What the changes to the Medical Council mean

Most people don't spend much time thinking about the Medical Council of New Zealand.

In fact, most people probably only know it exists when it pops up in the news.

But the Medical Council plays an important role in our health system ensuring doctors have the right qualifications and are competent to practise. Similarly, trades associations and boards make sure a builder, electrician, or plumber has the right licence and knows what they're doing.

The Medical Council also sets the standards doctors are expected to meet throughout their careers, oversees professional conduct, and helps ensure patients receive safe care. That means thinking about more than medical knowledge. Good healthcare is also about communication, trust, and understanding the people seeking care. 

This is where the current debate begins.

Health Minister Simeon Brown recently chose not to reappoint the chair and deputy chair of the Medical Council, even though they both had two more terms of three remaining.  His reasoning was the organisation had become distracted by politics and an "ideological agenda", particularly through its work on cultural safety, cultural competence, and Māori health.

In simple terms, ideology means a set of beliefs or ideas about how society should work. The disagreement in this case is whether understanding and addressing health inequities is part of good healthcare, or whether it goes beyond the Medical Council's core role. 

Supporters of the decision argue the Medical Council should focus on its core responsibilities and avoid broader social or political issues.

Others argue that understanding why some people experience poorer health outcomes is part of delivering good healthcare.  In fact, the Medical Council is required by statute to incorporate cultural safety, cultural competence and Māori health into professional practice.

The Medical Council has a role in law ‘to set standards of clinical competence, cultural competence (including competencies that will enable effective and respectful interaction with Māori), and ethical conduct to be observed by health practitioners of the profession.’ (s118(1)(i) of the Health Practitioners Competence Assurance Act 2003).  There is also an obligation to encompass the purpose of the Pae Ora (Healthy Futures) Act 2022.

The Act’s purpose is to:

• protect, promote, and improve the health of all New Zealanders

• achieve equity by reducing health disparities among New Zealand’s population groups, in particular for Māori

• build towards pae ora (healthy futures) for all New Zealanders.

Pae Ora (Healthy Futures) Act | Ministry of Health NZ

 Dr Love was the first wahine Māori to serve on the Medical Council.  The Council has recognised outgoing Dr Rachelle Love’s leadership in guiding Council’s response to the Royal Commission of Inquiry into Abuse in State Care, and the work she has done with survivors of Lake Alice.   Simon Watt (Barrister with extensive experience in departments, Crown entities, state-owned enterprises and climate change) was a layperson member of the Medical Council of New Zealand from 2023-2026, including three years as Deputy Chair.

The new persons appointed are Chair Dr Kenneth (Ken) Clarke; vocationally registered in both Obstetrics and Gynaecology and Medical Administration, and Deputy-Chair Ming-chun Wu; Chartered Director with the Institute of Directors.

For many New Zealanders, this debate on Medical Council appointments may sound distant from everyday life. 

We know that some groups of New Zealanders experience significantly poorer health outcomes than others. Māori, in particular, continue to experience higher rates of preventable illness and lower life expectancy than non-Māori.

These are not political opinions, but facts backed by decades of evidence.

The concern raised by many clinicians and health advocates is that efforts to understand and address these barriers are increasingly being described as ideology rather than healthcare incorporating the Treaty of Waitangi and ensuring improvements in health extend to every sector of our society.

Kaitiaki Hauora is deeply concerned by the Minister's decision not to reappoint experienced Medical Council leaders despite both being eligible for further terms. The move raises serious questions about the independence of professional regulation and sends a troubling signal that disagreement with the Government's preferred approach to cultural competence and Māori health may carry consequences.

Professional regulators exist to protect patients, not to reflect the political priorities of the government of the day.

Read Louisa Wall’s opinion piece here

Read “Culture Shock” editorial in the Otago Daily Times here