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 government’s intention to introduce legislation to “improve the effectiveness of health services delivery to patients” and Cabinet has approved a suite of amendments to the Pae Ora (Healthy Futures) Act 2022.
However, in RANZCOG’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 RANZCOG’s significant concerns about the implications of the bill are summarised below. For a more comprehensive overview, read the College’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 doctors’ 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 Zealand’s role
Clauses 13 and 14 expand Health New Zealand’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 Ora’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 ‘gaming’, 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 Zealand’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 Zealand’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
