‘Slippery’ health doc subject of several complaints

Thursday, 17 April 2025

Labour is accusing the Health Minister of “slippery” and leading tactics, after an official health document with made up patient scenarios was cast out to the public for consultation.

The senior doctors’ union has taken the rare step of complaining to the Public Service Commission.

However, Health Minister Simeon Brown is standing by it – saying it is about “making healthcare more accessible and responsive”.

The Ministry of Health document titled, Putting Patients First: Modernising health workforce regulation, is seeking feedback on the Government’s review of the health workforce regulation.

“The way New Zealand regulates the health workforce is overly bureaucratic. This affects how quickly you can see a health professional, and how much it costs,” the foreword from Brown states.

“We want to ensure it delivers for you – the patient – while enabling the workforce to practise efficiently and safely.”

With singular quote marks, it included statements like: ‘I keep hearing that this regulation is for my benefit, but no one has ever asked me what I want.’

And, ‘I don’t understand why we have 18 regulators, which is more than the UK or Australia? Is this an unnecessary cost and inefficient?’

Or, ‘I keep hearing about doctors from overseas who want to work here but can’t. I know we need more doctors, why is it so hard?’

About eight “scenarios” are also included in the document.

Clearly marked as a scenario and without quote marks, examples include: I’ve had some problems with my back recently, and my friend recommended a physiotherapist he’s been visiting. I want to make sure they’re registered, but I don’t know how or where to check.

Creative scenarios – ones that are made up – are sometimes used in Government communications, such as helping to illustrate how monetary changes can affect people in different types of housing and family situations.

However, Labour health spokesperson Ayesha Verrall called this instance “pretty slippery to put out a bunch of supportive quotes”.

“Regulation of health professionals is a balance between patient safety and the freedom to use to practice in different ways. None of that balance is reflected in the document.

“Consultation should be putting the facts in front of the public and giving them options, not directing them in one particular direction.

“The minister needs to explain why he sought to add to this document a set of leading scenarios.”

The Association Of Salaried Medical Specialists, the union for senior salaried doctors and dentists which is in a negotiation stoush with the Government and has just announced strike action next month, wrote to Director-General of Health Audrey Sonerson on April 3 expressing concern.

It also complained to the Public Service Commission.

In it, the association said it had “serious concerns about the poor quality of policy advice within the consultation document” and called the quotes and scenarios “highly misleading”.

Executive director Sarah Dalton said a review on regulation “is fine, but this document claims to be something it's not, it's misleading in tone and it's misleading in content'.

Dalton said it could run the risk of not “having a proper conversation, you're not opening it up to an informed debate, or to collect the range of views that you might reasonably expect if you're setting out an even-handed document…

“It's just full of assumptions and generalisations. There's no way for people reading that document, unless they're highly health literate, to dig in and check what the statements are and what sits behind the questions, and I think that real poses risk.

“It's a shocker.”

The minister’s office and Ministry of Health were asked multiple times about the health document – including if they were comfortable with the made up scenarios being used in it.

The ministry referred all queries to the minister’s office, and did not confirm if the quotes were from real people.

Brown said the document “includes a range of illustrative scenarios to reflect the kinds of experiences we’ve heard from patients across the country, as well as our workforce”.

“The aim is to start an honest conversation about how the health system is working – and where it’s not. We want a system that puts patients first, not red tape.

“These proposals are about making healthcare more accessible and responsive. We encourage Kiwis to read the document and have their say. If we’re going to deliver better results, we need to hear from the people who actually use the system.

“The document covers a range of topics, which have been explained in a variety of ways to reach a broad audience.”

On April 11, the NZ Nurses Organisation (NZNO)also wrote to Sonerson to express concern. Among the issues raised by chief executive Paul Goulter was, the “scenarios make use of politicised language and scenarios that risk obfuscating the focus on good regulation, patient safety, and clinical competence”.

“NZNO is also concerned the document is inappropriately and overtly political. It offers leading questions for the public and sector to answer.

“It is disappointing the Ministry of Health has released such a poor consultation document on this critical legislation.”

It requested the consultation document be withdrawn and revised.