Doctors warn of 'backwards step' after Medical Council leadership shake-up over 'ideological agenda'

Health Minister Simeon Brown's office says the Medical Council has become "increasingly distracted by politics".

Photo: RNZ / Mark Papalii

Doctors are warning political interference could undermine patient safety, after Health Minister Simeon Brown declined to reappoint two senior Medical Council leaders over their supposed "ideological agenda".

Outgoing Medical Council chair Dr Rachelle Love (Ngāpuhi, Te Arawa) and deputy chair Simon Watt will end their stints at the end of their respective terms, despite both remaining eligible for reappointment.

A spokesperson for Brown said the Medical Council had become "increasingly distracted by politics" instead of focusing on improving patient outcomes and ensuring New Zealanders could access timely healthcare.

"Ministers want to see the council focus on improving the timely delivery of health services that New Zealanders expect, without distraction from any other agendas," the spokesperson said.

Brown told The Post that Kiwi's "expect the Medical Council to be focused on strengthening the medical workforce, not on an ideological agenda," pointing to the councils recent consultation on draft statements outlining the expectations that doctors understand how culture can affect health outcomes and how bias and systemic factors can contribute to inequities.

The New Zealand Resident Doctors' Association said the decision to remove the leadership of the Medical Council over a 'ideological agenda' is a "troubling example of political interference in what should be independent health regulation".

National secretary Dr Deborah Powell told RNZ she was "deeply disappointed" and "worried".

"Cultural safety is not an ideological agenda. It is a fundamental part of good medical practice," she said, adding that it was wrong to suggest the Medical Council had become politicised.

"For all of the minister accusing the Medical Council of political ideology, actually the minister is more guilty of that than the Medical Council has been in our view... it is a very, very backwards step to have politicians interfering in regulation in this manner."

Powell said cultural safety was embedded in medical practice and directly linked to patient outcomes, and doctors were required to consider how culture, bias and communication could affect clinical decisions and patient outcomes.

"If we have lower standards, if doctors are no longer required to be aware of the cultural impacts that are affecting both themselves and also their patients, it will just reduce the quality of communication that we have between patients and doctors. That's not good for anyone. It's certainly not good for patients."

"Doctors work with people from all backgrounds and communities. Safe, competent care requires doctors to understand how their own position, bias, culture, and communication affect clinical decisions and, ultimately, patient outcomes,"

"That is true in Aotearoa New Zealand, and it is true across health systems internationally."

She said cultural awareness applied to all patients, not only Māori.

"You have to be patient-centred, and part of that is being aware of that patient's culture, whatever it is, so that when you are communicating with them, you are doing the best you can to do it in a way that they understand."

"The onus is on the doctor to be aware of not only their own culture, but their patient's culture, any patient's culture, and that is a fundamental in good medical practice."

Powell said the Medical Council existed to protect patients by setting and maintaining standards for doctors.

"Their objective, their reason for being, is to ensure the safety of patients," she said.

"We have to have an annual practising certificate, we have to meet certain standards so that we can practise here in New Zealand."

She said independence was essential to keep standards focused on patient safety rather than political priorities.

"We have some workforce issues with medical practitioners, but it's not the Medical Council's responsibility to fix our workforce problems," she said.

"They're there to say 'this is the standard that doctors in this country have to work to', to ensure that our patients are safe."

The Royal Australasian College of Physicians also pushed back on the characterisation of cultural safety as ideological.

RACP Māori Health Committee chair Dr Matt Wheeler said describing cultural safety as an 'ideological agenda' misunderstands its role in healthcare.

"This is evidence-based clinical practice that supports patient safety, quality care, and better outcomes," he said.

"Putting patients first means ensuring care is safe, equitable, and culturally responsive - these are not competing priorities, they are inseparable."

Powell said there was evidence both internationally and locally that supports culturally aware healthcare, including research showing persistent inequities in cancer survival outcomes for Māori.

In Aotearoa, Māori patients experience poorer survival outcomes for 23 of the top 24 highest mortality cancers for Māori.

The association was also concerned about the Health Practitioners Competence Assurance Amendment Bill, which Powell said could further reduce the autonomy of health regulators.

"Political ideology has no place in the regulation of health practitioners when patient safety is the fundamental tenet we are trying to protect," she said.

"We do have good standards here in New Zealand, and we should not be ashamed of that. We should be proud of it. Our people deserve that."

She warned that greater ministerial involvement in professional regulation could weaken those standards.

"We have a lot of problems in our health sector. We're not denying that. But one of the things that keeps our head above water, that keeps our patients safe, is those standards," she said.

"Something as important as patient safety shouldn't be a juggle. Those standards should be set by people who know what they're talking about."

Brown's spokesperson said it was not political interference for ministers to make ministerial appointments.

"Ministers want to see the council focus on improving the timely delivery of health services that New Zealanders expect, without distraction from any other agendas."

They said amendments to the Health Practitioners Competency Assurance Act, which would be subject to a full select committee process, were to ensure health workforce regulation aligned with patient needs and the Government's priorities for the health system.

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