Pharmac, Act and the Treaty of Waitangi

The acting prime minister has laid out his expectations for the drug buying agency.

Mōrena, and welcome to The Bulletin for Wednesday, July 17.

In today’s edition: The country’s future climate targets are at risk, has New Zealand abandoned its “independent foreign policy”, and inflation figures are due out this morning. But first, a look at the future direction of Pharmac.

A letter of expectation

Politicians like to routinely criticise Pharmac but are often apprehensive about getting too involved with it. The drug buying agency sits at arm’s length from government, as illustrated most recently with the saga over cancer drugs. In opposition, National had promised 13 named drugs would be funded. But after being elected, it realised that was opening a can of worms and instead opted to boost Pharmac and let it decide which medications it would make available. Yesterday, the acting prime minister (and the minister who just happens to be responsible for Pharmac) David Seymour came as close as an MP can to interfering with Pharmac’s own business. Ministers may have no control over what drugs Pharmac buys, but they can issue letters of expectation to guide the agency on how to act in a range of areas. 

What was directed?

The Herald’s Adam Pearce has the key details here, reporting that Pharmac has been instructed to stop consideration of the Treaty of Waitangi and make efforts to improve public trust in the organisation. We’ll get to the Treaty issue, which is unsurprisingly attracting the most media attention, below. But that’s not all the letter has outlined. Seymour also encouraged Pharmac to involve patient groups more in decision making, a move welcomed by Patient Voice Aotearoa. “Patient advocates welcome working alongside the government and Pharmac to usher in a new era where our drug procurement agency can be vastly improved for the benefit of patients. The letter of expectations signals that era is beginning,” the group’s chair Malcolm Mulholland said.

As noted by The Post’s Rachel Thomas, Seymour said that Pharmac should have “appropriate processes” for ensuring that people living with an illness, along with their carers and family, can participate in and provide input into decision-making processes around medicines.

Act’s views on Pharmac

Pharmac had never featured so prominently in an election campaign as it did in 2023, reported The Conversation. “Many parties are pledging more funding, but two are promising to overhaul the agency as we know it,” read the piece from October 2023. Those two parties? New Zealand First and Act. The former had promised a new medicines buying agency entirely. That’s unlikely to come to fruition but something similar was reportedly considered as the coalition decided how to fund those additional cancer medications.

Act’s proposal was dubbed the most “radical”, promising to overhaul regulatory approval processes and decision making. Being in coalition means Act’s hopes for Pharmac may be tempered somewhat, but Malcolm Mulholland, in his statement endorsing the letter of expectation, said it was clear that Seymour’s objective was “clearly to reform Pharmac”. 

The controversy over the treaty

The inclusion of the Treaty in Pharmac decision making only dates back a couple of years following a review of the agency ordered by the last government. That review, as RNZ’s Giles Dexter reported at the time, deemed that Pharmac was under-serving Māori, Pacific people and people with rare disorders. The agency was subsequently instructed to consider how it could help embed Te Tiriti o Waitangi across the health sector. Seymour, yesterday, said he believed that was inappropriate. “[Pharmac] should serve all New Zealanders based on actual need, without assigning their background as a proxy of need,” he said in his letter of expectation. It could prove controversial among some health professionals. Oncology professor Chris Jackson, on Twitter, said he agreed with Seymour that Pharmac’s focus on Te Tiriti had been performative – “just in the opposite direction to what he thinks”. And in an interview earlier today with RNZ’s Morning Report, former Māori Health Authority clinical lead Dr Rawiri McKree Jansen called the removal of the Treaty consideration “disappointing” and “playing to [Seymour’s] base.”

Seymour’s views are of little surprise given he’s also the architect of the government’s Treaty Principles Bill which would redefine the principles of Te Tiriti and unify it across legislation. According to Newsroom Pro’s Laura Walters (paywalled), we’re very close to seeing the draft of that proposed law – it will be released next week. National has promised to kill that bill after its first reading. Nevertheless, Seymour, by having his eyes across other portfolios, has managed to move on what he wants, or at least expects.

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NZ no longer on track for 2050 net zero emissions target

The country’s future climate targets are at risk, according to new figures out this morning. New Zealand is no longer on track for its 2050 net zero emissions target and is set to miss the third emissions budget in 2031 to 2035 as well. As the Herald’s Thomas Coughlan reports this morning, that’s a stark change from expectations under the former government, with projections published at the end of 2023 showing New Zealand hitting its first three emissions budgets. The projections were published alongside consultation opening on the draft Emissions Reduction Plan. Climate change minister Simon Watts said: “This draft Emissions Reduction Plan shows that with effective climate change policies we can both grow the economy and deliver our climate change commitments.” Writing for Newsroom Pro (paywalled), Marc Daalder said the latest projections showed New Zealand was “backsliding on climate policy at a time when the rest of the world is aiming to increase its ambition”.

Has Luxon abandoned NZ’s ‘independent foreign policy’?

Former political rivals Helen Clark and Don Brash have jointly criticised prime minister Christopher Luxon, claiming a new interview with international media show that he has “abandoned New Zealand’s independent foreign policy”. While in the United States, Luxon spoke to the Financial Times (paywalled, but republished by the Herald for premium subscribers) where he said he believed New Zealand could be “highly interoperable with Australia” and a “force multiplier for Australia and the US and other partners”. The joint statement from Clark and Brash, who have both been openly critical of the coalition’s drift towards Aukus, says that Luxon’s comments “orient New Zealand towards being a full-fledged military ally of the United States”.

Bed poverty: Meet the people working to give our tamariki a place to dream

Research shows 75 children a day are admitted to hospital for preventable conditions like pneumonia because of where and how they sleep.

For tamariki, a bed isn’t just a piece of furniture, it’s a place to dream and grow. But one in 10 kids in our poorest communities don’t have a bed of their own. Variety is working to give them a warm place to dream this winter. Get the full story, here. (sponsored)

Click and Collect

• Inflation figures are due out this morning – but what even is the Consumers Price Index?

• New documents show it could cost $100,000 for each teenager involved in the government’s “boot camp” programme.

• I recommend this interesting investigation from Stuff’s Nick Truebridge looking into a prominent National Party figure who reportedly once “duped” a couple out of $125,000.

• Newsroom has reported that a group set up to provide advice on a modern slavery law has been disbanded. Last year, The Spinoff’s Shanti Mathias looked at the calls for new anti-slavery legislation and where our political parties stood on the issue.

• Norm Hewitt died yesterday at the age of 55. Jamie Wall for RNZ pays tribute to the former All Black, writing that he was “a man from a violent era who realised just what years of alcohol abuse and toxic environments had done to him, and was determined to make a change”.

• Musical comedy act Tenacious D has cancelled all upcoming gigs, including in New Zealand, after band member Kyle Gass joked about the attempted assassination of Donald Trump onstage in Australia.

• This morning’s Media Insider column on the Herald has interesting insights into how the Trump attack boosted viewership for 1News.

Right now on The Spinoff

New Zealanders are in agreement about what causes crime, reports Lyric Waiwiri-Smith – but how to tackle it is a different question. Liam Rātana meets the most popular Māori on TikTok. Unity booksellers review their favourite children's books this winter. Auckland has earned a big city badge, writes Gabi Lardies: it stinks. Nick Iles considers the understated magic of Wellington restaurant Chan's Eatery. For The Cost of Being, a coffee-loving law student in a freezing Wellington flat examines her expenses.

That’s it for this morning, thanks for reading. I’ll see you back here tomorrow.

Let me know in the comments, or get in touch with me at thebulletin@thespinoff.co.nz, if you have any feedback on today’s issue or anything in the news.

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