The nation’s drug-buying agency, Pharmac, is being told by the Government to halt consideration of the Treaty of Waitangi and make efforts to improve public trust in the organisation.

Those are some of the key directives from Pharmac Minister David Seymour in his letter of expectations to Pharmac chairwoman Paula Bennett, which is being discussed at an event in Wellington today attended by Pharmac representatives, patient advocacy groups and others from the health sector.

In Seymour’s letter is an expectation Pharmac includes patient groups in decision-making processes to ensure patients, carers and families have adequate input.

“Patient advocates welcome working alongside the Government and Pharmac to usher in a new era where our drug-procurement agency can be vastly improved for the benefit of patients,” Patient Voice Aotearoa chairman Malcolm Mulholland says.

“The letter of expectations signals that era is beginning.”

The Government’s desire to strip back the application of The Treaty of Waitangi has extended to Pharmac, with Seymour referencing a previous letter of expectations in which Pharmac was informed it should consider how it could contribute to “embedding Te Tiriti o Waitangi across the health sector”.

“I do not believe this is an appropriate expectation to place on Pharmac,” Seymour said in his letter.

“Pharmac’s role should focus on delivering improved health outcomes underpinned by robust data and evidence, in accordance with its statutory responsibilities. This should serve all New Zealanders based on actual need, without assigning their background as a proxy of need.”

Seymour also indicated a view Pharmac was struggling to maintain public trust and build positive relationships with stakeholders.

His letter asked Bennett to ensure stakeholders understood “how Pharmac operates, that its legitimacy, credibility and trust is enhanced, and that all feedback and ideas are dealt with respectfully and valued”.

He added Pharmac should report to him regularly about how it was improving organisational culture and stakeholder settlement.

That was in addition to further reporting Seymour was requesting of Pharmac, such as publishing board meeting minutes and agendas in a timely manner, publicly reporting on technology applications and assessment periods, and drafting a new Statement of Performance Expectations for 2024/25.

Patient Voice Aotearoa chairman Malcolm Mulholland welcomed some of the expectations in the minister's letter. Photo / Mike Scott

Also mentioned in the letter was Seymour’s long-held view that Pharmac should assess medicines and technologies that could save money by lessening the burden on the public health system.

He noted how the agency was currently directed to secure the best health outcomes for people “within the funding provided”, which didn’t take into account the financial benefit funding some medicines could have.

“The Government is therefore proposing to reform Pharmac’s funding model to account for positive fiscal impacts on the Crown of funding more medical technologies and I will be seeking to work with Pharmac and the Ministry of Health on progressing this element of the Government’s agenda,” Seymour said.

Mulholland commended that aspect of Seymour’s letter, saying “cost containment” had become the sole focus for Pharmac instead of health outcomes.

“This has been the major concern of patient advocates since the inception of Pharmac 31 years ago.”

Adam Pearse is a political reporter in the NZ Herald Press Gallery team, based at Parliament. He has worked for NZME since 2018, covering sport and health for the Northern Advocate in Whangārei before moving to the Herald in Auckland, covering Covid-19 and crime.