Beware signs on footpaths

With a health system under pressure, would you prioritise more timely access to care or promotion of the Treaty? Supporting mums and babies, or climate change?

My free speech sensibilities were the first to kick in last week when I read in legacy media that the Minister of Health had supposedly told public health officials that their views would need to be vetted before being released. The headlines screamed ‘Trumpian’, ‘censorship’, and ‘chilling effect’ and that public health doctors were being prevented from sharing their views.

I should have known better. The headlines were of course sensational and not accurate. I also know the likes of Simeon Brown and others in government, and allowing free speech is a critical value to them.

What was being asked is as simple as it is basic – asking that public health doctors refer any advice they are about to provide comment on, to the National Office. The reason for this is to ensure that such efforts are in keeping with the primary focus of health system – to ensure people have timely access and appropriate care.

Now, if I step back, I can still see how an argument can be mounted that this added requirement could influence what these public health officials say as part of their official duties (they can say whatever they want as individual citizens). As some commentators and unionists are arguing, this request from the Minister will stop doctors speaking up on important issues.

It didn’t take long to find out that the ‘important’ issues were all the cultural and political issues du jour – climate change, the Treaty, along with aspects of critical race theory and cultural Marxism. Not in every case of course, but it’s clear that some public health doctors are more worried about propagandising you than healing you. They need to ‘heal’ your centrist or right-wing views, your conservatism and common sense, before addressing any actual health needs.

Helpfully, the Minister of Health fired off a series of X’s (tweets) to illustrate some of the reasons why the request was made for advice to be reviewed by the National Office first. Some may recall that McDonald’s is looking to open a store in Wanaka and some are up in arms. That it’s a legitimate business seems lost on many, including local health officials. As the Minister noted:

“In Wānaka, Health NZ made an 8-page submission against a proposed fast food outlet, including observations about planetary health, landscape values, traffic and Te Tiriti. The submission did not mention healthy eating.”

The last sentence I thought was the kicker! It’s not the only example though. Other public health officials wanted to stop charities, schools, and others running raffles for fear it could lead to a culture of gambling. Yep, you read that right, running a raffle to fund your kid’s school camp is a danger to public health.

Another example is asking that all coffee outlets put up signs asking people to use reusable cups for the sake of climate change. In Nelson, public health doctors were focused on sandwich boards – you know, the signs that businesses put on the pavement to share information with customers. Yep, you anticipated it – these doctors were worried about potential injuries by passing pedestrians.

If you need even more evidence, check out Mayor Nick Smith’s Facebook post where he shares how these health officials have opined on everything from roading bypasses to libraries!

It perhaps didn’t cross these doctors’ minds to focus their time and expertise on say diabetes, more efficient screening for cancer, or benefits of more exercise. No, instead, the danger of sandwich boards. Next, these officials will be worried about the luminosity of streetlights and the effect on the light sensitive, animals, and insects – not to mention the lights carbon footprint and undoubtedly, some impact on the Treaty of Waitangi.

As I say, my first reaction was based on free speech but it quickly became obvious that this has little do with free speech and all to do with keeping focus on what’s important within one’s area of expertise and responsibility. Healing the sick rather than sickening the average kiwi with political bias; preventing disease not propagating ideologies; and allowing people to live and run their businesses and not cause unnecessary interference on things that are not illegal, immoral, and quintessentially human (that is, eating!).

We are repeatedly told that our health system is under enormous pressure, and it is. I used to work in the system – in private health insurance - and as many will know, I also Chaired Parliament’s Health Committee for many years. ‘Health’ is a huge beast with massive issues no matter who is in power. Many commentators with health will say there is not enough money, not enough resources, not enough time, and so on. And yet despite saying this, the same commentators are the ones using their time to warn us of the grave dangers of sidewalk signs and the importance of the Treaty of Waitangi.

I can therefore understand why the Minister of Health is frustrated. From my perspective, if there is limited money, time, and resources then those in the system need to prioritise accordingly. The Minister has been clear – he wants focus on timely and quality care.

Speaking of timely and quality care, another bit of reporting around the health system illustrates where said public health officials should be focused (among other similar areas). It relates to National moving to allow women and newborns three days in hospital post-birth. It’s a great policy and one first put forward by Louise Upston MP, but now as a Minister she has had to hand the idea over to another MP (in this case, Catherine Wedd).

Appropriately, those in the sector and in legacy media are questioning whether the expansion can be done. I think we would all agree it’s a great idea and an important one. But the questions being raised also emphasise why the Minister’s call to prioritise the Ministry’s is the correct one. Instead of the multitude of distractions on often political matters, public health experts and other policy people should be focused on developments such as this. If there is pressure on providing three days of care to mums and bubs, then focus on solutions for this. It really is that simple.

Finally, these public health doctors might do well to reflect on what could be colloquially described as been ‘busy bodies’ when it comes to school fundraisers or people trying to go about their business. It’s the very first principle of medicine – primum non nocere. First of all, do no harm.