Explainer: What do New Zealand MPs have to disclose to the public about their health?

Explainer - Top US politicians are keeping their health struggles hidden. What are the rules for New Zealand MPs?

America has seen a steady stream of stories about politicians who have not been forthcoming about health issues that have kept them off the job, sometimes for months.

The former Senate Majority leader Mitch McConnell, 84, revealed this week after several weeks of speculation about his health that a fall had led to a lengthy hospital stay. Another congressman, New Jersey Republican Tom Kean, vanished from Congress for four months, with no information given about why, before returning to announce he had been dealing with severe depression.

The issues aren't just along America's polarised party lines - California Senator Dianne Feinstein, a Democrat, faced questions about severe cognitive issues before dying in office at age 90 in 2023.

And of course, the health of the last two US presidents - Democrat Joe Biden, who left office at age 82, and Donald Trump, who just turned 80 years old - is often in the news. There have been many health cover-ups in American presidential history. Polls show American voters concerned about their leaders' age and health transparency.

Could we ever see the same kind of situation developing here?

What are the rules about politicians disclosing their health issues in New Zealand - or are there any?

Are there any rules about disclosing the health of our politicians?

Short answer - No.

A spokesperson for the Parliamentary Service office confirmed there's no process in place.

"New Zealand has no general mechanism that requires an MP to step down because they have become medically unable to do their job," they said.

"MPs are elected representatives who hold their seats for the parliamentary term, and there is no fitness-for-office test or compulsory health assessment."

"Everyone's health information is their personal information including MPs' health information and medical records," the office of the Privacy Commissioner told RNZ.

"This is protected from disclosure under the Privacy Act and the Health Information Privacy Code but can be released with the MP's authorisation."

Otago University Professor Nick Wilson was part of a team who examined how health issues examined several former prime ministers, published in the New Zealand Medical Journal.

He agreed in terms of a requirement to disclose health, there is "essentially none."

"No one is compelled to disclose their personal information unless there is a specific requirement," the Privacy Commissioner's office said. "For example, the Cabinet Manual covers required disclosures about MPs' interests, but this does not extend to health information."

There have been complaints about American politicians like McConnell or Biden not being transparent, but New Zealand recently generally has a stronger record of voluntary disclosure when politicians have been ailing.

Politicians including Green Party co-leader Marama Davidson, former Labour MP Kiri Allan and the late National MP Nikki Kaye have been forthright about their cancer battles while in office.

New Zealand also has a somewhat younger-skewing demographic than America, where complaints of a "gerontocracy" of leadership by the elderly are frequent. The average age of the US Congress is older - nearly 58 for the House of Representatives and 64 for the US Senate.

The average age of the current Parliament is 49 years, one month, ranging from the youngest, Te Pāti Maori MP Hana-Rawhiti Maipi-Clarke, now 23, to NZ First leader Winston Peters, 81, who first entered Parliament in 1978.

On the other hand, the oldest US senator, Iowa's Chuck Grassley, is nearly 93 years old and will be 95 at the end of his current term.

"The US political system seems to have dysfunctional processes that favour politicians staying around well into their 70s and 80s - creating what seems to be a gerontocracy," Wilson said.

"NZ is much more like other democracies with more youthful politicians."

There's no mandatory retirement age for MPs, although there are for judges and some public figures.

"Compulsory retirement ages have been generally unlawful in NZ under the Human Rights Act 1993's age discrimination provisions," Wilson said.

Have we ever had issues with prime ministers and their health?

Yes, although not in recent years.

Five prime ministers or premiers have died in office - John Ballance (1893), Richard Seddon (1906), William Massey (1925), Michael Joseph Savage (1940) and Norman Kirk (1974).

Kirk, who died at only 51 years old, suffered from rapidly deteriorating health in his final years, including heart disease, diabetes and surgery for painful varicose veins.

The true extent of Kirk's health was still somewhat kept from the public, as Kirk himself wanted to keep working and was frustrated by his tragic decline as rumours swirled around him.

Wilson's study found poor health could have an impact on the whole country. The case studies looked back at several prime ministers who suffered health issues that affected their job such as Sir Joseph Ward, who resigned just six weeks before his death in 1930.

Ward's "second term as PM between 1928 and 1930 was marked by his poor and hasty decisions, frequent absences from Parliament as the result of illness and attempts by close associates to minimise the extent of his sickness and general debility."

"All of these figures were reluctant to accept limitations to their authority, despite urgings from associates who considered them no longer able to make sound decisions or too ill to carry out their work," the study concluded.

Health struggles and other debilitating conditions can take many forms. Former Prime Minister Robert Muldoon notoriously called a snap election while reportedly under the influence of alcohol, a decision which changed the path of the country.

What happens if a politician has a health condition that prevents them from serving?

A member can voluntarily choose to resign or seek leave.

"An MP who is unwell may seek permission to be absent or choose to resign, but that is a matter for the member," the Parliament Services spokesperson said.

"If the Speaker grants permission, the member can be absent without affecting their party's votes in the House, in accordance with Parliament's rules" under Standing Order 39, they said.

The Electoral Act 1993 lays out what happens if a parliamentary vacancy is created - whether through resignation, disqualifying criminal convictions or death.

A by-election can be held, although if the vacancy happens close to a general election it may be bundled into that.

The only health-related exception that could force an MP out of office is a rather obscure section of the Electoral Act, Section 56, which deals with members "becoming mentally disordered".

"In the law this means where the member is subject to compulsory treatment or detention under the Mental Health (Compulsory Assessment and Treatment) Act 1992," the Parliament Services spokesperson said.

"That process requires two medical examinations six months apart, with the results reported to the Speaker and laid before the House before the seat is vacated. It does not extend to physical illness or general incapacity."

There's no record of Section 56 ever having been used.

Should politicians be required to take a health test?

Wilson said while privacy is important, he believes that in the future some kind of health screening of top leaders could be useful.

The American president has a regular health checkup but it's not mandatory and there's no requirement as to how much information is disclosed.

"For leaders/deputy leaders of a country like NZ - I think it would still be desirable for some formal process to exist," Wilson said, noting a prime minister might have to deal with war, disaster or a pandemic and it could be useful for the public to know they were up for the job.

"This requirement could be to give health information to an independent panel that could then make an assessment around if the health issue is potentially impeding their ability to do their job."

Wilson said such a panel could review leaders' health information annually and assess their fitness to serve.

"If an acute health event occurred - then an extra assessment could be required within a certain time frame (eg, a few weeks). Perhaps a NZ-based citizen jury could deliberate on this issue and make recommendations."

Wilson said he didn't think other MPs should need to have their health tested, however.

But he pointed to several examples throughout history where the questionable health of a leader had a big impact on events.

"If an impaired leader stays in power they can make decisions that have bad consequences," he said.