Cultural safety is about good healthcare, not ideology

Kaitiaki Hauora Executive Member Louisa Wall is backing calls from doctors to protect cultural safety in healthcare and the independence of professional medical regulation.

Her comments follow a powerful article by specialist GP and Kaitiaki Hauora member Dr Orna McGinn, who argues that cultural safety is fundamental to good medical practice and patient trust, not an ideological agenda.

Dr McGinn’s article follows recent changes to the Medical Council of New Zealand and comments from Health Minister Simeon Brown criticising the Council’s work on cultural competence, cultural safety and hauora Māori.

In response, more than 1,200 doctors signed an open letter reinforcing the importance of cultural safety in medical practice and independent professional regulation. Members of New Zealand Women in Medicine also staged a silent protest during the Minister’s address to the Royal New Zealand College of General Practitioners’ annual conference.

Louisa Wall, who is also Chair of the Tūwharetoa Iwi Māori Partnership Board, says the issues raised by Dr McGinn should concern everyone who wants a health system in which people can trust the care they receive.

“I strongly support Dr Orna McGinn’s powerful defence of cultural safety and independent professional regulation.

Cultural safety is not an “ideological agenda”. It is about whether people feel heard, respected and safe when they access healthcare. It recognises that good clinical care requires understanding the person, their whānau, their circumstances and the experiences that shape their health.

For Māori, the persistent inequities in health outcomes are real and measurable. Cultural safety will not, on its own, close these gaps, but dismissing it as ideology risks undermining trust and the relationships that are essential to improving hauora.

We should also be concerned when political intervention reaches into the independence of professional regulatory bodies. Standards of medical practice must be grounded in evidence, professional expertise, patient and whānau voice, and the context of Aotearoa New Zealand.

As Kaitiaki Hauora, we believe whānau voice matters. As an IMPB, our role is to advocate for the hauora of our whānau and ensure their experiences and aspirations inform the health system.

Good healthcare starts with listening.

Nāu te rourou, nāku te rourou, ka ora ai te iwi.

With your contribution and my contribution, we can create wellbeing for all.”

In her article, Dr McGinn draws on more than 20 years of clinical practice to explain what cultural safety looks like in the consulting room and why understanding a patient’s history, circumstances and worldview can directly affect their experience of healthcare.

She also reflects on her own Irish heritage and the experience of language and cultural suppression in Ireland. Her grandfather was a native Gaeilge speaker who later became a teacher and championed the revival of the language. While careful not to equate the histories of Ireland and Aotearoa, Dr McGinn writes that growing up in the shadow of that history helped her understand what cultural loss, shame and recovery can mean.

It is a connection she brings back to medicine understanding who people are, where they come from, and what has shaped them is part of understanding their health.

As Dr McGinn writes: “Tell me your story, not just your symptoms.”

Read Dr Orna McGinn’s full article on E-Tangata: Cultural safety is worth protecting.