Letter to the Medical Council in Support of the Draft Statement on Hauora Māori and Statement on Cultural Competence and Cultural Safety

Joan Simeon

Chief Executive

Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand

By Email: jsimeon@mcnz.org.nz

26 February 2026

Tēnā koe Ms Simeon,

RE: In Support of the Draft Statement on Hauora Māori and Statement on Cultural Competence and Cultural Safety

Rights Aotearoa writes in strong support of the Medical Council's draft statements on Hauora Māori (Māori health and wellbeing) and Cultural Competence and Cultural Safety, and to rebut the intervention recently made by Todd Stephenson MP of ACT New Zealand, who has written to you urging their withdrawal.

We write, in particular, to affirm a matter of fundamental constitutional and regulatory principle: Te Kaunihera Rata o Aotearoa is a statutory regulator, established and empowered by the Health Practitioners Competence Assurance Act 2003 (HPCA Act) to set professional standards for the medical profession in Aotearoa New Zealand. That function belongs to the Council — not to Parliament, not to Ministers, and certainly not to individual Members of Parliament acting in a party-political capacity. Mr Stephenson's letter, while dressed in the language of clinical neutrality, is in substance a political intervention in a professional regulatory process. The Council should treat it as such.

The Council's Statutory Independence 

Section 3 of the HPCA Act makes clear that the Council's purpose is to protect the health and safety of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practise their professions. The Act grants the Council broad authority to determine what competence and fitness to practise require — including the values, cultural knowledge, and contextual understanding necessary to provide safe and effective care to all patients.

This statutory independence is not incidental; it is essential. Professional regulatory bodies exist precisely because clinical standards must be grounded in evidence, ethics, and the realities of practice — not in the shifting political preferences of whichever party holds power at any given moment. A politician's disagreement with a professional standard is not, in itself, a legitimate basis for that standard to be withdrawn or revised.

Mr Stephenson has not identified any statutory provision that obliges the Council to defer to his views. He has not cited any legal authority for the proposition that the Council's draft statements exceed its powers. His letter is, at its core, a political opinion — and the Council is entitled to receive it as such, give it appropriate weight, and proceed on the basis of its own professional and legal judgement.

The Substantive Case for the Draft Statements

Beyond the procedural point, the substance of Mr Stephenson's objections does not withstand scrutiny.

He characterises the reference to "historical and ongoing colonisation" as a political statement rather than a clinical one. This is incorrect. The causal relationship between colonisation and adverse health outcomes for Māori is extensively documented in peer-reviewed literature and is reflected in the findings of te Tiriti o Waitangi-based health inquiries, including the Waitangi Tribunal's report Hauora: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry (Wai 2575, 2019). The Royal Commission of Inquiry into Historical Abuse, the findings of numerous health equity researchers, and the consistent data published by the Ministry of Health all support this causal account. This is not ideology; it is evidence.

Mr Stephenson further suggests that requiring doctors to understand "colonial histories" and institutional structures imposes a "socio-political worldview" on the profession. But this conflates political opinion with professional knowledge. A doctor who does not understand the structural determinants of their patients' health — including the historical drivers of health inequity — is less well-equipped to provide safe, effective, and equitable care. The Council is right to require this understanding as a component of professional competence, just as it requires doctors to understand the social determinants of health more broadly.

His invocation of Cabinet guidance — that "public services should be delivered on the basis of need, not race" — similarly mischaracterises what the draft statements require. The statements do not direct doctors to prioritise patients on the basis of ethnicity. They direct doctors to understand the particular health needs and circumstances of Māori patients, and to take meaningful steps to address demonstrable inequities in health outcomes. This is precisely what need-based healthcare requires when one population group experiences systematically worse outcomes than another.

On the Inclusion of Gender Identity

Rights Aotearoa also notes, with concern, that Mr Stephenson's letter implicitly questions the inclusion of gender identity and sexual orientation within the Cultural Competence and Cultural Safety draft's definition of cultural groups. We reject any suggestion that these characteristics are improperly included. The evidence is unambiguous: transgender, non-binary, and intersex people in Aotearoa New Zealand face significant barriers to healthcare access and experience materially worse health outcomes than the general population. Culturally competent care for these communities is a patient safety issue — not a political one.

Conclusion

Rights Aotearoa urges the Medical Council to proceed with confidence in finalising and adopting both draft statements. The Council has both the statutory authority and the professional responsibility to set standards that reflect the full range of competencies required for safe, equitable medical practice in Aotearoa New Zealand. The political preferences of a parliamentary party are not a constraint on that authority.

We further encourage the Council to affirm, publicly and clearly, that its standard-setting processes are insulated from political interference — and that submissions to its consultations will be evaluated on their merits, not on the seniority or political affiliation of those who make them.

Ngā mihi nui, 

Paul Thistoll

Chief Executive

Rights Aotearoa

paul@rightsaotearoa.nz

02040063160