by Concerned
- The short answer most New Zealanders never hear
Ask most people who controls nursing in New Zealand and they’ll say something like: “the hospitals”, “the DHBs”, “the Ministry of Health”, or “Parliament”. In practice, however, the real power over a nurse’s livelihood increasingly sits elsewhere: with unelected regulatory bodies and the Health Practitioners Disciplinary Tribunal (HPDT).
This power is no longer limited to clinical practice. It now reaches into what nurses say in their own time, on their own social media, about contested public issues. A nurse can provide safe and competent care — with no complaints from patients — and still find herself facing disciplinary action because someone objects to her lawful opinions online.
That quiet shift, from regulating practice to regulating speech, is at the heart of the current crisis.
- What nursing regulation was originally meant to do—
Professional regulation in health was never meant to be an instrument of ideological control. Its purpose was narrow and specific:
- Protect patients from unsafe or incompetent care
- Remove genuinely dangerous practitioners from practice
- Maintain minimum standards of competence and ethics
- Traditionally, serious discipline followed things like:
–Repeated medication errors that put patients at risk
–Neglect or abuse of vulnerable patients
–Practising while intoxicated or severely impaired
–Serious breaches of confidentiality or exploitation
In that model, there was always a clear link between what a nurse had done and a concrete risk of harm to patients.
It was about protecting people at the bedside — not monitoring what nurses thought, wrote, or believed outside work.
- The quiet drift from harm to “reputational risk”
Over recent years, that sharp focus on patient safety has blurred. Regulatory documents and decisions increasingly rely on vague concepts like:
- “Maintaining public confidence”
- “Upholding the reputation of the profession”
- “Reflecting community expectations”
Those phrases sound harmless. In practice, they are elastic enough to stretch around almost anything.
Instead of asking:
> “Is this nurse’s clinical practice unsafe?”
regulators increasingly ask:
> “Might someone be offended, upset, or embarrassed by what this nurse has publicly said?”
This drift is most obvious in cases where:
- There are no patient complaints
- There is no allegation of unsafe care
- The only evidence is a practitioner’s social media posts or comments on public issues
A disciplinary system designed to address negligence and abuse is now being used to respond to tweets, Facebook posts, and lawful online commentary.
- The role of the HPDT: from safety backstop to speech enforcer
The Health Practitioners Disciplinary Tribunal was set up as the final safety backstop in the system. Its powers are considerable. It can:
- Suspend or cancel a nurse’s registration
- Impose conditions on practice
- Issue fines
- Order the practitioner to pay substantial legal costs
These powers make sense when patients are in clear danger. They are far harder to justify when the only “misconduct” is that a nurse has:
- Criticised a policy
- Expressed a strong moral view
- Disagreed with an official narrative
- Shared an article or meme that others dislike
Yet that is exactly the direction some modern cases have taken.
In the case of Catherine (“Cath”) Simpson, publicly described by the Free Speech Union, the complaint did not originate from a harmed patient. A member of the public saw her personal posts on X (Twitter) on topics such as covid-19, abortion, gender identity and politics, and complained. The Nursing Council then reportedly went through her account to “bulk up” the case, using her posts to construct an allegation of professional misconduct — even though her comments were made in her own time and did not involve identified patients.
Whether one agrees with her views is not the point. The issue is that disciplinary machinery intended for clinical danger is being deployed over lawful speech.
- Professionalism does not equal obedience
One of the most troubling confusions in these cases is the idea that “professionalism”
means never expressing controversial opinions.
Being a professional does not mean:
- Having no moral views
- Having no political opinions
- Agreeing with every decision of the government
- Remaining silent in all public debate
True professionalism means:
- Providing safe, competent, fair care to all patients
- Separating personal belief from clinical duty
- Treating patients respectfully, regardless of disagreement
A nurse can be personally conservative or progressive, religious or secular, critical of Treaty policy or strongly in support of it — and still treat every patient with care, dignity, and equality.
When regulatory bodies start treating disagreement as if it were clinical danger, they are not enforcing professionalism. They are enforcing conformity.
- How free speech cases are spreading across professions
Nursing is not alone in this. New Zealand has already seen a pattern of professional free-speech cases:
A teacher, writing under the alias Maria van den Berg, faced Teaching Council scrutiny after posts on social media about the Treaty Principles Bill and education policy. Her case has been discussed in multiple public forums, including reports on Chris Lynch Media and commentary by the Free Speech Union.
During and after the Covid-19 period, doctors such as Dr Sam Bailey, Dr Alana Ratna, and Dr Matt Shelton became focal points of disciplinary and media pressure over their public commentary on pandemic policy, risk, and official messaging. Whatever one thinks of their views, the pattern is the same: professional regulators stepping into the realm of public debate and lawful speech.
Across these sectors, the complaints often do not come from patients harmed in surgery, childbirth, or a consultation. They come from people who see something online and object to the opinion.
At that point, regulation stops being about protecting the vulnerable and starts being about managing what professionals are allowed to say in public.
- The chilling effect: what happens inside a profession under speech control
These high-profile cases send a very simple message to everyone watching:
> “If you speak up in ways that challenge the dominant narrative, you may be investigated. You may be dragged through a stressful, expensive process. You may lose your career.”
The rational response for many nurses is:
- Say nothing
- Avoid commenting on anything controversial
- Stay away from political or policy debate
- Keep your head down, even when you see obvious problems
That kind of climate benefits bureaucracies because it avoids embarrassment. It does not benefit patients, who lose the protection of frank, experienced voices willing to question unsafe systems or bad policy.
A profession in which everyone is afraid to speak is easier to control — but less able to protect the public.
- A centrist concern: this is bigger than “left vs right”
It is tempting to frame these debates purely in ideological terms. Some will defend regulators as keeping “misinformation” in check. Others will attack them as “woke” or “authoritarian”.
But at heart, this is not a left-wing or right-wing issue. It is a centrist, constitutional issue:
How much power should unelected regulators have over private speech?
How far can they go before they undermine democratic rights?
Where should Parliament draw the line between legitimate discipline and censorship?
New Zealand’s Bill of Rights Act affirms that everyone has the right to freedom of expression. That includes nurses, teachers, doctors and other professionals. If those rights can be effectively overridden by tribunals using vague concepts like “reputation”, then the practical meaning of the Bill of Rights collapses for whole classes of citizens.
- International signals: Canada as a warning and example
New Zealand is not the first country to face this issue. In Canada, high-profile disciplinary and speech cases — including the much-discussed proceedings against psychologist Jordan Peterson — have triggered a wider debate about professional gag rules.
One Canadian province has now taken steps to curb the ability of professional regulators to discipline lawful speech made in a practitioner’s private capacity. The underlying principle is clear:
- Regulation is for unsafe practice
- Courts and public debate are for contested ideas
New Zealand has reached a point where similar safeguards are needed.
A simple, centrist law-reform principle would be:
> A professional regulatory body may not initiate or continue disciplinary action solely on the basis of lawful speech expressed by a practitioner in a private capacity, unless there is clear and demonstrable evidence that this speech has caused, or is likely to cause, specific harm to patients or clients.
Such a safeguard would still allow regulators to act where a practitioner:
- Discloses confidential information
- Directly targets a patient with abuse or harassment
- Incites real-world harm
But it would prevent regulators from punishing practitioners simply for expressing unpopular or dissenting views on public issues.
- Who really controls nurses now — and why it matters
So, who really controls nurses in New Zealand today?
On paper, Parliament sets the law. Employers manage workplaces. Patients choose their providers.
In practice, however, the power to:
- End a career
- Destroy a reputation
- Impose unpayable costs
increasingly lies with regulatory bodies and the HPDT, operating with very broad discretion.
When that power was tied closely to clinical safety, most people accepted it as necessary. As it drifts into the realm of personal speech, the picture changes completely.
We are no longer just regulating how nurses give injections or administer medications. We are effectively regulating:
- What nurses are allowed to think aloud
- Which views they dare to express
- Whether they feel able to participate honestly in public debate as citizens
- That is not just a nursing issue. It is a free-speech issue and a democratic issue.
A centrist, balanced position is simple:
Yes, protect patients from genuinely unsafe practitioners.
Yes, enforce high standards of clinical care and ethics.
But no, do not turn disciplinary systems into tools for policing lawful opinion.
If we fail to draw that line, we may keep the surface appearance of order. But underneath, we will have created a professional culture of fear — and a society where some of the most informed voices are the least free to speak.
That should concern all of us, regardless of where we sit politically.
REFERENCES / FURTHER READING
Nursing – speech-based disciplinary case
Catherine (“Cath”) Simpson – Nursing Council / HPDT context (publicly reported case involving lawful public speech):
https://www.facebook.com/share/1GjfJUzGwD/
Teaching Council – free speech case (teacher using alias “Maria van den Berg”)
Chris Lynch Media – “Free speech row erupts over teacher’s Facebook post on Treaty
bill”:
https://www.chrislynchmedia.com/news-items/free-speech-row-erupts-over-teachers-
facebook-post-on-treaty-bill/
Free Speech Union – “Response to complaint regarding teacher’s Facebook comments”:
https://www.fsu.nz/blog/response-to-complaint-regarding-teachers-facebook-comments
COVID-era professional speech cases (medical practitioners)
Dr Sam Bailey:
https://www.facebook.com/share/p/17RbgDfMAD/
Dr Alana Ratna:
https://www.facebook.com/share/p/1BRW22NaTR/
Dr Matt Shelton:
https://www.facebook.com/share/p/1Cj1ffVU8D/
Additional video / commentary:
https://www.facebook.com/share/v/1CmUgr6ngB/
https://www.facebook.com/share/v/16PRrhfhZ8/
International precedent – Canadian reform
Canadian province moves to curb professional gag rules after Jordan Peterson case:
https://centrist.nz/canadian-province-moves-to-curb-professional-gag-rules-after-jordan-peterson-case/