Wide-ranging health concerns – from the rights of Māori and Pasifika communities, to public health and prevention, and healthcare system pressures – are on the table at the 7 November election in Aotearoa New Zealand, reports Croakey journalist Marie McInerney, who recently visited Ōtautahi Christchurch.
Marie McInerney writes:
Voters in Aotearoa New Zealand are heading to a national election in just over a week amid fears that the nation’s public health system is being eroded, doctors and other health leaders silenced, and hard-won Māori rights and protections systematically dismantled.
Early voting is now underway at shopping centres, transport hubs and community halls across the country ahead of the 7 November election, which polls suggest will be tightly contested.
Prime Minister Christopher Luxon’s centre-right coalition Government, elected in 2023, is seeking a second term, aiming to head off the centre-left Labour Opposition, led by former Prime Minister Chris Hipkins.
A number of smaller parties will, as is usual under New Zealand’s mixed-member proportional (MMP) system of voting, play a crucial role in determining who will have the numbers to govern.
Preliminary results will be released progressively from soon after the polls close on 7 November, but the election result will not be officially declared until 27 November.
Emma Rawson-Te Patu, immediate past president of the World Federation of Public Health Associations (WFPHA), has watched with dismay the impact in her homeland of a transformation in the country’s approach to Māori policies under the Luxon Government.
As well as efforts to weaken Te Tiriti o Waitangi – the Treaty of Waitangi, the Government has dismissed cultural safety as “ideological”, and – in shades of what is now also being seen in Queensland – significantly reduced Māori health leadership and representation.
Following its election, the Luxon Government also moved quickly to abolish the landmark Māori Health Authority – Te Aka Whai Ora, a decision slammed last month by the Waitangi Tribunal.
It has also required the public service to reduce the official use of the Māori language, including in the national education curriculum.
The Coalition has framed its undermining of Maori health and healthcare as restoring ‘equality’, declaring it has “a very simple approach to healthcare which is based on need, not ethnicity or race”.
This amounts to “a physical slap” for Māori, says Rawson-Te Patu.
“That’s what we mean when we talk about institutional racism,” she told Croakey. “It’s the pure description of institutional racism.”
In focus
Polls and headlines indicate that health and healthcare are high on the agenda for voters.
According to a September Ipsos New Zealand poll, 63 percent of respondents identified inflation and the cost of living as among the country’s most important issues.
Healthcare and hospitals came second at 44 percent. Another recent poll suggested that 70 percent of voters believe New Zealand’s public health system is in crisis.
However, several health professionals and organisations approached by Croakey about the election were reluctant to comment, saying they didn’t have authority to speak or might put their roles or priorities at risk if they did.
The Toi Mata Hauora Association of Salaried Medical Specialists (ASMS) is one of the more outspoken groups. Its president Dr Katie Ben told Croakey the ASMS is not party political. But it is “health political”, she said.
Christchurch health campus. Photo by Marie McInerney, October 2026
Rights under attack
Notably the Association spoke out against the decision earlier this year by Health Minister Simeon Brown to not re-appoint the then Medical Council of New Zealand chair Dr Rachelle Love (the first Māori person to hold the position), and deputy chair Simon Watt, citing what he described as the council’s “ideological agenda”.
Brown told a parliamentary inquiry he objected to proposed statements on cultural safety from the Medical Council “which ask doctors to examine their own ‘privilege’, to challenge the ‘dominant culture’ of the health system, to study the difference between cultural appreciation and cultural appropriation, and to help ‘dismantle’ systems”.
He took a similar axe to the NZ Nursing Council, refusing to reappoint several Council board members, including Māori chair Ngaira Harker, leaving just one Māori and one Pacific representative on the 15-strong board and prompting accusations of a “whitewash“.
(Read more in this Croakey article from June, Cultural safety under ideological attack from conservative government in Aotearoa/New Zealand, by Jayde Fuller and Dr Curtis Walker.)
The ASMS also accused Health NZ earlier this year of “gagging” clinicians by denying them the right to object to a proposal to remove equity-based access for Māori and Pasifika for type 2 diabetes medicines empagliflozin, dulaglutide and liraglutide.
“Specialists know that Māori and Pasifika people are most impacted by type-2 diabetes and comorbid conditions,” it said in a statement in June. “Removing ethnicity-based criteria will deny care to thousands of people who need it most.
Rawson-Te Patu said such shifts have led to Māori people feeling “disempowered and disheartened”, being blindsided by “such a destructive government, and being able to see that destruction on a daily basis at home”.
It’s a direction that she fears could lead to a deep and dangerous schism within Aotearoa over the long-term, “if we have one more term of this Government, and the left and anyone in the left block isn’t willing to be absolutely clear that it must honour Treaty rights in its most authentic and proper way”.
While Rawson-Te Patu has been buoyed by civic support for Tiriti and other rights-based movements and protests, she understands that many colleagues in public health have “felt impotent in one way, shape or form” in the face of such deleterious policies.
They have also felt “physical, emotional and spiritual pain” from having to stop using rights-based language, to “have to use language [around equity and equality] that you know is speaking to a manipulated truth”.
A step forward
On a more positive note, the Te Rōpū Mātai Hinengaro o Aotearoa | The New Zealand Psychological Society (NZPsS) and the NZ College of Clinical Psychologists recently apologised to Māori for psychology’s breaches of the Waitangi Treaty and the harms that had caused.
It acknowledged that “psychologists are trained with settler-colonial world views, and as a profession have undiscerningly adopted beliefs and values that perpetuate monocultural psychology in Aotearoa”.
“We have not acted within the spirit and intent of Te Tiriti o Waitangi and have colonised Māori of their space, leadership and empowerment in their journey of wellbeing,” said the apology.
NZPsS Executive Director Veronica Pitt told Croakey the apology had taken a number of years to finalise, in consultation with Māori groups and leaders, wanting to ensure a balance between engagement and listening, and making sure “we weren’t putting the burden onto them of doing the apology, doing all the work to fix what’s needed”.
The apology ends with specific commitments to action, including to fund and protect Kaupapa Māori knowledge, approaches, practices and research, address racism, and provide equitable access for Māori to practise, utilise and receive Māori psychology.
Notably, a third group involved in developing the apology, the New Zealand Psychologists Board (NZPB), a regulatory authority, was directed, “on the advice of the Ministry of Health”, to not be part of its delivery.
Shameful inequalities
Dr Katie Ben welcomes the election focus on health and healthcare though she suspects it is mostly around tertiary care and less about equity and important social, cultural, and political determinants of health.
In 2021 the ASMS hosted a conference titled Creating Solutions: Towards health equity outcomes for all, so health professionals could “take a hard look at the outrageous and shameful level of inequalities in Aotearoa New Zealand, as well as the social determinants which feed into them”.
“Since then, disgracefully, not much has changed,” it said in one of six papers published this year in the lead-up to the national poll.
It says Māori men and women still live an average of seven years less than their European counterparts. Material disadvantage for children is back to 2020 levels, real wages are lower than in 2020 and participation in early childhood education has reduced.
“We don’t have health equity and we still have a large gap with life expectancy for different ethnicities, which is unacceptable,” Ben said.
She also dismisses the Government’s notion that equality means that ‘everybody should be treated the same’.
The reality is that, for example, the Māori population gets bowel cancer on average 10 years earlier “and therefore they should be screened 10 years earlier because that’s when they are at risk”, Ben said.
“There are some populations that are more sensitive to pain medication than others, so they get less pain medication than people who need more of it. It should be an individually tailored thing.”
Under pressure
Ahead of the election, the Toi Mata Hauora Association of Salaried Medical Specialists has also highlighted concerns about entrenched staffing shortages, failing physical infrastructure, and outdated equipment and technology.
These all combine to produce “growing unmet need, longer waiting times for first specialist assessments and treatment, overloaded emergency departments, poorer health outcomes, and more time spent in ill health”.
The Government was put under pressure in recent weeks over revelations that child cancer treatments at Auckland’s Starship children’s hospital had to be postponed due to nursing staff shortages.
Ben said much needed cancer treatments, chemotherapy, and bone marrow transplants are usually done on “a really tight time-frame”.
“We recognise that sometimes we can’t do it to the exact date because kids get colds, white [cell] counts go up, and we do have to rearrange around that,” she said.
“But we should never have to rearrange around the infrastructure being available for them to have their treatment. That’s just terrible.”
It’s widely acknowledged that the National Government “inherited a health system under pressure”, but also that it hasn’t made any significant inroads.
Leading health academic Professor Robin Gauld said in 2024 the Government announced health targets to deliver faster access to cancer treatment, improve childhood immunisation rates, shorten stays in emergency departments and cut wait times for first specialist assessments and elective treatment by 2030.
“So far, it has failed to deliver,” he wrote recently at The Conversation.
“Underfunding and a lack of long-term planning have made it particularly challenging to achieve shorter stays in emergency departments and faster access to first specialist assessments and elective services, falling between 19-29 percent short of the respective targets.”
Gauld said the Government has moved to bolstering the private sector through long-term contracting for publicly-funded elective procedures, such as ophthalmology and orthopedics, which “essentially tilts the balance away from the public health system”.
It’s a concern shared by Dr Katie Ben, who is worried there is an agenda at play to “privatise the health system”.
Public Futures Aotearoa, a coalition of healthcare worker unions including the ASMS, this week said 80 percent of the increase in public health funding over the past three years has gone to the private sector.
In its election coverage, the New Zealand Medical Journal has listed major problems in the health system. These include “difficulty accessing general practice, workforce shortages, pressure on emergency departments (EDs) and elective services, an ageing population, rising costs of medicines and technology, persistent inequities and hospital infrastructure requiring substantial investment”.
A system under pressure. Photo by Marie McInerney, October 2026
Policy differences
The New Zealand Medical Journal also preaches caution on political promises.
“Making a service free does not make it accessible without a workforce; more screening requires diagnostic and treatment capacity; new buildings require clinicians, nurses and operating funding; and targets without adequate resources may simply document failure more accurately,” it says.
The journal has contrasted “materially different approaches” to health from the main parties.
The National Party “emphasises continuity, targets, capacity, medicines and workforce”, it said. Among other promises, it has pledged to divert 10 percent of funding from foreign aid, excluding its Pacific aid allocation, to fund more medicines and expand cancer screening.
Labour, the NZMJ says, is focused on primary care affordability, promising free prescriptions and that every New Zealander will get three free doctor’s visits a year through a new Medicard, “paid for by a simple, targeted tax on profit from the sale of investment property”.
“Whether they’ve got the GPs that can provide those appointments is another matter,” commented Ben.
Standing out on health among the smaller parties is the centrist Opportunity, headed by businesswoman Qiulae Wong, which is proposing a cross-party, 10-year health plan, Healthy People.
It would lift health funding from 7.4 percent to nine percent of GDP, focus on primary, community and preventative care, and introduce tougher lobbying and political donation rules “for industries that profit from illness”.
Its call for longer-term policy-making echoes concerns shared by many health organisations and professionals, such as Christchurch radiation oncologist Dr Feng-Yi Soh, that the nation’s three year political cycle creates a damaging short-term policy outlook.
Soh told Croakey the next New Zealand Government needs to provide proper funding to attract, train and retain medical specialists in radiology and radiation oncology.
But he said these critical investments “take many years to bear fruit” and require a focus also on prevention and early intervention of common cancers.
Soh hopes that New Zealand will follow Australia’s lead on rolling out a national lung cancer screening program, but is disappointed the Luxon Government scrapped the previous Labour commitment to make the country tobacco-free by 2030. Labour has pledged to reinstate this commitment if it wins the election.
Soh is also worried about the “whittling down” of policies and structures aimed at improving equity of access and outcomes for the Māori and Pasifika communities.
“Some of these policies have also borne fruit over the years. To dismantle systems and structures in the name of ‘homogenising’ care will probably undo a lot of those benefits,” he said.
Tobacco control on the election agenda. Sign nearby a hospital in Christchurch. Photo by Marie McInerney
Climate matters
The 2026 Oceania Report of the MJA–Lancet Countdown on Health and Climate Change, released this week, also sounds some dire warnings for New Zealand, including a doubling of heatwave days per year over the past ten years.
It’s part of a backdrop of warming that’s pushed the country into “uncharted territory”, according to the recent Our Atmosphere and Climate 2026 report that shows New Zealand has warmed by 1.36°C since record keeping began in 1909, with seven of the ten warmest years within the decade since 2016.
The Public Health Communication Centre, an independent organisation hosted by the Department of Public Health at the University of Otago, says the past three years have seen “unprecedented attacks on environmental policy”, including the Government’s approach to energy and climate.
“This election the major choice facing voters is either more of the same, with subsidies and fast track approvals that virtually guarantee continued climate chaos on the right, or a return to well-meaning but mostly insufficiently ambitious energy and climate policies on the left,” it said in its election overview.
Climate is also top of the agenda for the New Zealand College of Public Health Medicine which has called on all parties to put prevention, equity and long-term wellbeing at the centre of their policies.
“Aotearoa New Zealand cannot treat its way out of preventable illness,” it said in a statement, also calling on parties to stop health harm from the commercial determinants of health.
Other health issues raised with Croakey include the views of influential NZ First leader Winston Peters, who has said he hopes the country’s 2022 ban on gay conversion therapy is revisited and has also shared anti-abortion misinformation.
New Zealand’s High Court this month ruled that Luxon Government regulations banning new prescriptions of puberty blockers for young people with gender dysphoria were unlawful; however, many health observers expect an appeal of it is re-elected.
These are also important concerns given amendments proposed to the Health Practitioners Competence Assurance Act 2003 which underpins the regulation of New Zealand’s health workforce.
Under the proposed changes, the Health Minister would be able to direct the regulators of each health profession to give effect to Government health policy, raising concerns from health leaders about the potential for interference, for example, on vaccination or abortion regulation if a Minister was so inclined.
https://www.theguardian.com/world/2026/oct/26/lula-wins-brazil-election
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