A good submission to the Medical Council

Simon Brown has blogged his submission to the Medical Council:

Let me start by stating I support the Council’s goal of promoting culturally responsive care and addressing health disparities. New Zealand’s healthcare system must evolve to meet the needs of our diverse population, and I acknowledge the well-documented inequities in health outcomes for Maori, such as lower life expectancy (7–8 years below non-Maori), higher rates of preventable deaths, and unmet primary care needs (44% for Maori). These gaps are real and demand action.

My core concern with the drafts, however, is their tendency to conflate socioeconomic status (SES) with systemic racism as a primary causal explanation for these disparities. While the draft documents do not explicitly state “systemic racism” it is evident from the use of terms like “systemic bias,” “unfair systems,” “institutional structures,” “power imbalances,” and “colonial histories”. This attribution of systemic racism remains unproven on rigorous scientific grounds and risks embedding socially and scientifically contested interpretations into professional standards, potentially at the expense of more practical, evidence-based solutions focused on prevention, education, and individual responsibility.

So the goal is good, but the draft is bad.

However, the drafts’ mandatory requirements for medical doctors to “actively acknowledge and address your own power, privilege, biases” and “use your professional influence to work in partnership with Maori to identify and dismantle unfair systems and power imbalances” imply acceptance of “systemic racism” as a settled fact. This goes beyond encouraging respect and self-reflection; it mandates endorsement of a causal framework that conflates SES-driven problems with racism, without sufficient causal evidence.

The Medical Council is trying to impose a political view on all doctors, without evidence.

The Medical Council’s role is to ensure clinical competence and patient safety, not to enforce interpretive frameworks on causation. By conflating SES with racism, the drafts risk dividing the profession and distracting from holistic solutions. I urge the Council to refine these statements to prioritize evidence, prevention, and individual agency alongside equity. I believe this balanced approach is better suited and will better serve all New Zealanders.

Hopefully the Council listens.

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