Let the muppets out

The present Minister of Health, Mr Simeon Brown expressed concern that public health officials were spending time on health advocacy when they should be responding to the concerns of the minister and ministry officials. This opinion was supported by the then Acting Prime Minister David Seymour, who hit back at concerns about Mr Brown’s comments, saying he’s “cheering on Simeon [Brown] putting those muppets back in their box.”¹ Mr Seymour’s comments show a lack of respect that borders on bullying for the medical profession as well as inferring that the opinion of the “muppets” was not valued.

Who are these muppets? We believe he was referring to public health physicians, who are considered by many in the medical profession to be the intelligentsia of medicine. As a group they spend much of their time teaching and advising the government and the community on how to avoid illness and thereby reduce healthcare costs.

Criticism of this section of the medical community is important, especially coming from highly ranked government officials. Their comments may be seen as a direct attack on the free speech and open discussion we value as a profession. It also suggests that political leaders do not value or respect public health doctors working in Health New Zealand – Te Whatu Ora. This would, however, be in direct contrast to the earlier views expressed by Mr Seymour in his statement Strengthening Free Speech in Universities, released on 19 December 2024. Here he stated, “That’s why the National/ACT coalition agreement committed to introduce protections for academic freedom and freedom of speech to ensure universities perform their role as the critic and conscience of society.”² Though he was talking about university staff at that time, his point appears to support open discussions about issues.

These restrictions on freedom of speech are not confined to New Zealand—similar but more severe restrictions are being propagated in the United States of America (USA). The Trump administration has launched an all-out attack on the health and medical research community in the post-COVID space. The USA Government’s retreat from international health partnerships, combined with substantial budget reductions, poses real threats to USA and global health security.

The use of certain terms is banned on USA government websites (and in manuscripts submitted to scientific journals), including “gender”, “transgender”, “LGBT” and “non-binary”, and a directive has paused the submission of new work for publication for all Centre for Disease Control (CDC) employees and contractors. These measures have been reported to have an effect on medical journal processes outside of the USA, with journals such as the Lancet reporting that the impact has already been felt, with reviewers declining and authors self-censoring.³ This politicisation of science has resulted in some researchers’ ability to work being limited or stopped altogether and is being interpreted that “free speech” is restricted.

Freedom of speech and expression, especially discussion about public issues such as health, is important in any democracy. A democracy depends upon a literate, knowledgeable population who access information that allows them to participate fully in the public life of society. This includes criticising unwise or tyrannical government officials or policies. Citizens and elected representatives should recognise that democracy depends upon the widest possible access to ideas, data and opinions. The right to freedom of expression is enshrined in the New Zealand Bill of Rights Act 1990, which states “Everyone has the right to freedom of expression, including the freedom to seek, receive and impart information and opinions of any kind in any form.”⁴ Perhaps government ministers should ponder the bill of rights before taking up their posts.

Those who work for the government as employees of Health New Zealand – Te Whatu Ora also have this enshrined in their employment contract:⁵

Section 40: Public Debate and Dialogue

40.1 In recognition of the rights and interests of the public in the health service, the employer respects and recognises the right of its employees to comment publicly and engage in public debate on matters relevant to their professional expertise and experience.

40.2 In exercising this provision employees shall, prior to entering into such public debate and dialogue, where this is relevant to the employer, have advised and/or discussed the issues to be raised with the employer.

Those who work in the university system within the health sector or in joint clinical contacts have similar rights. The University of Otago statement⁶ is the clearest and—we suspect—speaking out is actually an obligation.

University of Otago Statement on Free Speech

Free speech is the lifeblood of a university. It enables the exploration of ideas, the challenging of assumptions, and the uncovering of truth through open exchange. It allows students, teachers and researchers to know better the variety of beliefs, theories and opinions in the world. Only through a preparedness to challenge, question, and criticise ideas can progress in understanding take place. Consistent with its motto Sapere Aude, ‘dare to be wise’ and the ikoa Māori Ōtākou Whakaihu Waka, the University of Otago is committed to the fearless pursuit of knowledge driven by māhirahira (curiosity) and bounded by pono (integrity). That commitment requires a wide range of views to be freely presented, discussed and debated.

The University affirms that it will not restrict debate or deliberation simply because the ideas put forth are thought by some to be offensive, unwise, immoral, or wrong-headed. It is for the members of the University community – its students and staff – to make those judgments for themselves. The University is not a place for safety from ideas – it is a place to engage in critical thought and debate in the pursuit of knowledge and understanding. Our students will not be prepared for a complex and challenging world unless they have experience negotiating conflict and disagreement.

The University therefore guarantees all members of its community, including invited visitors, the right to advance ideas in the spirit of free and open enquiry. Furthermore, in its role as critic and conscience of society, the University provides a space in which contrary and unpopular positions can be advanced free from political interference or suppression.

This commitment to free speech does not mean that any utterance is appropriate in a university setting. The University may properly restrict expression which violates the law. Moreover, the University accepts no duty to provide a space for those who are not members of its community to advance their ideas or theories in ways which fundamentally undermine the University’s character as an institute of higher learning. The University may also reasonably regulate the time, place, and manner of expression to ensure that it does not disrupt the ordinary activities of the University.

The University’s support for free speech carries with it corollary responsibilities. Although students, staff, and visitors are free to criticise, contest, and condemn the views expressed on campus, they should not obstruct, disrupt, or otherwise interfere with the freedom of others to express those views.

The University challenges members of its community and invited visitors to be tolerant of the diversity of identities and beliefs of others. We encourage debate in good faith guided by the principles of manaakitaka (care and respect for others).

This statement was ratified on 9 July 2024, to reiterate the University’s solemn and long-standing responsibility not only to promote lively and fearless freedom of debate and deliberation, but also to protect that freedom when others attempt to restrict it. Portions of the statement were adapted from the University of Chicago’s Report of the Committee on Freedom of Expression (January 2015) and the Model Code advanced as part of the Independent Review into Freedom of Speech in Australian Higher Education Providers (April 2019), the University of Oxford’s Statement on Free Speech (August 2016), and the University of Cambridge’s Statement on Free Speech (December 2020).

While The University of Auckland statement⁷ is difficult to find and appears to be in draft form on their website, we suspect it will end up expressing similar ideas.

Restrictions on debate and discussion of health issues and advocacy should be called out for the damage they cause. It does leave one wondering, however, who the real muppets are.