Since the National-led coalition government formed in 2023, nursing has been targeted as a problem by both Health New Zealand and the Minister of Health. Nurses have been blamed for Health New Zealand overspend (Daalder, 2024); subjected to hiring freezes (O’Dwyer, 2026) and criticised for striking for safe staffing (Palmer, 2025). New graduate nurses have not been appointed into positions or at best have been offered reduced FTE (Adams, 2025; Longmore, 2026a) and thousands of nurses have moved to Australia (Butler, 2025). Despite nurses raising their concerns with the Minister of Health about risks to patient safety, missed cares and increasing adverse events (Jull & Carryer, 2026), just this past week it has been revealed that Health New Zealand’s nursing workforce has increased by only 54 FTE nurses between 2024 and 2026 (Smith, 2026). Nurses from the emergency department of North Shore Hospital have declared a ‘state of emergency’, where unsafe staffing is putting patients, nurses and their community at risk (New Zealand Nurses Organisation, 2026). While these examples could possibly be argued away by the tough fiscal environment, there is an ideological intent more deeply eroding the autonomy of the nursing profession that is of great concern for the safety of the public and future of health services in Aotearoa.
In March 2025, the Ministry of Health released a consultation document, “Putting patients first: Modernising health workforce regulation,” with the intention of informing the review of the Health Practitioners Competence Assurance (HPCA) Act 2003. The overarching narrative of the consultation document - that health professionals do not put patients first; health regulators are shaping workforces in ways which can lead to worse outcomes for patients; and ministerial oversight is necessary - alarmed medical and nursing professional groups. Some mergers of regulatory bodies were signalled. Furthermore, the document upheld the coalition government’s policy direction, including removing the requirements to enact Te Tiriti o Waitangi and diminishing the value of cultural safety. The failure to acknowledge cultural safety as central to patient safety and health outcomes is deeply concerning for nursing and the wider health sector.
Ultimately, the consultation signalled the increased governmental control of health professionals’ regulation and therefore practice: “By giving the Government more general direction or the ability to set expectations of regulators, we could ensure that regulation works for patients and the health sector, rather than against them” (p. 12, Ministry of Health, 2025). Despite widespread criticism of the consultation together with the majority of submissions not supporting increased ministerial control, the Minister of Health, Simeon Brown, proceeded to introduce the HPCA Amendment Bill on 18 May 2026.
There are several major points of concern for health professionals’ autonomy and independence in the HPCA Amendment Bill 2026. Section 126 provides for the Minister of Health to directly intervene with regulatory matters, including creating or combining scopes of practice, streamlining registration processes (such as for specific scopes or for overseas trained professionals) (Table 1). Sections 105B to 105O will establish a new committee, chaired by lawyers with members appointed by the Minister, with the authority to overturn regulatory board or disciplinary decisions. Amendments to Section 118 results in a reduced focus on cultural competency by removing the specific reference to “including competencies that will enable effective and respectful interaction with Māori”. No longer will nurses be in control of our profession.
Just as there is no clear evidence of a problem that needs solving, there is no identification of what problems the proposed radical revision aims to address. It is difficult not to see this as a further example of ideologically based tinkering from a coalition government intent on exerting its power and control and dogmatically refusing to value the knowledge and experience of health professionals. Sadly, the HPCA Amendment Bill is yet another energy sapping distraction whilst the real and significant problems that put patient’s lives at risk every day are ignored.
This Bill is still in its first reading, and we are concerned that the Government will again abuse due process by pushing it through under urgency before Parliament rises in September. Meanwhile, Minister Brown has already taken various steps moving towards the intent of the proposed amendments. In June 2026, Minister Brown removed the chair and deputy chair of the Medical Council from their positions due to ideological differences on cultural safety (Naish et al., 2026). For the Nursing Council of New Zealand (the Nursing Council) changes began in September 2025, when Brown appointed Sharon Brownie to the Board. Since that time several board members have resigned with others not being reappointed. There are now nine ministerial appointees to a board of 12 members with Brownie becoming chair in April 2026. Tragically for nursing, after years of work to create a board with diverse membership (including six Māori board members), just two board members have remained in their position for 12 months and there is now only one Māori representative (Longmore & Maxwell, 2026).
Then in August 2026, four senior executive members of the Nursing Council suddenly resigned within a week of each other - Catherine Byrne, Chief Executive and Registrar; Annette Huntington, Chief Nursing Education Advisor; Clare Prendergast and Nick Davis, senior legal advisors and deputy registrars. The resignations have been seen by many as resulting from unprecedented ministerial interference, with Kerri Nuku (New Zealand Nurses Organisation [NZNO] kaiwhakahaere) blaming Minister Brown for exerting his own political ideology and failing to advocate for nursing and patient safety (Longmore, 2026b). On 25 August 2026, Brownie (Board Chair) announced the appointment of Interim Chief Executive, Chelydra Percy, with expertise in organizational change and mergers. Within the sector many scenarios and explanations are circulating. It is impossible to know with certainty the truth behind recent events and thus nursing is rendered silent and powerless. History will tell us that this is a dangerous state of affairs.
The nursing profession has a long history of advocating for social justice and promoting health equity (Rudner, 2021). Nursing in Aotearoa New Zealand has internationally led the way in its commitment to cultural safety and equity through nursing education standards and regulation, building on the earlier work of Dr Irihapeti Ramsden in the late 1980s and early 1990s (Ramsden, 1993, 2000). The medical profession has followed suit, strongly positioning cultural safety as a necessary component of patient safety and achievement of health equity together with the imperative of addressing Indigenous health (Curtis et al., 2025). Curtis et al. argue that “addressing health inequities requires a structural critique of power and privilege, which requires anti-racist and structural interventions, above and beyond solutions arising from Indigenous knowledge alone” (p. 8). This is perhaps at the heart of the coalition governments’ ideological opposition to Te Tiriti o Waitangi, equity, Indigenous rights, and cultural safety; their fear of a deep critique of the societal and health systems in Aotearoa.
Over the past five years, the Nursing Council has achieved significant milestones to ensure that nursing delivers healthcare that meets contemporary health needs and uphold public safety. This has included a revision of registered and enrolled nurse competencies and standards using a pou-based framework and the launch of the Te Tiriti o Waitangi, Māori health, kawa whakaruruhau, cultural safety guidance (Nursing Council of New Zealand, 2025a, 2025b). Authentic consultation and enactment of Te Tiriti obligations have been at the forefront of the Nursing Council’s work and much applauded by the profession. It is devastating that ministerial interference now puts at risk professional practice and education standards that not only promote public safety but are likely to inform nursing internationally.
Multiple senior nurse leaders across Health New Zealand’s central and local structures, the Ministry of Health, and others are conspicuously quiet due to institutional silencing. Their leadership voice is needed on issues relating to the severe impacts of current governmental policy on safe staffing, hiring freezes, healthcare access and equity. Extant governmental ideology is persistently failing to value nursing knowledge and nurses’ longstanding commitment and contributions to health and wellbeing. Such unprecedented interference poses great risks to the erosion of professional nursing autonomy. It is for this reason we raise our voices as academics with the freedom to speak.