‘We’re not finding spaces to have an intelligent and ongoing conversation about how we want our health system to be.’

At 9.15am this morning, the minister of health, Hon Simeon Brown, will address the Association of Salaried Medical Specialists’ annual conference at Te Papa. Or at least so it says on the published programme. A few days ago, the union for senior doctors and dentists received word that he would not after all be there, with no reason offered, reported The Post. 

A spokesperson for Brown told the paper: “He looks forward to continuing to engage with the union on a regular basis, as he always has done.”

The minister’s office had offered to instead send a pre-recorded welcome from the minister but “we’ve declined”, said Sarah Dalton, executive director of the Association of Salaried Medical Specialists (ASMS). “We don’t need a videotaped message,” she told The Spinoff in an episode of the podcast At Large with Toby Manhire.

Dalton said: “We don’t take it for granted, but we do have an expectation, and our members really appreciate that ability to engage directly with the minister of the day.” 

The decision to miss the conference, which the union says is the first non-appearance by a health minister since 2007, follows a tense encounter in 2026, which took place as the ASMS was involved in industrial action over a pay dispute. Then, Brown suggested doctors had “crossed an ethical line”. 

Asked if that hostility might be what was keeping him away this time around, Dalton said: “I think it was hostile because he said that our members had been unethical by taking industrial action in support of their claims for improved pay and conditions. Our members are used to hard conversations. They’re really happy to have a debate. But I think it was not a welcome characterisation of our public health, medical, and dental workforce to say they were unethical.”

If Brown had been present this week, what would senior doctors have had to say to him? “We have called this year’s conference Hitting the targets and missing the point,” said Dalton. “I think that is very much the flavour of the conversation our members would like to have with him. We have been very clear with him, as a union and a number of our individual members, that a slavish adherence to those limited health targets means that whole swathes of healthcare are missed, are not accounted for, not invested in.”

She added: “We’ve also said, look… we’re not mad for targets, but if that’s what works for you, how about some workforce targets to go alongside what you have set in place? Because this is all sticks and no carrots, and how are we supposed to make a positive difference to access to care when you’re actually spending time stripping staffing and resource out of our health system and throwing targets on top?”

Brown rejects suggestions he has led a contraction of staffing. After reports emerged of a Health NZ hiring clampdown, the minister insisted he had not approved the policy drafted by officials, and has encouraged acceleration of recruitment. He has meanwhile hailed facilities including the new Outpatients Building at Dunedin Hospital and plans or a new medical school at Waikato University. 

A series of headlines have detailed overcrowded emergency departments and inundated ambulance services in recent weeks, with pressure exacerbated by seasonal flu. The scenes described – many of which Brown acknowledges are “not good enough for patients or for staff” – had “just become part of the norm”, said Dalton. 

“I think what is so frustrating for our members is that none of this is news. None of this is new… We used to talk about winter surge, but for many of our emergency departments it is entirely normal to be at or above 100% occupancy most of the year. So this is all predictable… We know we get a flu uptick every year. This should not be a surprise.”

She said: “So if the minister came to conference, he would say we’re spending more than anyone else ever has on healthcare. We disagree, so there may be a dollar amount that is more, but when you look at it in terms of population growth, acute presentations, which are growing at a greater rate than population growth, all those kinds of comparative measures of what the overall investment in in health is, it doesn’t add up. But we’re not finding spaces, whether it’s with the government, with Health New Zealand, or with the ministry to try and have an intelligent and ongoing conversation about how we want our health system to be and [what] we need to make it run.”

The message Dalton drew from his absence was, “I’m not interested in being accountable to you,” she said. “I’m more interested in being the campaign manager for the National Party. We’re getting towards election time. I’m going to spend that hour doing different things. Which is a shame.”

Health was placed second in the list of voter priorities cited in the latest Ipsos Issues Monitor. It showed up as “significantly more important for women, so will be a key issue to address for political parties seeking to secure the votes of women this election”, according to Carin Hercock of Ipsos.