The Northland doctors said they were seeking “a direct doctor-to-doctor response” from Health Minister Shane Reti.
Photo: RNZ / Angus Dreaver

Northland emergency doctors say they feel they have been fobbed off after a letter to the health minister highlighting their concerns about plans to repeal smokefree legislation was passed on to an associate minister instead.

The group of 18 emergency medicine specialists penned the open letter to Health Minister Shane Reti, who is also the MP for Whangārei and a former GP, earlier this month.

In it they describe the burden of tobacco-related diseases on emergency departments, and say “the government was not voted in on a promise to bring back lung cancer”.

However, a brief response sent to the group said the issues raised fall into the portfolio of Associate Minister Casey Costello, so the letter had been transferred to her office for consideration.

Northland emergency doctor Gary Payinda.
Photo: Supplied

Gary Payinda, one of emergency doctors who signed the letter, said he was shocked and disappointed.

“We wanted to talk as doctors to a fellow doctor, and instead we got kind of a form letter saying, please talk to my associate. So he’s handed this off to one of his fellow politicians, which is ironic for a health minister not to be wanting to deal with such an important health issue … We sought a direct doctor-to-doctor response, and instead we got, ‘Speak to my underling’, and that that doesn’t sit well with us,” Dr Payinda said.

“We expected a lot more. And it’s even worse, when Shane is a Northland doctor, a Māori doctor, and the health minister.”

Dr Reti’s office, however, rejected claims the doctors had been “fobbed off”, and said the health minister had fronted the topic many times during the past three weeks.

“The delegation has formally passed to Minister Costello so it is correct for queries or correspondence to have been referred to her office … Minister Reti absolutely reinforces the coalition government’s commitment to drive down smoking rates,” a spokesperson said.

The website of the Department of the Prime Minister and Cabinet show Costello’s delegations within the health portfolio are the Smokefree Environments and Regulated Products Act 1990, vaping, smokeless tobacco, and oral nicotine.

Matt Doocey (National) and David Seymour (ACT) are also associate health ministers but have no delegations listed as yet.

Costello is a New Zealand First list MP.

Dr Payinda said healthcare workers were “blindsided” when the coalition government announced its intention to repeal the smokefree environments law.

“This isn’t something that National campaigned on. You would never campaign, ‘We’re going to do a move that supports big tobacco and increases cancer rates in New Zealand’.”

A group of 18 Northland emergency medicine specialists penned the open letter to Health Minister Shane Reti, who is also the MP for Whangārei and a former GP, earlier this month.
Photo: RNZ / Nate McKinnon

Dr Payinda said researchers outside New Zealand had praised the smokefree law, saying it would save the country around $5.2 billion in direct health care costs and increase productivity because fewer people would develop smoking-related illnesses.

“Repealing the smokefree law is going to lead to more emphysema, more lung cancer and other cancer deaths. And all that disease and illness and death costs the system enormously. It’s just incredibly short-sighted to try to sell more cigarettes now so you can raise more tax money and get tax cuts through – without acknowledging the costs in suffering and sickness and death and lost productivity are going to be enormous in the future. It just doesn’t make sense, financially or morally,” he said.

Eugene Fayerberg, another Northland emergency doctor, was bitterly disappointed by what he described as the health minister’s “punting” of the group’s concerns to an associate.

He was still hoping the emergency doctors and Dr Reti would be able to meet face-to-face.

The Northland emergency doctors’ open letter:

Kia ora Dr. Shane Reti,

We, a group of Northland emergency doctors, implore you to keep Smokefree Environments and Regulated Products Amendment Act. This world-leading legal reform that bans smoking is an incredible public health feat and should be celebrated, not repealed.

The government, however, seeks to prioritize short-term tax revenue over long term public health. As a fellow physician, you surely must know the costs of such short-sightedness. As emergency medicine consultants, these are costs that we see and bear everyday.

Each shift we are confronted with the direct and indirect health impacts of tobacco use. From chronic obstructive pulmonary disease (COPD)/emphysema, cancer diagnoses, high blood pressure, heart attack, to stroke, the burden that tobacco use has on our emergency departments is incalculable.

We have had enough of delivering bad news about someone’s new diagnosis of lung cancer. We have had enough of resuscitating ruptured aortic aneurysms. It is not the role of the government to reimpose these burdens onto us as physicians or onto the public as victims.

This government was not voted in on a promise to bring back lung cancer. Let’s instead maintain Aotearoa’s status as a world leader in public health. Keep the Smokefree Environments and Regulated Products Amendments Act.