Regulators Removing Health Workforce Cultural Safety Risks Clinical Safety

Te Tiratū Iwi Māori Partnership Board is calling on health regulators to immediately reject any proposal to remove cultural requirements from the regulation of healthcare professionals, saying such a move would be “irresponsible, inequitable, and dangerous.”

It is responding to the current Ministry of Health online survey Putting Patients First: Modernising health workforce regulation that closes just before midnight. One of the survey questions tests whether regulators should focus on factors beyond clinical safety — such as mandating cultural requirements.

Te Tiratū, which represents 114,000 whānau Māori of the Tainui waka rohe, has submitted a formal response opposing the proposal to remove cultural requirements from regulation.

The submission, Response to Proposal to Remove Cultural Requirements from Regulation was prepared by Board member Dr Mataroria Lyndon (MBChB, MPH, PhD), a Senior Lecturer in Medical Education at the University of Auckland, where he trains health professionals in cultural safety.

Dr Lyndon emphasises that cultural safety is not an optional extra — “You cannot have clinically safe care without culturally safe care. Cultural safety is not a parallel concern to clinical standards; it is foundational to them,” he said.

“Removing cultural requirements from regulation can compromise quality of care, deepen inequities, and breach our rights as tangata whenua under Te Tiriti o Waitangi.

“When patients don’t feel culturally safe, they may not share pertinent health information, and as a result diagnosis, treatment, and trust can all suffer. Cultural safety isn’t just about respecting cultural values — it’s about improving health outcomes, clinical quality, and patient wellbeing.”

Te Tiratū fully backs this position. Without cultural safety, patients may not feel comfortable disclosing vital information or engaging with treatment plans — all of which undermines clinical outcomes.

Cultural safety empowers patients — not providers — to define what ‘safety’ means in their care. Without it, patients, especially Māori and other marginalised communities such as takatāpui (LGBTQI+) and tāngata whaikaha (disabled) whānau, face disengagement, reduced access to services, and poorer health outcomes.

The Council for Medical Colleges’ Cultural Safety Training Plan, developed in partnership with Te ORA (Te Ohu Rata o Aotearoa Māori Medical Practitioners), outlines how cultural safety must be embedded across training, clinical practice, governance, and at a systems level.

Its principles are widely recognised by national health bodies, including the Australian Medical Council and Royal Australasian College of Physicians, which link cultural safety directly to clinical and patient safety.

“Culturally unsafe care is unsafe clinical care,” said Dr Lyndon. “To remove these requirements would not only wind back decades of progress toward health equity — it would expose our communities to poorer quality care.”

Research shows that cultural safety is an important pathway to health equity, supporting respectful and accountable engagement between practitioners and communities.

It enables clinicians to work more effectively with Māori whānau by recognising and countering bias, racism, and harmful stereotypes — all of which contribute to more positive patient experiences in the health system.

In September 2024, as part of its legislated functions under the Pae Ora (Healthy Futures) Act 2022, Te Tiratū delivered its Priorities Report to the government, which emphasised the importance of culturally responsive care. [1]

In a separate Community Health Plan also handed to the Deputy Chief Executive of Te Manawa Taki region and senior officials, Te Tiratū reinforced the need for high-quality, community-led, culturally safe healthcare across the Te Tiratū rohe. [2]

Even the government’s own Te Pae Tata Interim New Zealand Health Plan reaffirms the importance of cultural safety training for the Te Whatu Ora workforce. [3]

“These are not new ideas — they are community-driven imperatives and government-endorsed priorities,” said Dr Lyndon. “Contemplating removing cultural requirements from professional regulation flies in the face of both.”

“It’s about ensuring our patients, whānau, and communities are seen, heard, and treated with dignity. Cultural safety is a critical lever to transform the system and structures that continue to disadvantage Māori who on average die between seven and nine years earlier than the general population.”

He points to the recommendations in the groundbreaking 2019 Hauora Report from the WAI 2575 Health Services and Outcomes Kaupapa Inquiry, which affirms the Crown’s binding obligation to ensure Māori have access to culturally appropriate healthcare.

“We are urging all regulators to uphold their obligations to Māori under Te Tiriti o Waitangi and to Aotearoa’s wider commitment to equitable, patient-centred care.”

“This is not the time to retreat — it’s time to double down on cultural safety, for the benefit of all.”

[1] Pg23 https://tetiratu.co.nz/wp-content/uploads/2024/10/Te-Tiratu_Hauora-Maori-Priorities-Summary-Report_FINAL.pdf

[2] Pg 6,8,11 https://tetiratu.co.nz/wp-content/uploads/2025/02/Te-Tiratu-IMPB_Community-Health-Plan_FINAL-updated.pdf

[3] Pg15 https://www.tewhatuora.govt.nz/publications/te-pae-tata-interim-new-zealand-health-plan-2022

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