Aotearoa National Committee in representing members: advocacy overview 

In 2025, our advocacy in Aotearoa New Zealand (AoNZ) remained focused on patient safety, workforce sustainability, and ensuring equitable access to quality surgical care. By championing the needs of Māori, Pacific peoples, and rural communities, we continue to uphold RACS’ social contract with both the profession and the wider public.

Our advocacy program, delivered through the AoNZ National Committee, Māori Health Advisory Group, and AoNZ Trauma sub-committee,  is built on collaboration.

In 2025 we:
• made 30 formal submissions to ministers, regulators, government agencies, and Parliament, with nine proactive contributions on issues of concern to our profession 
• provided strategic briefings to the new Minister of Health, new Director General of Health, and new Chief Executive of Te Whatu Ora
• held regular consultation with Te Whatu Ora – Health New Zealand (Te Whatu Ora), the Medical Council of New Zealand (MCNZ), the Accident Compensation Corporation (ACC), Southern Cross Healthcare
• developed collective policy statements and initiatives with the 17 other medical colleges in Aotearoa as members of Te Kaunihera o Ngā Kāreti Rata o Aotearoa – Council of Medical Colleges New Zealand (CMC). 

Advocacy wins for 2025 

A primary focus in 2025 was the government’s priority of clearing elective surgery backlogs. RACS played a pivotal role by establishing the Principles for Outsourcing Planned Surgery Waiting Lists. We successfully advocated for surgical training to be embedded in these private-sector contracts, ensuring registrars maintain access to the case mix necessary for their development. 

We also celebrated wins for the surgical workforce, including:
• Growing the surgical workforce and securing futures: Following years of RACS’ advocacy, Te Whatu Ora adopted a national policy for advance offers of employment. This allows doctors to commit to specialist Fellowship training with the certainty of a role in Aotearoa on completion.
• Recognising diverse practice: our input on Te Whatu Ora Conflict of Interest (COI) policies led to the recognition of the value of private practice and voluntary roles, moving away from the restrictive ‘secondary employment’ terminology.
• Streamlining training: we successfully implemented direct billing for training fees between RACS and Te Whatu Ora, removing a significant financial hurdle for our Trainees.

We remain proactive in the legislative space. Our submissions on amendments to the Health Practitioners Competence Assurance Act 2003 and the Healthy Futures (Pae Ora) Act 2023 opposed measures that undermine cultural safety or restrain the professional advocacy of doctors.

Following the government’s decision to regulate physician associates, we worked with MCNZ on the regulatory framework. We advocated for a narrow scope of practice and tight supervision. We also proposed a strong emphasis on cultural safety and hauora Māori, acknowledging that all physician associates initially practising in Aotearoa will have trained overseas.

Our preference is the title clinician assistants. 

Advocacy priorities for 2026 

Workforce planning
One of the significant issues for surgeons in Aotearoa in 2026 is achieving a sustainable, culturally safe, future-ready surgical workforce that delivers equitable access and outcomes for our diverse communities. We need:
• increased funding for medical schools and training placements within the public and private hospital systems. 
• a training system with agreed volumes to meet the needs of all surgical specialties to ensure consistent services across all regions including rural hospitals. 
• a workforce that reflects the communities it serves, especially those with high proportions of Māori and Pacific peoples.

A critical element will be to plan, allocate, and fund supervision nationally to address the critical shortage of supervisors, which constrains student learning and career opportunities. We will strengthen our support for International Medical Graduates (IMGs) providing mentoring, cultural safety training, and support for settling into the health system. In all of this, we will work with the specialty societies, CMC, Te Whatu Ora, and the Workforce Planning Group at Manatū Hauora. This work will closely align with the College’s broader Surgical Pathways Strategy over the next couple of years, which will bring better coherence across the whole of surgical education.

Outsourcing
With Te Whatu Ora now having long term contracts in place to outsource surgery to the private facilities, RACS will continue to focus on ensuring registrars maintain access to the case mix necessary for their development. A priority during 2026 will be advocacy for increased investment in the public hospital system, in terms of theatre capacity, information technology, and additional funding for both consultant and trainee positions. 

Moving forward, RACS will continue to be a strong, evidence based advocate for patients and  surgeons in Aotearoa New Zealand. Through principled engagement with government and sector partners, we will champion patient safety, equitable outcomes for Māori,  high quality training, and a sustainable surgical workforce grounded in cultural competence and cultural safety. Our advocacy will remain focused on ensuring the health system supports surgeons to deliver the best possible outcomes for all communities, now and into the future.