddy, CE of the New Zealand College of Midwives.

There is also a chronic shortage of midwives to support women, both in maternity units and in their homes. Extended postnatal stays will be available only in theory and not in practice if midwives are not available to support women and their newborns.

“We do not want to see a ‘postcode lottery’ determining who can access extended postnatal stays under the new legislation”, said Raewyn Stone, NCWNZ Health Action Hub Convenor. “We would like to see the Government invest in strengthening the maternity workforce as a matter of priority, to ensure that existing disparities are not deepened.”

With maternity units across Aotearoa already operating beyond capacity, introducing extended postnatal stays without expanding facilities and resources risks deepening disparities for those facing barriers to healthcare.

According to the Select Committee Report, implementing the Bill would require 175 additional postnatal beds, costing between $31.9 million and $38.3 million annually in operational expenses. Capital costs for expanding facilities would exceed $100 million. These figures raise serious questions about the Billā€™s feasibility and return on investment, especially given there is limited evidence to support that longer in-patient stays lead to improved postnatal outcomes.

Dr Gibson concluded:

We welcome legislative reform that will genuinely improve postnatal outcomes. But to be effective within the current environment, it must be grounded in evidence and clinical need, and supported by the necessary investment and resources to ensure it can be delivered safely, equitably and sustainably.

Media enquiries

Catherine Coooper
°µĶųTV Executive Director Aotearoa New Zealand
Phone: +64 21 137 0748
Email: ccooper@ranzcog.org.nz

Phase One explored Māori traineesā€™ experiences in the FRANZCOG training program. Participants highlighted the importance of role models, supportive placements, and whanaungatanga in their decision to pursue O&G. While the application process was generally considered transparent, the interview structure was seen as misaligned with te ao Māori values. The study also identified cultural loading, racism, and a lack of formal cultural support systems as key retention challenges.

Phase Two examined when and why Māori doctors choose their specialisations. Survey data collected from members of Te ORA (Māori Medical Practitioners) showed most decisions are made during prevocational training, with clinical placements and mentoring from Māori professionals being highly influential. However, negative experiences, including bullying and unsafe environments, often deterred Māori students from choosing O&G.

Both reports captured many Māori experiences and voices using quotes throughout, which He Hono Wāhine Chair, Dr Leigh Duncan, shared during the first public presentation of this research at the recent Aotearoa ASM in Ōtepoti, Dunedin.

Both reports provide clear, actionable recommendations. These include enhancing whanaungatanga during FRANZCOG application processes, improving processes to support cultural safety in training placements, increasing visibility of Māori O&G role models, and strengthening support networks through He Hono Wāhine and other initiatives.

Together, the findings reinforce the importance of intentional, culturally appropriate approaches to supporting Māori into and through specialist training. RANZCOG is committed to progressing action for culturally safe and responsive training, CPD, and workforce, with the ongoing support and commitment of He Hono Wāhine, Māori health leaders, and RANZCOG members.

He Hono Wāhine extends their heartfelt thanks to all Māori trainees, Fellows, prevocational doctors, and medical students who generously shared their experiences and whakaaro as part of this research. Your voices and insights are at the heart of this kaupapa and will help guide meaningful change for future generations of Māori in obstetrics and gynaecology. Ngā mihi nui ki a koutou.

Read the reports

• Phase One: Māori Traineesā€™ Experiences of the FRANZCOG Training Programme
• Phase Two: Factors that Influence Māori Doctorsā€™ Decisions When Choosing a Medical Specialty

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG, the College) calls for action following the release of the landmark report “Femicide: Deaths resulting from gender-based violence in Aotearoa New Zealand” by Te TāhÅ« Hauora Health Quality & Safety Commission.

The report reveals alarming statistics that demand urgent attention from the maternity care sector. Suicide remains the leading cause of maternal death in New Zealand, with 63% of these women having experienced family violence. This figure likely represents a significant undercount as most violence goes unreported to authorities. Shockingly, 40 perinatal deaths annually are linked to family violence, more than double the number of female homicides which sits at 16. From 2020ā€“2022, perinatal deaths related to violence rose sharply compared to 2018ā€“2019.

°µĶųTV emphasises that violence against pregnant women is a violation of reproductive autonomy and the right to safe motherhood. Attacks targeting the abdomen, often causing placental abruption and fetal death, are among the most brutal forms of gender-based violence.

ā€œEvery maternal suicide or perinatal death due to violence is a preventable tragedy,ā€ said Dr Susan Fleming, RANZCOG Vice President. ā€œOur duty of care extends beyond clinical practice to ensuring women’s safety.ā€

The report also exposes stark inequities, particularly for Māori women and babies. Wāhine Māori experience substantially higher rates of family violence homicide. Over half of maternal suicide victims with recorded family violence histories were Māori, despite being a smaller percentage of the population. Disturbingly half of all maternal suicide victims were aged 25 or younger, highlighting the vulnerability of young mothers.

Despite the best efforts of clinicians working within a chronically underfunded and overburdened system, the reality remains clear: the system is failing women. In 58% of maternal suicide cases, there was evidence of inadequate service provision. Dr Susan Fleming stated:

This report exposes a public health crisis that demands urgent action – not only from our profession, but from the wider healthcare system and policymakers. Maternity must be recognised as a critical juncture in life, where women face heightened risks. We cannot continue to fail the women and babies in our care who are experiencing violence.

The College supports the recommendations in the report and identifies several immediate priorities:

• Maternity care providers need training on identifying and responding to family violence, including understanding the link between violence, mental wellbeing, and pregnancy outcomes.
• There is an urgent need for the development of locality-appropriate, culturally aligned support services for hāpÅ« māmā and pregnant women, particularly for Māori women who face disproportionate risks.
• Comprehensive maternal mental health services during pregnancy and after pregnancy loss, and bereavement care pathways specifically designed for women who have experienced violence need to be developed.
• Systematic collection of data on violence exposure, ethnicity, disability status, and migrant status is essential to better understand and address these disparities.

While the findings are sobering, RANZCOG acknowledges several developments that provide a promising foundation for change.

The Ministry of Health’s recent release of a Suicide Prevention Action Plan 2025-2029 demonstrates government commitment to addressing this critical issue through comprehensive, coordinated approaches.

The Kahu Taurima programme is working to strengthen maternity and early years care across Aotearoa, with a focus on equity, accessibility, and whānau-led care.

The developing Maternity Commissioning Framework offers opportunities to embed violence-informed care and culturally responsive services into regional maternity service design.

“This report presents some hard truths,” Dr Fleming concluded. “We must not let discomfort with these findings stymie us from taking action to protect the most vulnerable women and babies in our communities. The foundations for change exist – we must now ensure these are implemented with the urgency this crisis demands.”

°µĶųTV commits to working with government agencies, Māori health providers, community organisations, the New Zealand College of Midwives and the Kahu Taurima programme to support the critical reforms required to address this crisis.

Media enquiries

Catherine Coooper
Executive Director Aotearoa New Zealand, Global Health & Foundation
Email: ccooper@ranzcog.org.nz
Phone: +64 21 137 0748

Support services

If you or someone you know needs help:

• Family Violence Helpline: 0800 456 450
• Women’s Refuge: 0800 733 843
• Suicide Crisis Helpline: 0508 828 865

°µĶųTV acknowledges the women and families behind these statistics and commits to honouring their memory through meaningful action.

On 22 May 2025, the New Zealand Finance Minister presented Budget 2025, with healthcare receiving modest targeted investment.

Total Vote Health received an increase of 4.8% from the current financial year to $31.052 billion for the coming financial year. Te Whatu Ora hospital and specialist services received a slightly larger share of the funding allocation, increasing from 49% to 51% of Te Whatu Ora Health New Zealandā€™s portion of Vote Health funding.

However, given that healthcare delivery costs continue to escalate, this funding increase is unlikely to fully address the cost pressures Te Whatu Ora faces, which are felt daily by clinicians trying to care for patients. Health experts have noted that increases below 5% in the current economic environment amount to merely maintaining existing service levels when accounting for inflation, population growth, and increasing complexity of healthcare.

Key health investments

Vote Health funding included several targeted initiatives:

• $91 million over four years towards 12-month prescriptions
• Over $440 million over five years for primary care initiatives
• Over $1 billion for infrastructure including hospital and capital projects in Wellington, Palmerston North and Nelson

Primary care focus

Primary care received focused attention in this budget. The funding package includes over $440 million over five years for various primary care initiatives that have been previously announced, $164 million over four years for urgent and after-hours care expansion, and investment in a new 24/7 digital primary care service as part of the broader primary care package. Despite the July launch date for the digital service, limited detail has been provided about its implementation.

°µĶųTV remains hopeful that Te Whatu Ora Health New Zealand will support primary care initiatives that specifically address gynaecology first specialist assessment waiting lists and improve access to gynaecological care for women.

Positive development for womenā€™s health

A significant positive for womenā€™s health in this budget is the introduction of 12-month prescribing where clinically appropriate and safe. This change is designed to remove unnecessary barriers and reduce costs for patients with stable, long-term medication needs. Medical practitioners and patients will determine the need for follow-up based on clinical requirements rather than arbitrary timeframes.

°µĶųTV participated in the Ministry of Health consultation on extending prescribing duration late last year and supported this shift. We noted that 12-month prescribing will be of particular benefit in womenā€™s health for:

• Oral contraceptives
• Hormone replacement therapy
• Folic acid and iodine supplementation during pregnancy
• Progesterone for abnormal uterine bleeding

The Ministry of Health expect increased maximum prescription length to be available in early 2026, after changes to regulations and IT systems.

Looking forward

Of concern is that approximately half of the $5.3 billion in annual budget savings came from controversial changes to the pay equity regime, which will undermine efforts to address historic pay inequities, including in female-dominated health professions which are critical for delivery of health care.

°µĶųTV will continue to advocate for targeted investments that address the specific healthcare needs of women and support the specialist workforce required to deliver quality gynaecological and obstetric care across Aotearoa New Zealand.

Media enquiries

Catherine Cooper
Executive Director Aotearoa New Zealand
Email: ccooper@ranzcog.org.nz
Phone: +64 21 137 0748

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) is committed to excellence and equity in womenā€™s health while recognising our workforce includes and cares for people of all gender identities, including cisgender, non-binary, transgender and gender diverse people and their whānau.

In our 2023 member survey, 88% of respondents had cared for transgender or gender diverse patients, highlighting the importance of using patient-centred language. Everyone deserves respectful, appropriate and safe healthcare.

°µĶųTV opposes the Legislation (Definitions of Woman and Man) Amendment Bill. This Bill attempts to inaccurately reduce people to their sex assigned at birth using language like ā€œa woman means an adult human biological female,ā€ which fails to provide clinical clarity and ignores the complexity of human sex characteristics.

°µĶųTV acknowledges that sex and gender are different. Sex describes the physical characteristics a person may have, while gender is the internal identity a person experiences. Human sex is a complex product of chromosomes, genes, epigenetics (how genes are turned on and off), hormones and enzymes.

Sex is a spectrum between male and female. While most people are at one end or the other, there is a range of possibilities all the way between, known as intersex or innate variation of sex characteristics (IVSC). This is estimated to be around 1-2% of the population. Equally, a personā€™s gender identity may or may not align with their sex.

This Bill harms both intersex and trans & gender diverse communities by refusing to recognise them for who they are, impeding their equitable healthcare access. It also harms cisgender people by reducing gender to biological functions, for example, defining women by their reproductive capacity regardless of individual circumstances.

The Bill ignores te ao Māori concepts like takatāpui^[1] and violates Te Tiriti o Waitangi by failing to recognise that takatāpui and takatāpuitanga^[2] are taonga. It threatens the right of takatāpui whānau to equitable, safe healthcare access through exclusionary language.

°µĶųTV is implementing the Gendered Language Project to improve inclusive language and spaces. We are beginning to implement actions from this project and look forward to working with trans and gender diverse whānau on developing patient safety and clinical guidelines.

°µĶųTV emphasises that an inclusive society that welcomes everyone, acknowledging and embracing the infinite complexity of human existence, is vital for wellbeing and health outcomes. The Legislation (Definitions of Woman and Man) Amendment Bill has the potential to do harm if it is selected and progresses.

Notes

^[1] An umbrella term for a person with diverse gender, sexuality or sex characteristics

^[2] Practices and ways of being takatāpui

Media enquiries

Catherine Cooper
Executive Director Aotearoa New Zealand
Email: ccooper@ranzcog.org.nz
Phone: +64 21 137 0748