OPINION PIECE: Repealing the Health Charter:
Cutting 'red tape' or the lifeline of our health system?

It has long been recognised that the health of a nation is only as strong as its healthcare workforce. We’ve seen this reality play out more vividly than ever during the pandemic. Recognising this, as part of the health system reset, the Pae Ora (Healthy Futures) Act introduced a requirement for a New Zealand Health Charter that set out shared expectations for how the health workforce should be treated at work.

Developed as a framework for transformation, this long-overdue Charter Te Mauri o Rongo was endorsed in 2023 by then-Minister of Health Dr Ayesha Verrall. Its purpose was to support and promote safe workplace cultures across the entire health sector, signalling to workers that their contributions were valued.

Walking back the Health Charter requirements

Valuing our health workers shouldn’t be controversial, even in today’s highly charged political climate. So, imagine our surprise, when Minister Brown recently announced a raft of unilateral changes to Pae Ora – including repealing the Health Charter – with no warning or consultation. In what seems to be a familiar pattern for this government, the decision was revealed in a weekend announcement, kicking off a series of policy shifts designed to reduce access to crucial worker protections like sick leave and personal grievance processes, alongside health and safety reforms that narrow employer focus to only the ‘most critical’ of risks.

Packaged under the guise of “reducing the red tape” and “making things clearer for everyone”, this repeal feels particularly disingenuous given the requirements of the Charter were hardly burdensome. Beyond asking organisations and workers to uphold its principles, there was only a minimal requirement for Health New Zealand to report on its progress once every five years. That’s less frequently than the Olympics are held. Ironically, this rather bureaucratic move by the government sends a very clear message: they see health workers as nothing more than replaceable cogs in a machine.

The Charter as a foundation for a healthy workplace

The Charter set out four pou (pillars) designed to shape positive workplace behaviours. Psychological safety was a cornerstone, allowing staff to feel safe speaking up about patient safety concerns or their own wellbeing, without fear of reprisal. Ongoing training and leadership development was another. Why wouldn’t we want our health workforce to be as skilled and competent as possible? This can only lead to better quality care and more fulfilling health careers.

Crucially, the Charter was also introduced to tackle the kinds of destructive workplace behaviours that have plagued the health sector for too long. Bullying, harassment, and discrimination take a huge toll on staff wellbeing and morale, driving our skilled professionals overseas or out of the sector entirely. While New Zealand struggles to compete in a global labour market that offers more attractive pay and working conditions, the Charter represented the absolute minimum we could do to ensure our health workers felt valued and supported.

People have a fundamental right to be treated with dignity and respect at work, within a safe and healthy work environment. This is what the Charter boiled down to. It is not a complex message that requires “clarification”. It is a universal human right, enshrined in international labour law. Patients have their rights codified in the Code of Health and Disability Services Consumers’ Rights. Our health workers had the Charter. All that repealing this Charter “clarifies” is that workers’ own wellbeing is simply not a government priority.

Investing in our people

While announcements about long-overdue infrastructure upgrades and a focus on improving health targets are welcome, hospitals and health programs are simply buildings and policies without a dedicated workforce to bring them to life. Investing in bricks, medications, and regulation alone will not meaningfully “put patients first”. Investing in our most valuable asset – our health workforce – will. As the World Health Organization Director-General has rightly stated: “no country, hospital or clinic can keep its patients safe unless it keeps its health workers safe.”

Admittedly, the scale of change envisioned by the Health Charter could never occur overnight. It required time and commitment – something Health New Zealand and the unions had already begun to jointly progress. To repeal the Charter now is a short-sighted move that would dismantle years of effort, waste resources, undermine workplace safety, and ultimately threaten the very foundation of our health system: our people.

When will our government realise that a healthy workforce isn’t “red tape” but the very pulse of a healthy nation?

ENDS

For further information please contact:

Dr Deborah Powell
APEX National Secretary
Email: ask@apex.org.nz