New Zealand Associate Minister of Health David Seymour on Tuesday delivered a letter of expectation directing the government agency responsible for funding pharmaceuticals, Pharmac, to cease considerations of the country’s founding constitutional document the Treaty of Waitangi/te Tiriti o Waitangi.

In the letter, Minister Seymour stated that he did not believe embedding the principles of the Treaty was an “appropriate expectation” for Pharmac and instead said the agency should focus on “robust data and evidence” in the pursuit of improving health outcomes. Later, at a press conference on the letter’s publication, the Minister claimed Pharmac had “burnt a lot of energy trying to fulfil this commitment to embed the Treaty in everything that they do.”

Letters of expectation allow ministers to outline annually the government’s priorities to statutory entities. For Pharmac, a government-funded agency that maintains a degree of separation from executive decision-makers, the letter constitutes a strong directive from the minister to cease work on considering how to implement the Treaty and achieve equitable health outcomes for Māori, the country’s indigenous people.

Minister Seymour’s instructions contradict advice in the previous 2023/2024 Letter of Expectation, requesting Pharmac explore ways to contribute to “embedding Te Tiriti o Waitangi across the health sector.” In last year’s letter, Pharmac’s role in assisting the health sector to discharge its obligations under the Treaty was also stressed. The Treaty of Waitangi/te Tiriti o Waitangi is New Zealand’s foundational constitutional document, signed by Māori and the British Crown in 1840.

The agency’s founding statute, the Pae Ora (Healthy Futures) Act 2022, also imparts a raft of obligations on health entities, including Pharmac, to give effect to the principles of te Tiriti o Waitangi, such as partnership and active protection, by following health sector principles that include improving outcomes for Māori. 

Addressing inequities of Māori and Pasifika in New Zealand’s health system received widespread public attention after the release of an independent review of the agency published in June 2022. Key findings of the report included Pharmac’s flawed decision-making processes and lack of te Tiriti o Waitangi-based partnership with Māori.

In response to these comments, the opposition party Te Pāti Māori (the Māori party) called for Minister Seymour’s resignation, citing his concession that there is no proof that consideration of the Treaty has led to worse health outcomes.

Ensuring patient involvement in the development, approval and funding of pharmaceuticals was also a focus of the letter and was welcomed by the advocacy group Patient Voice Aotearoa as a sign that a new “era is beginning” for communication between the government and patients.