National Public Health Service national director Dr Nick Chamberlain told other health officials he was "ethically and morally" challenged by the Government's proposal to scrap smokefree laws. Photo / Michael Cunningham
One of the country’s top health officials told colleagues he was “demoralised” by the Government’s repeal of smokefree laws and appears to have considered quitting over the issue.
Correspondence released under the Official Information Act shows that some health officials expressed frustration and disbelief after the coalition agreement between National, Act and NZ First was released on November 24.
On November 26, national director of the Public Health Service (NPHS) Dr Nick Chamberlain raised his concerns with other doctors within his department and Health New Zealand Te Whatu Ora.
“Please keep this in confidence... I’m sure we have all been challenged ethically and morally by the notion, firstly that our Government will repeal the Smokefree legislation, and even more so that this will help fund tax cuts,” he said in an email.
“I’m sure anyone working in public health will feel pretty demoralised by this, but I’m aware that we signed an oath which is why I’ve copied in our other doctors who may well be feeling a lot like I am right now.”
Chamberlain went on to say he was considering his future in the role.
“I have discussed with a few senior people as to what my next moves should be personally/professionally, but I am hoping to have a chance to discuss this with our new minister (who is also still a practising doctor) in the next day or two.”
Chamberlain remains in the same role at Health New Zealand.
Health Minister Shane Reti was asked at an event in Auckland today whether he discussed the matter with Chamberlain - who he knows well, the pair are both from Northland – and whether he talked him out of resigning.
“No and no,” Reti said.
Asked about the outrage expressed by health officials over scrapping the legislation, Reti said: “There was a decision made collectively by Cabinet and we were pleased and continue to be pleased with the reduction from 8.6% to 6.8% in smoking and I’m sure that [Associate Health Minister Casey Costello] will lead us... successfully”.
Chamberlain declined an interview request but said in a statement: “I regret how this played out. As a public servant, I remain committed, as I have been throughout my careers, to working to achieve better health outcomes for all New Zealanders.”
The previous Labour Government’s smokefree reforms would have restricted the number of retailers allowed to sell cigarettes, banned those born after 2008 from buying them and cut the amount of nicotine allowed in tobacco.
Chamberlain asked colleagues to provide him with evidence of the benefits of the legislation, in particular how many lives it would have saved.
“One could reasonably assume that if that were the benefit, the opposite would be true if the legislation was repealed,” he wrote.
“I have also heard that we have been widely congratulated for this legislation overseas and any info on that would be appreciated as I’m sure repealing this legislation would irrevocably tarnish that reputation.”
He also said the issue would be important for many politicians and asked whether it was possible any repeal legislation would be put to a conscience vote.
Conscience votes allow MPs to vote according to their personal beliefs, rather than along party lines, and have previously been used for law changes on liquor licensing and gambling.
This did not happen when the smokefree legislation was repealed in February – it was passed under urgency and MPs voted with their parties.
Other health officials also expressed their disappointment.
In response to Chamberlain’s email, chief public health clinical officer Dr Maria Poynter said: “Yep pretty challenging”.
“Yes, pretty difficult to explain this to the kids,” said NPHS national director of intelligence Dr Julia Rumball-Smith.
Rumball-Smith went on to say that there was strong evidence for the previous Government’s smokefree changes and suggested that health agencies teamed up in response to the issue.
“We should definitely connect up with the PHA [Public Health Agency] on this. It’s a real opportunity for us to have a single voice, and also for us to practice working together.”
Chamberlain later told officials that he “obviously” could not “say nothing” on the smokefree repeals and that it was “very difficult to show leadership” if he stayed silent.
The documents show officials scrambling to provide advice on the smokefree changes to the new Associate Health Minister Casey Costello before a deadline in mid-December, including evidence of the economic benefits of keeping the law unchanged.
Chamberlain proposed an alternative plan which kept the ban on people born after 2008 from purchasing cigarettes – known as the “smokefree generation”.
“I still believe we shouldn’t be putting up any alternative to the smokefree generation,” Chamberlain said, noting in another email that there was “absolutely no rational or irrational argument why we wouldn’t implement it”.
Chamberlain also wanted the alternative plan to include broader public health measures including a sugar tax, ban on junk food advertising to children and banning alcohol sponsorship within sports - but other health officials advised against this.
Ministry of Health director-general of health Dr Diana Sarfati later noted the backlash the Government was receiving from health professionals over its smokefree proposals.
“The Government is certainly under considerable pressure on this issue,” she said in early December.
The Government has outlined its own smokefree policies, including a ban on disposable vaping products, harsher penalties for sales to under-18s, and reforming regulations of vaping, smokeless tobacco and oral nicotine products.
Labour Party health spokeswoman Dr Ayesha Verrall said the correspondence showed the level of stress that health officials felt having to implement a policy which could harm New Zealanders’ health.
It also highlighted how health leaders felt the need to convey the breadth of opposition within the health sector to the policy changes, she said.
Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics and social issues.