The Aotearoa New Zealand National Committee and the Wellington office deliver a range of advocacy activity on behalf of surgeons working in the Aotearoa New Zealand health system.

We do this against a background of significant changes in government policy and in the health system. The government is trying to make the boat go faster with too few health professionals, including surgeons, significant funding gaps, and the need for greater investment in infrastructure. In the first quarter of 2025, we saw a new Minister of Health, a new Acting (now permanent) Chief Executive of Te Whatu Ora – Health NZ, and a new Director General of Health (who is also Chief Executive of Manatū Hauora – Ministry of Health).

When the three leaders were appointed, RACS provided written briefings setting out the current issues facing surgical services and the role of RACS in the healthcare system. We said RACS shared the minister’s intention to facilitate effective decisions and advance concrete action to implement health reform. However, we also asked for better communication and collaboration. We offered to make available to government the wealth of clinical expertise and system intelligence within RACS.

We advised the biggest priorities needing action by government with support from RACS are:

1. Health reforms – stabilisation and funding
2. Workforce – supply, training, and retention
3. Needs-based equitable healthcare – access, service delivery, and outcomes
4. Maintenance of and improvements to existing health infrastructure
5. Planned care – meeting targets to reduce waiting lists. 

In March, the Minister of Health announced his five key health priorities: 
1. Focusing Health New Zealand on delivering the basics and achieving targets.
2. Fixing primary healthcare to ensure New Zealanders have timely access to a doctor.
3. Reducing emergency department wait times so that 95 per cent of people are admitted, discharged, or transferred within six hours.
4. Clearing the elective surgery backlog by partnering with the private sector to deliver more planned surgery.
5. Investing in health infrastructure, both physical and digital, so we are building for the future.

This was followed a month later with the Minister releasing the first New Zealand Health Infrastructure Plan detailing more than $20 billion investments in physical infrastructure required over the next 10 years, and the Health New Zealand National Asset Management Strategy. We are waiting for more details.

On 7 July 2025 the Minister announced creation of a new Board for Te Whatu Ora Health New Zealand to take over from Commissioner Professor Lester Levy, who was appointed in 2024. 
• Professor Levy will be Chair of the new Board for 12 months to ensure continuity of leadership.
• Dr Andrew Connolly FRACS will be Deputy Chair of the Board. He is an experienced surgeon and clinical director who has held numerous appointments across governments, including Chair of  Te Kaunihera Rata o Medical Council, Crown Monitor, and Commissioner on District Health Boards.
• Hamiora Bowkett was appointed as Crown Observer to support and monitor the Board, advising the minister directly, focused on the financial position and delivery of health targets.
• Dr Margaret Wilsher was appointed as Chair of a new Ministerial Health Infrastructure Committee to oversee the delivery of critical health projects.

We are meeting regularly with Te Whatu Ora, and with the Minister of Health on 14 August 2025.

Outsourcing planned (elective) surgery waiting lists in Aotearoa New Zealand
In February 2025 RACS Council approved the Position Statement: Principles for outsourcing public sector waiting lists in the Aotearoa New Zealand health system. The first sentence made it clear RACS does not support outsourcing to the private sector, preferring the government invests in the public health system. Dr Ros Pochin, AoNZ National Committee Chair, has advised our position in meetings with Manatū Hauora – Ministry of Health, Te Whatu Ora – Health New Zealand, and with frequent radio and online coverage. She has advocated consistently for the government to invest in the capacity of the public hospital system to deliver these surgeries.

The Position Statement was prepared in anticipation of the Minister of Health requiring a significant increase in the level of outsourcing. This was confirmed when the minister announced on 7 March 2025:
• his five health priorities including “clearing the elective surgery backlog by partnering with the private sector to deliver more planned surgery”
• an Elective Funding Boost of $25m for an additional 10,579 elective procedures by the end of June 2025. 

As the outsourcing program proceeds at pace, we are speaking regularly with Te Whatu Ora, Southern Cross Healthcare (the largest private healthcare network in Aotearoa New Zealand), the NZ Private Surgical Hospitals Association, and the Accident Compensation Commission. We have also sent our position statement to the Chief Medical Officers in both public and private hospitals. We now see much of our content reflected in discussions and documents being developed within the health sector. The focus of discussions has shifted to ensuring arrangements are in place for surgical Trainees to receive the case mix and experience they need during surgeries outsourced to private facilities. We have also been vocal on ensuring continuity of care for patients who move between the private and public systems. 

The Minister of Health advised Te Whatu Ora on 23 May 2025 of his expectation they move ‘towards longer term agreements (circa 10 years) to improve the cost effectiveness of delivery from the private sector and to provide clear investment signals.’

The minister then announced on 1 June 2025:
• under the initial Elective Funding Boost 12,764 procedures had been achieved 
• statements of work had been issued to 60 private providers to deliver surgery at consistent national rates
• a further 21,000 elective procedures to be contracted over the next year
• reiterating his long-term goal is to treat 95 per cent of patients within four months by 2030.

We recognise most RACS members work across the public and private health systems, with training a significant component of the work of many surgeons. Whatever role members play, we would all like to see 95 per cent of patients treated within four months of referral as soon as possible, effective training arrangements in place as part of outsourcing to the private sector, and significant investment in the public sector surgical workforce and facilities.

RACS submissions oppose the Regulatory Standards Bill

The RACS Aotearoa New Zealand National Committee and Māori Health Advisory Group strongly opposed the Regulatory Standards Bill, warning it could undermine future government efforts to protect public health and Māori rights. They argued the Bill prioritises individual, corporate, and property rights at the expense of public health, climate action, and equity, potentially straining the healthcare system and hindering laws that support vulnerable populations. 

RACS also criticised the Bill’s failure to explicitly reference te Tiriti o Waitangi, a cornerstone of New Zealand’s constitutional framework, cautioning that this omission could weaken the Crown’s obligations to Māori. They called for substantial amendments to ensure the Bill respects te Tiriti, aligns with existing legislation, and promotes a fair, sustainable approach that safeguards the wellbeing of current and future generations.

Read full submission: RACS submissions oppose the Regulatory Standards Bill | RACS

Opposing speed limit reversals (Aotearoa New Zealand) 

The RACS Trauma Committees submitted strong opposition to proposed speed limit reversals on 16 Urban Connector sections of state highways in Aotearoa New Zealand, where these roads intersect with urban environments. 

As part of a broader program led by the Minister of Transport and NZTA to undo speed limit reductions introduced by the previous government, these specific roads were open to consultation under the Setting of Speed Limits 2024 Rule, which requires consideration of safety data and a Cost Benefit Disclosure Statement. 

On 13 May 2025, RACS submitted that reversing these speed limits would be unsafe, especially without adequate cost-benefit analysis, and urged that current limits remain beyond 1 July 2025. The submission, co-signed by the RACS President and Chair of the Bi-National Trauma Committee, highlighted the emotional toll of road trauma on whānau and communities, and its significant burden on the healthcare system, including emergency departments, trauma specialists, and surgical services.

Read submission: Increasing the speed limit to 110 km/h for two portions of State Highway 1 | RACS